Will Astor’s article on “single-practice” physicians tells of the decline of solo doctors, how an increasing share of physicians have become employees of large health care systems. Independent hospitals also are in decline.
In 1990, there were 13 private, independent hospitals in Monroe County and the five counties that surround it. Ranging in size from the 772-bed Strong Memorial Hospital to a pair of 72-bed hospitals (Clifton Springs in Ontario County and Nicholas Noyes in Livingston County), licensed beds totaled 3,700.
Fast forward to 2017. Nearly all these local hospitals have become part of either Rochester Regional Health (1,700 beds) or the University of Rochester system (1,400 beds in the Rochester area, plus St. James in Hornell and Jones Memorial in Wellsville). And then there’s Finger Lakes Health, a small, two-hospital system that includes the 132- bed Geneva General in Ontario County plus Soldiers & Sailors Memorial in Penn Yan. Licensed beds have fallen to 3,200.
Jobs in health care are up, just not in hospitals. From 2000 to 2017, total health services employment grew about 15 percent, with most of the growth occurring since 2013. (Due to a change in sector definitions, a consistent comparison can be made only from 2000, although what data we have suggests that 1990 employment was about the same as 2000.)
Total payroll is up, too. After adjusting for inflation, payroll in the health sector rose one- fifth, increasing the sector’s share of the total metro payroll from 10 percent to 14 percent. By contrast, payroll in manufacturing, the region’s largest sector in 1990, fell by nearly half over the period (again, adjusted for inflation).
When UR Medicine’s hospitals are combined with the UR schools of medicine, dentistry and nursing, UR Medicine is the region’s largest employer. CGR’s periodic assessment of UR places the university in a three-way tie with New York University and Verizon as the state’s fifth-largest employer.