The image of the house calling doctor, traveling around town with his bag and his stethoscope is fading into the past. More and more doctors leaving their single doctor practices and are joining clinics and hospital systems. And more and more young doctors, instead of starting a private practice are joining a system.

This happens for a variety of reasons. For example a new imaging device comes out. The doctor wants to use it, but doesn’t see enough patients of that type to make the huge capital expenditure worth it.  Whereas a group of doctors can predict that they will have enough demand to make the machine a good investment.

Another factor is young doctors coming out of medical school with debt decide to take a guaranteed salary to pay of their student loans instead of taking on all the risk of opening up their own practice.

This is a trend that has been accelerating for years, and was hurried on its way by Obamacare. An article in the the New York Times from 2010 stated:

“Traditionally, American medicine has been largely a cottage industry. Most doctors cared for patients in small, privately owned clinics — sometimes in rooms adjoining their homes.

But an increasing share of young physicians, burdened by medical school debts and seeking regular hours, are deciding against opening private practices. Instead, they are accepting salaries at hospitals and health systems. And a growing number of older doctors — facing rising costs and fearing they will not be able to recruit junior partners — are selling their practices and moving into salaried jobs, too.

As recently as 2005, more than two-thirds of medical practices were physician-owned — a share that had been relatively constant for many years, the Medical Group Management Association says. But within three years, that share dropped below 50 percent, and analysts say the slide has continued.”

What does this trend mean? For one thing, medical recruiting will continue to increase in importance. If more and more doctors are playing on teams, then you need to have the best team possible.

Ideally larger practices and health groups can provide better and more coordinated and continuous care.

Group practice and hospital based doctors already outnumber solo practitioners in the chart above. Solo physician practices are at 32% while Group and Hospital based are at 47%. This is only expected to grow in the next few years and as the health reform efforts accelerate.

Most of the experts say that whatever the effects of Obamacare are, physician shortages are sure to increase. This means that good doctors will have even more choices about where they want to work. If everyone needs doctors for their system, doctors will be recruited more and more and will be able to chose where and how they work.

As more and more people need doctors, and more and more companies and groups seek to find good ones, medical recruiting is sure to get more difficult and more important. When teams are forming, you want to be on a good team.