For decades, nearly all medical practices were private. Today, that paradigm has shifted to where private practice is now the exception to the rule rather than the norm. The reason for this shift is multi-faceted. Initially, physicians left private practice for employment by hospitals, and fewer graduating medical students are pursuing entrepreneurship or primary care, opting instead for employment within systems or specialty practice. More recently, Wall Street and private equity firms have been acquiring private practices. While some involved parties have benefited from this model, many would argue that physicians have lost their autonomy and patients have become more disconnected from their care providers.
However, independent practice is not yet extinct. Many physicians sit in a sweet spot where costs are low, quality and patient satisfaction are high and physician burnout is less common compared to the hospital-owned scenario. But some challenges remain. Just like an endangered species needs an ecosystem in which to thrive, so do private practice physicians.
1) Take Advantage of Strength in Numbers
It has been said that there is strength in numbers, and this is true for physicians who wish to reap the benefits of a larger organizational structures while remaining independent. As the healthcare industry continues to shift toward value-based care, groups like Physician Organizations (POs), Managed Service Organizations (MSOs), and Accountable Care Organizations (ACOs) have emerged as a solution for independent physicians who wish to prosper with changing financial opportunities.
By providing resources to support their members, these groups can help to improve practice performance, reduce costs, boost payer reimbursements, and ensure quality care for patients. The benefit of a PO, MSO, or ACO model is that risk, rewards, and responsibilities regarding care and quality measures are shared by individual providers and the larger group. That means that physicians can remain autonomous without shouldering patient wellness alone.
It is this strength in numbers that inspired me to create the physician organization Accountable Healthcare Advantage (AHA) in 2010 and join the Consortium of Independent Physician Associations (CIPA) the same year to gain access to additional benefits in contract negotiation and support services offered by Medical Advantage. Now, I serve as the Medical Director for AHA, CIPA, and the Medical Advantage ACO so that I can drive forward efforts to support independent physicians across the state of Michigan and beyond.
2) Deliver Exceptional, Coordinated Patient Care
Physicians who choose to remain independent may be the exception, but they still have a history of delivering exceptional care. In fact, it is their dedication to patient care that compels many physicians to remain independent. After all, independent physicians generally do not have to meet quotas for the number of patients they see on a given day and often have more freedom in specialist referrals. That means they can spend more time with patients, build relationships, and provide more personalized, cost-effective care.
Additionally, independent physicians are also business owners connected to and caring for their local community, which means they are highly invested in the success of their practice and extremely motivated to produce positive patient outcomes.
If an independent practice opts to join a PO, MSO, and/or ACO, they have an even greater opportunity to improve the quality of patient care. These models encourage cooperation and collaboration between providers because their patient care and practice profitability are more closely tied to other participants.
When selecting POs, MSOs, or ACOs to join, I recommend that physicians consider the following:
- Do these organizations support my autonomy?
- Does the organization align with PCP needs, or does it try to align PCPs with the organization’s needs?
- Do they provide on-going support to optimize patient outcomes and payer reimbursement?
- Do they provide recommendations for quality specialty providers for patient referrals?
- What are the financial, operational, and technical risks of joining? The benefits?
- Are organizational leaders transparent about groups’ earnings, quality, and decision-making?
- Will I have a say in the groups’ decision-making?
Your participation in these groups will impact your practice and patient care, so you should join organizations that are aligned with your values and patient care goals.
3) Use Technology to Your Advantage
The importance of technology as a driver in physician success and patient care cannot be overstated. According to the Office of the National Coordinator for Health Information Technology (ONC), when used effectively in private practice, EHRs (Electronic Health Records) can:
- Provide accurate, up-to-date, and complete information about patients at the point of care
- Securely share electronic information with patients and other clinicians for more coordinated, efficient care
- Help promote legible, complete documentation and accurate, streamlined coding and billing
- Enhance privacy and security of patient data
- Enable providers to improve efficiency and meet their business goals
Telehealth is another component of a competitive independent practice. Providers can utilize telehealth to expand their patient base geographically and satisfy patients who have come to expect convenient, remote care. It also can help reduce no-show appointments and increase collaboration between providers through virtual consultations.
Finally, telehealth can help improve patient outcomes. Follow-ups are easier and, during virtual visits, physicians can gather valuable insights about the patient’s surroundings at home and potential risks within that environment.
4) Build Connections with Professional and Local Communities
While technology is a valuable tool for practice management and growth, nothing quite beats the human touch. Nurturing relationships with other practices can help you grow your referral network and happens to be one of the oldest – and most trusted – forms of marketing.
To encourage referrals, practices can appoint an administrator or a community liaison internally to engage with potential external referral partners. Participation in POs, MSOs, or ACOs can also help to build relationships with other practices, healthcare groups, and hospitals.
For rich networking opportunities – along with a wealth of educational resources – I recommend joining local professional groups such as the Michigan Academy of Family Physicians as well as national organizations like the Medical Group Management Association (MGMA). Involvement in these kinds of professional organizations can provide deeply personal, as well as professional, fulfillment.
Community outreach can go a long way toward maintaining and growing your practice as well. Get involved with community non-profits organizations and events, such as charity fundraisers. Or seek sponsorship opportunities with local schools, such as sponsoring little league teams. You will not only feel good about making positive contributions to your community, you also can benefit by creating better name recognition and trust, setting your practice apart from competitors.
5) Market your Practice
Once you have created a solid strategy for staying competitive, you now must look at your patients as healthcare consumers. That means seeing your patients and potential patients as “shoppers” who are looking for the best healthcare value and experience as they would for any other services or consumer product goods. Marketing is an important part of staying competitive in an increasingly crowded market, and for healthcare marketing, the average budget is around nine percent of net revenue.
Your website is the “virtual front door” to your practice and should be a priority in your digital marketing strategy. Today’s patients have an overwhelming number of choices, so to remain competitive, you need a strong online presence. Be sure to prioritize intuitive design and search engine optimization (SEO) on your website. SEO will help improve your Google ranking organically, which will help patients find you ahead of your competitors.
Your website is just one online space for practice marketing. Social media is another powerful tool to help you remain competitive and to connect with your community. Nearly 90% of all adults in the USA search for health information on Facebook, Twitter, YouTube, and other social media sites.
Conclusion
Remaining an independent physician can sometimes feel like an uphill battle. But, by staying true to your beliefs and collaborating with like-minded providers, independent practice success is possible. If you have robust internal and external resources, you can use the strategies discussed in this article to attract and retain patients and stay competitive. Remember, you do not have to do it alone!