Recently, I was reading that it is predicted that over the next 5 years, only 30% of doctors will stay in private practice. Increasingly, doctors are retiring early or selling their practices to hospitals or other entities. The pressure of successfully running a practice these days has grown precipitately over the past few years. I have personally had hospitals and even medical device companies offer large amounts of money to purchase my practice.
Why are doctors leaving private practice?
– Reimbursements have remained stagnant or decreased over the past decade or longer while overhead costs have soared. There is no cost of living increase or calculations for inflation in our salaries.
-mandates are being placed on us like never before. The media is overloaded with information about meaningful use and e-prescribing requirements. Additionally, ICD 10 will be rolling out later this year. All these changes cost us time and money to carry out. And if we fail to comply, we will be soon facing penalties.
-Liability costs have sky-rocketed. Malpractice premiums continue to rise, even for doctors with clear histories. Frivolous lawsuits continue to be filed, with additional costs and stress. Sure, there needs to be a mechanism in place to protect patients from medical negligence. But, perhaps the malpractice climate needs a reform as well.
-Technology is expanding at a rapid pace. While we try to keep up, we need to manage the business of our practice. Most doctors never received a business education and are learning it as we go along: a rather costly and time consuming procedure.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
– Doctors are now competing with other market forces: telemedicine and minute clinics are just 2 examples. We need to be marketing ourselves and our practices.
For many physicians, the burdens and cost of running a practice are no longer worth it. Many feel it is easier to take an employed position and leave the management burdens to some one else. I, however, have always felt that I have provided the best care for my patients when I manage every aspect of my practice. I am the one who decides what services to offer, how long to spend with each patient, who is the right staff for my patients and all the other details needed to run a practice. And, we should not be forced to feel like the only way to survive practicing medicine is to close our doors.
Many have joined ACO’s as a way to reduce some of this strain. But, now is not the best time to join. A doctor is only allowed to join one after all and then can’t change. Most ACO’s are new in the game and on the learning curve. It would be premature, in my opinion, to join an ACO. And I have been already providing quality and cost-effective care for years
How can Private Practice Survive?
–We need to continue to be involved in every aspect of our practice. This means knowing when to hire someone to tell us where we are losing money or how we are inefficient. But, once we put that knowledge completely in someone else’s hands, we lose vital information about our practice.
-We need to be aware of all the new mandates. It will not be good to learn after the penalties roll out. We need to be ahead of the curve not catching up. ICD 10 is coming. We need to be ready from now.
-We have to study the market forces around us. Why does a patient go to the minute clinic instead of seeing me? Maybe, answers to such questions can make me aware of faults in my office.
-Our staff needs to be trained. Not just experience but trained in the way we need them to be. And we need to listen to their ideas. They often have great ones.
Can private practice survive? Certainly. It is just going to be more difficult. But for those of us with the nerve, we will last out the healthcare changes. I plan to stay in private practice until I die. I may die clutching an unsigned ACO contract in my hand, but my patient’s best interests come first. And for me, that means private practice.
