San Francisco Marin Medical Society Blog

Small and solo medical practices remain essential to independent medicine



The membership of the San Francisco Marin Medical Society (SFMMS) is broad and diverse, including physician groups of all sizes and economic models, as well as academic, administrative, and government medical practices. The makeup of medicine in the two counties has changed over time, however. As consolidation of physician practices has accelerated throughout California, the proportion of our membership that represents small group practices (i.e. four or less physicians) has shrunk from about 20 percent in 2013 to about 10 percent in 2019.

The roots of modern medical practice can be traced back to the recommendations in the Flexner Report of 1910, which formed the basis of what we today understand as the social contract between the medical profession and the people it serves. Patients are entitled to competence, altruism, morality, integrity, accountability, transparency, objectivity, and promotion of the public good. To ensure the quality of care and patient choice, physicians are entitled to, among other things, the trust and autonomy to practice independently of economic or political interference. For these reasons, the small and solo medical practice remains essential to access to care for rural and underserved geographic areas and to patient choice. In today’s highly polarized political environment, the value of this autonomy cannot be overstated.

Independent physician practices are facing existential challenges. As the COVID-19 pandemic has reduced the ability of practices to sustain the patient volumes required to support their practices, we face a stark scenario: a medical landscape in San Francisco and Marin counties without small and solo physician practices. To prevent this outcome, SFMMS and the California Medical Association have produced local and state resources related to financial relief, access to personal protective equipment and reliable, quality testing, and resuming routine patient care, as well as transformational support to implement telemedicine.

SFMMS is in regular contact with officials from the San Francisco and Marin County Departments of Public Health with regards to protocols and guidance related to COVID-19. If you have specific questions not answered by existing guidance, please enter them using THIS FORM so that we can send it to our contacts at the Departments of Public Health.

SFMMS remains dedicated to raising the voices and serving the needs of all of its physicians. During this unprecedented time, we reaffirm the central importance of our small and solo independent physician practices to the practice of medicine in San Francisco and Marin counties, and commit to the continued inclusion of their voices on our Board, Committees, delegations, policy and practices.


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