"The ideas you continually, insatiably explore,
going deeper and deeper into chosen subjects,
reinforcing and regrounding your principles
and your success concepts is what defines you
and makes the achievements others define
you by, possible."
----Dan S. Kennedy
"Structure your medical practice business to adjust to the
continuing and future changes."
Anna Wilde Mathews, a WSJ journalist, may not have the answers to the future of U.S. Health Care, but competently points out in her article in the December 12, 2011 issue of the WSJ the current thinking among the healthcare planners. If you plan to remain in your private medical practice that you own or plan to own, you absolutely should be planning your alternatives right now.
Are you simply going to sit back and watch the vulture’s picnic? The unsettled dust storm of future healthcare management, by all indications presently, is sending a clear message to private
practice physicians.
Either be the compliant victim of the upcoming new healthcare system trend of merging everything and taking complete control of the medical profession and healthcare, or make the difficult decision to remain in control of your own medical practice, how you practice, and
where you practice.
Don’t ever let yourself fall into the “victim” mode. You have a good number of medical practice business management alternatives available to you that you may not have ever considered seriously.
The forces that are blinding the minds of the healthcare planners are those that compete with the traditional format of medical practice and healthcare management we have always been so comfortable with. No matter what system we evolve into, personal independence to practice as we want and make medical judgments based on our knowledge, skills, and experience can never be taken away from us.
Our independent decisions regarding how we practice medicine, however, are rapidly being diminished. That process is being escalated by the clever government strategy of increasing the restrictions on private medical practice thereby forcing physicians out of private practice and into government controlled services, such as HMOs--that is, if they decide to continue
practicing medicine.
Forces that always prevent quality healthcare...
1. Cost of providing healthcare varies indirectly with the quality of healthcare…
Evidence that forcing physicians to cut costs that consequently reduce the quality of
healthcare is abundant. The British healthcare system is a good example.
Not only do they continue to lose their good physicians to other areas of the world, but also continue to see a steady transition back to private practice for the same reasons that physicians
in our country are frustrated to the point of quitting practice. The more physicians are pushed
to reduce cost, the poorer the health care will be.
2. Reduction in medical doctor’s incomes vs. increased assembly line medicine...
When medical practice income is restricted by any means because of the larger issue of affordable healthcare for everyone, it’s clear that college students likely will select a different profession, unless they have a robotic personality and love being told what to practice, how to practice, where to practice, and if they can practice. Physicians already in private medical practice today are being forced to increase their patient load, sometimes unethically, to financially survive.
All private practice doctors will reach a burnout phase sooner or later. Marketing medical practices will reduce the possibility of that considerably. The more the physicians incomes drop the more physicians will leave their medical practice. College students won't pick a career that results in debt and poverty of physicians that results from increasing government domination of private clinical medical practice.
3. Medical provider mergers vs. private medical practice…
Healthcare planners are bullied by political, economic, and human rights issues. Building large systems by mergers or cooperation, from hospitals to medical practice offices and private medical practice businesses, always leads to the same end. For physicians, it’s loss of independent medical judgment, income control, personal choices for medical care of patients, and one’s motivation to improve medical skills and knowledge.
For hospitals, it’s a thundering conflict of methods and elements of medical care being provided or not. Hospitals merging with doctors and their medical practices brings on financial and practice control headaches. Applying this approach has helped some hospitals to survive financially, but huge numbers of smaller hospitals have closed their doors as a result of no mergers. All of this one way or another comes under the control of our politicians.
4. Professional satisfaction vs. dictatorial medicine…
Are you a physician that derives professional satisfaction from independent private medical
practice management, or a physician whose satisfaction comes with a focus on time off, fixed schedules, employee status, and acceptable limitations on your skills and medical knowledge?
The new generation of physicians trend towards the latter. Actually, about 50% of all graduating medical students apply to governmental controlled healthcare facilities before or after internship.
I’ve purposely inserted these common issues here to give you a running start for considerations for what you will soon need to make decisions about...your style of practice, what gives you the highest potential to fulfill your goals and dreams for your medical practice career.
Ideas about what to concentrate on in your medical practice business plans and
goals for the immediate future...
Whatever decisions you make about what you’re willing to do or not do in your medical professional career, the most important thing to keep in mind is to prepare your present medical practice to be adaptable to any healthcare system established in the future.
