"Business" has been able to exploit
physicians because,
in general, physicians have persisted in failing to operate their medical practices as a business – they remain fragmented and unprepared in their business dealings. In many
cases, physicians and doctors have not been able to get it together
even in their own practices. Mostly it is egos and lack of sufficient
business experience that seem to get in the way. Although most physicians want changes to occur,
a consensus commitment level has not yet evolved.
So how does a doctor exist and 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 gaining the business skills needed to
accomplish 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. 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.
4. The best defense is still a good offense. My
suggestion is that, in your practice, you reach out to your colleagues 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 whatever organization you choose to join or if you
develop your own. How much time does it take to make that happen?
The answer lies in your ability to recognize and deal with the
hard issues. Get them on the table early and deal with them.
How much do you want change, and still maintain stability and
some control? How expensive will it be? Will you have to personally
guarantee some of the expense? How much? If someone or some
organization provides the capital there is always a price to
pay. How dear is that price? I can promise you this – if you
don’t get it together, you will continue to be exploited. If
that is ok, do nothing.
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. Compliance Plans,
HIPAA implementation and regular internal audits will become
a part of everyday business. Your businesses will continue to
evolve to meet the needs of your patients. Physicians and doctors
will continue to expand and build upon their individual specialties
and incorporate new specialties again, 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) 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.
Jeffrey P. Thompson is the owner of JP
Thompson & Associates, an integrated physician-consulting
firm. For more information, Mr. Thompson can be reached at (732)
528-7645, e-mailed at jpt@jpthompson.com.