COLORADO SPRINGS, Colo. — In an industry that is increasingly consolidating, Vanguard Skin Specialists in Colorado Springs is a unique example of an independent practice that moving in the opposite direction.
"We believe that autonomy must be maintained in medical care," Dr. Vinh Chung, MD, a Mohs (skin cancer) surgeon, said.
Dr. Chung founded Vanguard as a solo practitioner 15 years ago and has grown the practice to include more than 20 medical providers at 8 local offices today.
"This upcoming year we're planning to add 5 to 6 more providers," Dr. Chung said.
Remaining independent is a choice, one that he believes best serves patients. That hasn't stopped larger companies from sharing their interest in buying the practice.
"On a daily basis we have invitations from private equity groups and other large organizations to purchase us, but we have resisted," Dr. Chung said.
Many doctors cannot resist those offers, a recent survey conducted by the American Medical Association suggests.
In 2012, roughly 60% of doctors surveyed owned their own practice. That number fell to 47% in 2022. Hospital groups, nonprofit foundations and private equity firms are the next three largest owners.
"There is tremendous pressure in all sorts of ways," Dr. Rocky Khosla, MD, said.
He opened Pueblo Sports and Family Medicine as a doctor-owned practice, but later partnered with St. Mary Corwin Hospital and Centura.
"At that point I was starting to look into doing more concussion management," Dr. Khosla recalled. "And they had more resources, marketing, developing booklets, getting into things that wouldn't have been as easy."
The partnership produced the concussion protocol used today by School District 60, School District 70, Colorado State University Pueblo and the Pueblo Bulls professional ice hockey team.
Dr. Khosla has since switched back to being an independent, a move he said would be harder for a young doctor coming out of residency to make.
"Where they do their residency is usually in the big hospital system," Dr. Khosla explained. "And the big hospital system usually then will approach these folks and say hey, how about you don't have to worry about finding a location, you don't have to worry about buying exam tables, exam rooms, tongue blades, the myriad of things you have to do. We'll just take care of those things for you."
Inflation, higher property values and higher interest rates have also elevated the costs facing doctors who wish to maintain an independent practice.
The AMA survey data shows, while physician owned practices have declined across all age groups, the drop is sharpest among younger doctors under age 45. This suggests younger doctors are not replacing older doctors in practice ownership as they retire.
Dr. Chung credits a strong company culture and a commitment to a long-term vision for Vanguard's success.
"When medical providers come to join us, we see it as a lifelong investment because we want to bring someone who embraces our culture and shares our mission and who will be with us for the next 10, 15, 20 years," he said.