Here are a few ideas...
1. Focus your practice on a medical care niche that you especially like.
You’ve no doubt recognized the trends towards increasing numbers of medical subspecialties...niches. You probably also agree that a medical student or doctor can’t possibly
learn all they should know about medicine in medical schools, which is manifested by the
increasing subspecialties in medical practice.
Within your medical practice business, you have areas of medical care that you love to do and you’re very good at doing for your patients. Rather than becoming a "commodity practitioner" where there are hundreds of doctors doing the same thing you are, you are obliged to create a position for yourself above the others, at least for any successful financial outcome for your
medical practice business. You do that by being the best at one or two elements of your
medical practice focus.
From a marketing strategy and successful medical practice business management, you will do far better in your career by narrowing down your expertise to what you do best. You’ll earn much more money, be recognized for being the best in those areas among patients, and put yourself in much greater demand when and if you are forced into collaborating with the medical system
that’s coming.
A small percentage of medical students are unable to decide what specialty to practice in. Many of those find themselves unhappy in that choice. Training for another specialty than the one you chose, requires precious time, money, and tolerance, unless you pick a specialty as I did, in OB-Gyn.
Even that choice of OB only later on, or of GYN alone later on, results in an enormous number of problems such as--quit OB and you lose over half of your practice immediately. It's like starting practice all over again to build up a GYN patient practice.
Most physicians do not change specialties even if they dislike the one they chose, for many personal reasons. It's far better to narrow down the specialty you are already in, to subspecialty elements that you can live with for the duration of your medical careers.
2. Make decisions about what you will do... now... not later when all hell is breaking loose.
If you haven’t already formulated in your mind what you can and will do in medical practice, this is a good time, before the government gains total control of the medical profession. Take time to read everything you can about what the healthcare planners are saying and thinking because you will end up in their pockets…you need to know which pocket you prefer to be in long before the final choice has to be made.
Decisions you are making here concern you personally. For example, if you have already worked as a physician employee inside an HMO, like Kaiser Permanente, then you may have made a decision you liked…or you just couldn’t continue to practice under their supervision and quit. In that case, the decision has already been made. Now, after deciding one way or the other, the next step is to settle on a pre-planned path of positioning yourself and your practice for the most advantages possible.
Medical students still in medical school in 2022 should be considering the income/salary aspects of the choice of specialty. Today, salaries of each specialty within the government mandated healthcare system are 5-10% higher that the incomes of the same specialty physicians in private practice. All that comes out of employed physician salaries are taxes.
Because the private practice physician's income is composed of salary as well as medical office business overhead, their take home pay is less than employed physicians. These facts now drive new large numbers of physicians into employed positions. Should the economy crash, many employed physicians stand to be let go, or fired. Private physicians will still have income... but less of it.
If you are happy inside a healthcare managed system, you can work yourself up to the chief of the department, or some higher administrative position where the salaries are higher and your time is more adjustable. At that point, you will be able to transfer to another managed care system for even greater advantages.
If you are fitted to be your own boss, then it’s time to stop doing the parts of your medical practice you dislike and spend more time on what you do like. Remember, you don’t have to practice everything you learned, just the things you really find exciting and fulfilling. Practicing everything you were taught is neither smart nor efficient. When your patients see what you love to do, the word spreads. Referrals increase. Practice income hits a high.
3. The importance of timing
As of today, you have very little time left to position yourself for the top spots. It’s time enough to create the adjustments in your practice that can open doors in any direction when it becomes necessary. You can move to an area of the country you find more attractive to practice in, so as to be fully established when the government takeover tsunami hits.
When you read the medical practice stats, about 14% of physicians move their practice sites each year in the USA. It reminds you that many doctors settle in spots that they eventually learn was a mistake, or are dissatisfied with the area for some reason that shows up later on (like practice competition, lack of adequate consultants, hospital facilities inadequate for what you want to be doing in your private medical practice). Are you one of those doctors? Do it now…you’ll never find a better time to move if your circumstances permit.
Another more practical issue where timing is critical is that of improving your knowledge and skills to a new level…planned to do, never did. If you are a primary care doctor, take some office surgery courses and do your own biopsies and laceration repairs instead of referring to dermatologists
or surgeons.
