PRACTICE MANAGEMENT
TO JOIN OR NOT TO JOIN?
Is Private Practice dying a slow death in this country?
I hear the question often in my consulting business and I must say, being an entrepreneur myself, I am biased. Over the many years working with physicians, they have a tendency to be independent and not typically “joiners.” Having said that, I have also assisted many clients (and friends) in making that decision away from independence to join a group or become a hospital employee.
I think there will always be private practice in this country, although the “mega systems” might disagree. Remember, we have seen this wave of purchasing practices come and go before.
In making this very important decision, a physician must determine his or her priorities. For instance, rank in order:
- security
- flexible hours
- salary
- control of staffing decisions
- relationships with partners
- location
- call coverage
- personal health concerns
Very often the decision to become employed comes after 20 years in practice. The partners are tired of the demands of operating a business and just want a “paycheck.” In those cases, in the beginning, they enjoy the freedom of having someone else in charge. Then the day comes when they are reminded that they took too much vacation time or they realize that their MA of 5 years is moving to another office (not the physicians’ decisions). Reality hits and is sometimes painful.
The most important step in joining, merging or becoming employed after independent practice is absolutely the agreement. Does it include the “what ifs?”
- What if I want out?
- What if I want to work less?
- What if I add services?
We spend most of our waking hours earning a living and hopefully being passionate about our work. The environment of the practice is just as important, for instance, the partners, key employees, equipment (often ignored) and available technology.
If the choice is to remain independent-not always easy, but certainly, at the end of the day, gratifying-if it works.
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