Those of us involved in the healthcare industry love to share the tidbits and gossip of what's going on in the practices in our community. While there may be hundreds of practices in our particular demographic area, word spreads like wildfire when a physician practice does not work or play well with others. A practice may find itself literally blackballed when it comes to referrals from colleagues when business models are based on the Gordon Geko philosophy of "greed is good."
There is a world of difference between a healthy attitude of ambition and a toxic desire for money that allows certain physicians to ignore the rules of healthy partnerships and collaborations.
In our current climate of reimbursement reductions, physicians are using their imagination and resources to create marketing programs and lease space arrangements that should benefit all parties involved. Many practices have enjoyed great success as a result of these collaborations, however, certain parties cannot find satisfaction unless they take much more than their mutual agreement called for, or worse, find a way to constantly renegotiate their business deals to their own advantage. It may take a while for the manhandled party to realize they are on the short end of the deal, but sooner or later the deal falls apart and the reputation of the physician who did not keep his promises often cannot be repaired.
We have seen a societal change in our country where fair play and hard work is downplayed in favor of winning at any price. Pride in a job well done has been replaced by the sole desire for material reward. Indeed, it becomes increasingly difficult to find employees or even professional staff who operate with kindness and consideration both for patients and colleagues alike. All of us have born witness to those barracuda physicians who operate as if they were the only game in town. Partnerships are broken, employees become disgruntled and burn out, and fellow physicians stay as far away from the practice as possible.
Often, these "bad press" practices initially enjoyed moderate success and were well respected in their communities. Over time, however, they failed to acknowledge some basic truths. The first and most important rule that is disregarded is that every business eventually reaches the "glass ceiling of cash."
There are only so many patients that can be effectively treated in a business day. You may have taken your practice into the millions of dollars range, but eventually you will reach a level of reimbursement that is appropriate for your specialty and the number of physicians that you employ. The expectation of a "no limit" cash flow year after year, is unrealistic and the physicians who deny this basic tenant will go over and above the rules of fair business practices.
A second and perhaps more grievous error is the hiring of multi-specialty physicians outside of your specialty before due diligence is performed. Practices who deal in this behavior are constantly in a revolving door situation where physicians come and go, often at great expense and legal consequences. These physicians do not make an adequate study of whether or not the incoming physician will be a good fit for their patient demographics and they may not realize that they are now paying for a physician in the same specialty as those doctors in their community who provided them with referrals. They ignore the warning signs for the sake of "empire building" and may lose the possibility of future practice growth. Many of these business deals end up in disaster, especially when the physicians who join the group do not meet their expected financial goals. The comings and goings of these doctors have serious implications for the hiring practice and the unhappy physician who ends up leaving the practice will eventually voice his complaints loud and clearly in the community at large.
A medical practice cannot exist in a vacuum. Those in our community will not experience our level of skill or caring attitude in the exam room. We will be judged by our fair and equitable business practices and once our reputation is damaged, repair may not be possible.
There is a world of difference between a healthy attitude of ambition and a toxic desire for money that allows certain physicians to ignore the rules of healthy partnerships and collaborations.
In our current climate of reimbursement reductions, physicians are using their imagination and resources to create marketing programs and lease space arrangements that should benefit all parties involved. Many practices have enjoyed great success as a result of these collaborations, however, certain parties cannot find satisfaction unless they take much more than their mutual agreement called for, or worse, find a way to constantly renegotiate their business deals to their own advantage. It may take a while for the manhandled party to realize they are on the short end of the deal, but sooner or later the deal falls apart and the reputation of the physician who did not keep his promises often cannot be repaired.
We have seen a societal change in our country where fair play and hard work is downplayed in favor of winning at any price. Pride in a job well done has been replaced by the sole desire for material reward. Indeed, it becomes increasingly difficult to find employees or even professional staff who operate with kindness and consideration both for patients and colleagues alike. All of us have born witness to those barracuda physicians who operate as if they were the only game in town. Partnerships are broken, employees become disgruntled and burn out, and fellow physicians stay as far away from the practice as possible.
Often, these "bad press" practices initially enjoyed moderate success and were well respected in their communities. Over time, however, they failed to acknowledge some basic truths. The first and most important rule that is disregarded is that every business eventually reaches the "glass ceiling of cash."
There are only so many patients that can be effectively treated in a business day. You may have taken your practice into the millions of dollars range, but eventually you will reach a level of reimbursement that is appropriate for your specialty and the number of physicians that you employ. The expectation of a "no limit" cash flow year after year, is unrealistic and the physicians who deny this basic tenant will go over and above the rules of fair business practices.
A second and perhaps more grievous error is the hiring of multi-specialty physicians outside of your specialty before due diligence is performed. Practices who deal in this behavior are constantly in a revolving door situation where physicians come and go, often at great expense and legal consequences. These physicians do not make an adequate study of whether or not the incoming physician will be a good fit for their patient demographics and they may not realize that they are now paying for a physician in the same specialty as those doctors in their community who provided them with referrals. They ignore the warning signs for the sake of "empire building" and may lose the possibility of future practice growth. Many of these business deals end up in disaster, especially when the physicians who join the group do not meet their expected financial goals. The comings and goings of these doctors have serious implications for the hiring practice and the unhappy physician who ends up leaving the practice will eventually voice his complaints loud and clearly in the community at large.
A medical practice cannot exist in a vacuum. Those in our community will not experience our level of skill or caring attitude in the exam room. We will be judged by our fair and equitable business practices and once our reputation is damaged, repair may not be possible.
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