If you are a surgeon, learn new surgical procedures and skills that are not available in your peer community. Make yourself different from other practices. There will be large numbers of doctors trying to position themselves at the last minute before the tsunami hits, as you can imagine. Treat yourself well now and it will pay off whatever happens in healthcare.
Laparoscopy was introduced in the USA by Dr. Curt Semm, Germany, while I was in private practice. I took the first workshop course given in the USA by Dr. Semm because I recognized the need for that skill and what it could do for patients.
My associate and I started the operative procedures at our local hospitals and taught other physicians. It was and is a remarkable addition to surgical skills for any physician in surgical
specialties, and rare other specialties.
4. Rather than solo... go, group.
It’s better not to waste time reinventing the wheel. Use what already works and modify it to meet your needs. Can you imagine how many solo doctors are going to be tramping over each other to join a private practice group when or if the new healthcare system is structured so as to obliterate solo medical practice?
One obvious reason this is a profoundly good choice for solo physicians in private medical practice, whether the system is changed or not, is the overhead savings when in a group practice. Better to do it now and not when every doctor is trying to find a group position.
It’s almost impossible today to begin a new medical practice coming out of med school or residency because of the horrific educational debt hanging over new physicians. Can you imagine going to a banker to request a new loan to open a practice when you are indebted for $165,000 or so and unemployed?
Medical groups, mixed or single specialty, offer advantages that combine your relative independence of medical practice and sharing the costs of overhead. Both factors are essential to remaining financially solvent and profitable. Many medical practice business experts feel that private solo practice is a lost cause for future planning. They may be right.
As the disintegration of private medical practice continues, it is very important for private practice physicians to consider "Concierge" or cash for care. The advantages offered by that practice method has become the primary choice alternative as practice incomes decrease.
5. Time to create a non-professional additional business income
It doesn’t take a genius to recognize that the continual drop in private medical practice incomes over the last 20 years or so will continue. Any college student thinking about going to medical school today probably understands the debt harness they will have at the time they graduate from medical school... or maybe not.
Additionally, those of us physicians who are now at retirement age understand that it would have been a good decision (had we known the future) to have developed a separate multiple stream income business to help meet our family obligations that most private practice doctors can’t meet today... like funding a retirement plan and paying for a kid’s college education.
Any person considering a career in medicine should already be creating such a second
income business.
Fact: Physicians and other healthcare doctors will never (rare exceptions) reach an income level commensurate with their educational level, time and money spent in education and training, or hard-earned professional lifestyle, without a sound business education.
Physicians never signed in to the medical profession to be relegated to the lower middle class in our society, meaning, being professionally poor and unfulfilled.
All of the personal gratification, fulfillment, joy, self-esteem, and aggrandizement resulting from years of medical care of patients doesn’t compensate for having to compromise our family obligations, not being able to reach our personal dreams and goals, and having our full potential trashed. All because of lack of financial resources. And we all know what causes that… and it’s not from lack of hard work, motivation, or passion.
Get started now in your additional business… it’s not as hard as you think. What's hard is making the business profitable without a business education.
6. Employ a family member as a marketing manager?
Literally, every private medical practice needs a special person hired to do the marketing for the medical business. Not only will it add a second income to the family, but also will be a person you can easily keep tabs on to insure the job is done right. And, they will work overtime without compensation... maybe!
I must point out that employing family members can have very deleterious consequences. Having a spouse with a suspicious personality about what is happening around the office can be fatal, or worse. My daughter worked in my office to help out with a summer job while still in high school. Everything was reported back to her mother, including what's being said, her perceptions of events, and office business troubles. Not Good!!
If not a family member, then hire someone with marketing knowledge from the local college or marketing agencies. Don’t hire a patient of yours.
Comment...
I’ve covered only a few of the ideas and marketing strategies here for lack of space. Keeping a focus on the downward trends associated with professional medical doctors and the medical profession in general, is my way of finding ways to help you avoid them... not simply to help you get out of them.
----Professional Probe----
"Physicians need to be prepared for the socialized medicine changes, these weapons collected from the crowd at
a soccer game in Europe might be an acceptable
choice for physician's protection from our
government's dictatorial mandates."
Articles © 2013-2022/CGG INVESTMENTS LLC. All rights reserved. #28 3-16-22
