http://money.cnn.com/2012/01/05/smallbusiness/doctors_broke/index.htm?hpt=hp_t3
Interesting article on CNN today. I would consider many of my medical experiences to be sheltered from these issues, considering I grew up in the military. However, I have spent a significant amount of time in the private medical sector here in Colorado and have not been exposed to many of the issues brought up in the article.
I am curious to see what other SDN'ers experiences are, particularly in CO. Do you think we are somewhat shielded from some of the negative financial aspects here in CO or is this just my perception?
It is difficult to have a fully informed opinion when such little detail is provided about each situation presented in the article. However, I believe that the business side of medicine will always and should always contain certain elements of risk. Just because you are selling healing does not mean that your business modeling should be any less flexible or defensive than the guy next door selling apples. The underlying principle of business is preparing a model that will float, and then changing the model when conditions change. With creativity a model to thrive can be defined for any business climate. Medicine should not be immune to standard business principles, and there will always be risks and rewards inherent to private practice that are not present in institutionalized medicine.
What do you think?
Airman,
I might be able to answer a couple of your questions. Having worked in a private practice (specialty kept anonymous) for 2 years, I can tell you that the problem in the article is VERY real, even here in CO. I watch the practice barely stay out of "the red" on a daily basis.
One of the big questions is, "what is causing the problem?" I only skimmed the CNN article, so I'm not sure what was said, but there are a number of causes that I see. First is reimbursement. If your practice has a large portion of medicare patients (say 25% or more), the poor reimbursements WILL affect the practice. Also, the cost of supplies can be very expensive, not to mention rent. If you are in a nice building, the cost of rent can really impact the budget.
The business model you mentioned is very simple on paper -- make more than you spend on employees, supplies, rent, malpractice insurance, etc. And, there is SOME flexibility, but no matter what change you make to keep the business afloat, it WILL affect your patients. For example, you could cut costs on equipment, but then you face the problem of being out of stock or having a crummy piece of equipment that a patient really needs. You could cut down your number of employees, but then your patients will not receive call backs and care in an appropriate amount of time. You could move into a marginal building and face the problem of not having enough or inappropriate space. You could see 40 patients a day instead of 25, but then you won't have time for adequate patient care or documentation. THE WORST OF ALL IS, well, Medicare reimbursements are sub par, so cut the amount of Medicare patients you see (or don't see them at all). Then, you are withholding care from the fastest growing category of patients in the U.S. This group of people will include many of our parents in the next few years.
More and more private practices are being forced to sell out to big physician networks and hospitals. But then you have a boss and a boss' boss, which is the whole reason you went into private practice in the first place -- so you could be your own boss.
Ultimately, it's a big problem and I don't see it getting any better. I HOPE for all our sake that it does get better. I hope this didn't come off too pessimistic, but it's just what I've observed for the past couple of years.
