Physicians Practice - January 2008 - (Page 64)

CME CAREER the competition. There’s an ethical code between on-call physicians, he says, where emergency patients still belong to the primary physician. That doesn’t always stop your patient from fancying the on-call doctor and deciding to switch, but all in all, Zarin says, it’s a congenial atmosphere. “You cover for them, they cover for you. It’s a give and take.” Specialists enter the picture when the emergency is acute — say, a surgeon for a ruptured appendix. And, while a group of physicians in the same specialty area create a center for excellence by playing off each other’s strengths and enjoying a high level of collegiality, mixed specialty groups often encounter problems with compensation, says Zarin. Namely, who is worth more? But sometimes, more so than compensation, it all boils down to personalities. Communication is the key. For the most part, physicians try to work things out, Zarin says, but personalities can get in the way. Raymond advises physicians to say what’s on their minds, and seek an environment that works best for them. SEEKING ANSWERS WITHIN and cons on a sheet of paper. He’s quick to point out that a physician shouldn’t be surprised by the negatives of partnership — for example, loss of autonomy and less input on staff management. It’s important for physicians to know themselves, as well as the groups on all sides of the fence, says Raymond, who was a member of two partnerships before going solo. Take some time to investigate your own core values: • Do you cherish autonomy? Doctors who like to do their own thing might ﬁnd switching gears to a protracted decision-making process a harrowing experience, says Dahl. Physicians must acknowledge how much control they can comfortably relinquish. When members of Conti’s first practice decided to change the payment schedule from the “earn as much as you work” plan to a more communal strategy, Conti’s veto power was usurped. • Do you thrive better in a group? medicine, and then to focus ﬁrst on the management side. • Is practicing medicine a job or a passion for you? Raymond encourages physicians to ask themselves, “Am I working to live, or living to work?” There are those who want to work long hours and those who don’t. And the two sides rarely understand each other, Raymond cautions. Each practice marches to its own tune, with the physicians deciding which song to sing. Raymond’s ﬁrst practice was a democratically run group where everyone got a vote. In her second, one physician assumed the decision-making role and everyone else was ﬁne with that. Both practices were great, she says, recalling wonderful colleagues. The ﬁrst group was very efﬁcient and made great money, but it wasn’t the ideal setup for Raymond to take time off for speaking engagements or seminars, something she loves. A partnership is most worthwhile when the physician gets the right ﬁt, Raymond says. Despite enjoying a successful “marriage” with both of her partnerships, she yearned to have more control over determining her own ofﬁce hours. So, ultimately, Raymond went solo, where she now works part-time hours to allow for other pursuits: “I figured out how much I needed for overhead, how much I wanted to take home, and how many patients it would take for me to achieve that goal.” GET IT IN WRITING “Why do I want to partner or stay solo?” That’s the one nagging question a doctor has to answer clearly, Hertz insists. Write down the pros IN SUMMARY There is much to consider before deciding whether to remain in solo practice or become a partner in a multi-physician practice. Ask yourself: A veteran doctor often enters a partnership because of fatigue, Hertz explains. The burden of running the business alone and being on call all the time is exhausting. However, he warns, once a physician decides to partner, things will be different. Decision-making, staff management, and payment structures, to mention a few, will change when creating a partnership. The question becomes: How much change can you live with? • Do logic and data rule your brain? • Do I like to interact routinely with professional peers? as part of a group? • Do I like to make decisions alone or • How much do I want to work? • How much do I want to make? If you decide to join a partnership, be sure to: • Find a good cultural match. • Develop a thorough contract. • Communicate constructively. 64 | PHYSICIANS PRACTICE | JANUARY 2008 A new physician often partners because it makes sense, says Hertz. Negotiating managed-care contracts — where often there’s more strength in numbers — purchasing technology, navigating medical bureaucracy, and ﬁguring out the complexities of modern healthcare make it difﬁcult for solo doctors to do well, and often require the ﬁnesse and emotional stamina of a veteran medical “jack-of-all-trades.” Raymond explains: “We don’t get enough business classes in medical school.” She advises new doctors to decide how they want to practice Consider everything before leaping into a partnership. How often do you want to see your family? How much money do you want to earn? How good are you with managing staff and collections? Are you satisﬁed with your negotiating power with managed care organizations and insurance companies? If you decide to take the plunge, make sure you get all of the details in writing. “Partnering is like a marriage,” Hertz says, “Easy to get into, not so easy to get out of.” For doctors who aren’t happy, whether WWW.PHYSICIANSPRACTICE.COM http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - January 2008

Physicians Practice - January 2008 Contents The Bigger Picture: Fixing Medicaid Letters Physicians Practice Pearls: You Can Teach an Old Dog New Tricks Noteworthy Cover Story: Fee Schedule Survey: 2007 Results Adding Ancillaries: Bucking the Practice Ask the Experts Idealab: 'How I Got Over My EMR Excuses' Technology: Don't Be Denied The Tech Doctor: Blessing or Curse? The Administrator's Desk: Learning From the Best Coding Career: To Partner, or Not? Management: Controlling Your Inventory Human Resources: How to Fire an Enployee Finance: Beyond Reimbursment - How to Fix Your Mix Classifieds Advertiser Index

Physicians Practice - January 2008

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