How To Navigate Private Practice In The Age Of Big Medicine

We are currently in the age of Big Medicine, a trend that started over the last decade. Hospitals and Medical Networks have bought out 13,000 private practices from 2015 -2018 alone. The physician’s dream of a solo private practice has been diminishing at an exponential rate.  This phenomenon is driven by multiple factors, including the rise in costs from malpractice insurance, payroll, rent, supplies, and technology. These rising costs are met with lower insurance payouts and higher regulations, all contributing to diminishing returns in private practice. The result is fewer private practices, younger physicians are more averse to the high risk, and an increasing number of seasoned physicians are joining larger organizations to avoid the crippling high costs.

Despite all of this, Private Medicine still has a strong draw and plenty of advantages. One of the biggest decisions for doctors who decide to move to private medicine, or who have been in private medicine and understand its challenges, is to start a solo practice or to join a group medical practice.  A solo practice grants the doctor autonomy and decision-making power but comes with high costs and high risk. A group practice, on the other hand, dilutes the risk, lowers costs, and increases buying power, the downside of joining the average group practice becomes the loss of control, and inability o set standards of care for your patients.

Group medical practices generally fall into two categories, single-specialty or multi-specialty. With a single-specialty practice, the practice, can create a very precise set of operating rules, to increase efficiency, and create a brandable experience.  This can be an extremely effective practice with the right leadership in place, dictating culture, and standards of care. In a single-specialty practice operating at peak efficiency and unison, the individual physician must accept the loss of autonomy and control, in order to succeed.

Multi-specialty practices are different as the physician or group with most control set the standards of care and practice protocols for the entirety of the practice, whether or not it benefits each individual practitioners’ specialty. Both single and multi-specialty practices share the same benefits, the ability for the group to leverage their shared resources allows for better insurance payouts, layers of management, and more purchasing power. 

Physicians who are contemplating private medicine, and our on the fence between solo medicine or group medicine, need to decide between profitability and autonomy. The other factors to consider, especially if the physician care about both profitability and degree of autonomy, are the operational benefits of the organizations they are to start or join.

Billing & Collections Department: Does the medical group have an internal or outsourced billing department? Outsourced billing is generally a red flag in a multi-specialty group, as the outsourced companies tend to lack efficiency, particularly with smaller claims. 

Staff & Training: Are the medical group’s staff well trained? Are they understaffed? Do they have layers of management and training standards and processes? As a physician, you are joining a group to inherit great people processes, eliminate the hassles and lost time staffing and training incurs and should be proud of the level of customer service and culture.

Branding & Marketing: The ability to leverage branding and marketing to increase client acquisition at a more efficient return on investment is paramount to the success of the team as a whole. A large consideration should be placed on the company’s attention to client acquisition for the practice and physicians as individuals.

Level of Autonomy: Every medical practice operates differently, if you are a physician who is in private medicine or is looking to move into private medicine, autonomy is most likely a key factor. Group practices that allow each physician to have a vote in the operations, and standards of care, generally have a higher-level physician satisfaction.

Heart and Health Medical of Long Island is a great example of a multi-specialty medical group that provides its physician partners all of the benefits of group medicine yet the highest level of autonomy. The phrase “a practice within a practice” rings true as each physician has complete control over their patient care. Yet has the benefits of a dedicated and seasoned billing department, four office locations for expanded client networking, and over 15 years of experience with staffing and training medical employees. The group offers a high level of customer care and is always innovating and adapting to better serve their communities.

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