The Impact of Mandates on Medical Practices
Independent physician practices overwhelmingly support and advocate for accessible care for all. However, the growing accumulation of unfunded regulatory mandates are making it increasingly difficult for independent practices to survive, let alone thrive, in today’s healthcare market.
It seems that every day, a new mandate appears. And initially, as more mandates roll out, it is easy to think of them as one piece.
Accessible exam tables? Done.
Wheelchair scales? Done.
Transfer equipment? Done.
Staff training and documentation? Done and done.
But what happens as every federal agency adds just “one more” reasonable requirement? This is when independent practices begin to struggle. As our policymakers think along the lines of “just buy one more table,” the reality behind the scenes is more like:
- New exam table
- Installation
- Electrical modifications
- Larger exam room
- Staff training
- Policy revisions
- Annual competency documentation
- Preventive maintenance
- Equipment downtime
- Compliance tracking
- Legal review
- Opportunity cost
What starts out as a table that costs between $8,000 and $15,000 becomes so much more with the implementation that is required. Not to mention the workflow impact that happens because accessible equipment can change clinic flow.
Implementing a new accessibility standard is not simply purchasing compliant equipment. It requires evaluating clinic layouts, training dozens of employees, revising policies, budgeting for future replacements, coordinating vendor timelines, and ensuring ongoing competency. These activities occur while practices are simultaneously adapting to reimbursement pressures, workforce shortages, cybersecurity requirements, and numerous other federal and state regulations.
When the cost of implementing these accessibility mandates starts getting higher, many practices are faced with operational challenges that lead to fewer exam rooms, patient scheduling changes, longer appointment times, and more equipment maintenance. These challenges lead to more financial struggles on top of a high initial implementation fee and reduce the revenue that keeps independent practices operational.
While accessibility is important for all, every new mandate makes it harder for practices to stay independent. Ultimately, the patients that policymakers hope to protect lose access to care altogether as more practices sell to hospitals or merge with health systems, stop accepting certain payers, close clinics, or choose to retire early.
Independent practices are not asking for exemptions and do not want less accessibility for the patients that they care so deeply about. Independent practices are advocating for realistic implementation timelines, financial assistance/tax credits/grant funding, reasonable flexibility, and harmonization between agencies to prevent duplicative regulations.
Accessibility is not optional. Preserving access to healthcare and independent physician practices should not be optional either. Federal policymakers must recognize that every well-intentioned regulation carries real financial and operational consequences. If we want practices to remain independent, innovative, and accessible, we must pair new mandates with practical implementation support rather than assuming physicians can simply absorb another unfunded requirement.