A 13-employee orthopedic practice could be heading for bankruptcy


Andrew Bush, MD, of Central Carolina Orthopedic Associates in Sanford, North Carolina, hasn’t seen his practice profit since at least 2018, Kaiser Health News reported October 13. As an independent physician, he is one of many feeling the pressure of growing hospital systems buying up smaller practices and attracting surgeons.

Before the COVID-19 pandemic hit, Central Carolina Orthopedic Associates was seeing up to 1,000 patients a month, but now Dr. Bush fears going bankrupt.

The practice received $300,000 in federal COVID-19 assistance, but Dr. Bush suspended most in-person visits and had to cancel surgeries early in the pandemic. Although the money helped support its 13 employees, it did not cover losses from visits and canceled surgeries.

Dr. Bush said KHN he could not retire because the firm is in debt. Visits are only half of pre-pandemic levels as residents grapple with inflation and cannot afford the cost of a doctor’s visit.

The sale of the practice is on the table for Dr. Bush, but a preliminary offer from a hospital system has been rescinded.

Independent physician practice is not something Dr. Bush would recommend to young physicians.

“If I could go back 30 years, I wouldn’t be a doctor,” he said. KHN. “Looking back at life, it was the wrong choice.”

Safety risks and fatigue caused by COVID-19 played a role in the sale of some doctors to large health systems, but the distribution of pandemic aid was another major factor. According KHN, grants and loans were disproportionately sent to wealthy institutions that did not need the money as much as independent practices and rural hospitals. This has allowed some large chains to reap bigger profits and pursue mergers.


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