Wow - who really knows what is going to happen? no one does - however, we've proven over and over again that research, strategic planning, effective implementation and managing results are the corner stones of successful businesses.

Some history - historically, "Business" has been able to exploit physicians because, in general, physicians have persisted in failing to operate their medical practices as businesses – even today, many remain fragmented and unprepared in their business dealings. We do see important changes though and it is very evident that physicians are becoming more adept business people - literally their futures depend on it!

So how does a physician owner perpetuate his/her “business” in this corporate environment and earn a reasonable profit?

1. The successful practices (from now on businesses) usually have a strong management infrastructure. In any successful business, considerable time is invested in strategic planning and allocating resources (people and finances). Decisions are made and people are held accountable. It gets done or jobs are lost! Who is holding the physicians and doctors accountable in your practice?

2. Successful businesses always have a leader with strong business skills. Being a proficient full time corporate business manager and a proficient full time physician is a dichotomy. As long as physicians and doctors think it can be done, business will continue to exploit their inability to recognize that, it usually cannot. So what can you do? Well, you can do nothing, which is what many physicians and doctors have chosen to do (remember the definition of insanity? "Doing things the same way and expecting different results"), continue to do both jobs yourself or you can hire proficient and seasoned business people to assist you in accomplishing your personal and professional objectives.

3. Understand the costs of doing business! Yes there is a difference between income and profit. Find and use some cost accounting methodology (eg. resource based relative values) to determine where you are earning a profit and where are not. Take steps to make corrections in contractual and other arrangements to operate your businesses at a predetermined profit levels.

4. The best defense is still a good offense. My suggestion is that, in your practice, you reach out to your partners and gain some mutual agreement on goals and objectives. Select an unbiased businessperson or business people that will assess your resources and work with you to design a written plan that will result in a clear explanation of your goals and objectives. Armed with such a document reasonable alternatives and strategies may be agreed upon. You will be bringing immediate value and increased leverage to your business. You will be on the path to reducing uncertainties and gaining more control of your future.

I believe the future for many physicians and doctors will be continued consolidation and emphasis on developing efficient, accountable, responsible and profitable “companies”. There will continue to be very strict regulation on reimbursements. ARRA, RAC, EMR, Compliance Plans, HIPAA implementation and regular internal audits (RAC and commercial payer) are now a part of everyday business. Your businesses will continue to evolve to meet the needs of your patients, especially electronically and via the internet. Physicians and doctors will continue to expand and build upon their individual specialties and incorporate new specialties, in conjunction with those patient needs and quality outcomes. The most successful businesses will be those that make it easy to do business with them (well trained staff), have systems (software like EMR) designed and in place that support (through business and financial reports) the physicians, doctors and staff in providing the very best medical care and can understand and quickly react to developing trends and finally, that truly understand the difference between income and profit and manage for profit and perpetuating their businesses.

Jeffrey P. Thompson is the owner of JP Thompson & Associates, an integrated management - consulting firm. For more information, Mr. Thompson can be reached at (732) 528-7645, e-mailed at jpt@jpthompson.com.