March, 2013

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March, 2013

Read This Before You Give Up on Private Practice

Recent surveys reveal that the number of privately owned medical practices continues to shrink as established doctors sell their practices to hospitals and new doctors choose employment by hospital-owned practices or hospitals over private practice. Doctors cite economic pressures, healthcare reform and long hours as the main reasons for their decisions…

Nearly two-thirds of established physicians and half of physicians straight out of residency or fellowship are now being placed in hospital-owned practices, according to a recent physician placement report. But there are still many financial and personal reasons why you should not sell your practice.

The many joys of autonomy

Having your own practice means that you are the boss – the pilot of your own plane. You can choose your own work hours, apply your own mission statement or philosophy of patient care, devote as much time to patients as you want and avoid being stifled by a hospital’s or large medical group’s sometimes draconian policies.

You can design your practice the way you want it and create an environment in which you will be happy to work. You can choose your own staff and decide whom you want to interact with on a daily basis. You can even choose the types of cases and procedures you enjoy most – without kowtowing to hospital rules or large group practice quotas.

Maintaining your sense of self

Many doctors have told us that this is a big reason why they went into medicine. Most of the doctors we know are Renaissance men and women with a variety of personal interests and the ability to do many things well. Many are fascinated by the business side of running a practice, and they have the ability, skills and resources to succeed in business and medicine.

You can match your practice to your own personal values. For example, many of our doctors practice in strong church-going demographic areas, and they want to instill a certain amount of spiritualism, Christian or otherwise, into their practices. They want to attract patients with similar beliefs who will feel more comfortable with them. Some doctors even pray with their patients.

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Building your own legacy

When you build a healthcare practice, you develop trusting relationships with patients. Over time, that trust continues growing until it becomes bigger than just you. It includes your associates and staff in the practice as well as referring colleagues and the community at large.

A successful practice is also a successful business that can be sold or passed down to future generations. Many of the doctors we work with have sons or daughters who follow their footsteps into medicine. And there is much to be said for a young physician inheriting a successful medical practice and carrying on a family tradition of helping others.

Avoiding administrative bureaucracy and politics

Many doctors hate politics. Unfortunately, most hospitals and conglomerate-owned or hospital-owned practices are big businesses with the same reporting hierarchies, structure and office politics found in most big businesses.

You also have a loyal staff in your own practice. Some members of your staff may even be members of your family, as well. You pay their salaries and they work for you. Many doctors have reported that they have difficulty relating to and interacting with hospital staff. When the hospital pays staff salaries, they are loyal to the hospital, not you. And you cannot hire family members to help with your practice in a hospital.

Choosing your own patients

Your only real job security is your patients. If one mismatched patient leaves the practice, you can still attract many others who may be better-suited. But if there is a mismatch between you and your hospital or conglomerate group practice employer, you can easily find yourself unemployed.

You can attract and choose the patients, cases-types and procedures you want through savvy marketing and selective screening. In a hospital, you must take what they give you. In a large group practice, you will often get those patients and cases the other physicians don’t want, not necessarily what you want.

Serving the community at eye level

Your practice fills a need in the community. In many parts of America, there are still communities that are underserved by medicine. Some locations simply do not attract large enough numbers of physicians or big group practices. They need small, independent practices like yours to provide adequate healthcare. They need doctors they can trust to look them in the eye and tell them what’s wrong and how it can be fixed.

Managing your time and money

You don’t have to work around the clock. Most areas now have hospitalists who can make rounds for you and free up some of your time. You can also share after-hours call with other independent practitioners who are also seeking to optimize their time.

Your practice is in a position to generate a good income – as long as you know the ins and outs of running a business. You can generate income by attracting and retaining patients and by offering ancillary, cash-based services. Small and solo practices can grow their incomes by bringing in additional cash revenue from weight management, hormone balancing, allergy management, nutritional supplements, wellness and on-site pharmacy or lab services. Remember to check with your state board to make sure these ancillaries are allowed in your state. In New York, for example, it is illegal for a doctor to have an onsite pharmacy.

On the flip side of the financial coin, you can control or reduce your costs. Start with your payroll, because that’s where many doctors overspend by hiring too many staff. Once you have trimmed your payroll, you can cut your expenses, too. Avoid buying high-end décor. Share your overhead and supply costs with other practices to achieve lower rates.

Last but not least… making yourself happy

When it comes to your work, perhaps nothing is more important than your own personal satisfaction. Many physicians went into medicine to be in their own practice. That is what makes them happy. For them, it’s not about working for financial gain. It’s about working for their personal, day-to-day satisfaction and quality of life.
Bottom line: it’s about knowing yourself, respecting your personal limits and tolerance levels and appreciating what is most important to you. Before you give up on your private practice, think long and hard about what’s really at stake.

Your feedback is always welcome

If you have questions or comments about this newsletter, please email them to:

Or if you want more information about ways and solutions to stay in private practice (and improve), (855).898.2710 to talk to one of our program consultants or attend on of our Practice Success Workshops.

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