Someone wants your practice, your patients, and your profits. And they don't particularly want to pay for them.
Although the healthcare battle being reported in the popular press is over Obamacare, the more immediate battles in terms of your practice's survival concern fighting off two converging trends: The growth of so-called "national groups" that want your practice, and the vision of hospital-centric healthcare.
National Groups
So-called national groups are stepping up their competitive push in a growing range of physician specialties.
Although some of these groups are true integrated medical practices, many are simply staffing services masquerading as such, almost functioning as franchisers of healthcare services in the way of hamburgers.
And as in the case of the national hamburger chains, the same concerns of quality apply.
Certainly, many facilities, and many patients, will be content with national-chain quality just as they are at McDonald's which, after all, is hugely successful. Many providers will be content working for lower wages that are the key to these groups' ability to compete.
The battle then takes place at the fork in the road, one leading to further commoditization of healthcare with fungible providers, many of whom will be paraprofessionals, and the other leading to high quality, high touch medical care.
Hospital-Centric Healthcare
In the world of the future being designed in hospital board rooms and faculty lounges, healthcare relationships are seen as hospital-centric. In that vision, patients are no longer referred to the hospital; rather, the hospital becomes the hub in a wheel-like delivery system, with it directing patients to affiliated providers for care. That is, maybe to you, or maybe not.
On the payment side, this agenda manifests itself, for example, as bundled payments and as the ACO initiative.
On the delivery side the agenda includes employment of physicians by hospitals or by their related foundations.
The aspirations of national provider groups mesh with the short term elements of the plan for hospital-centric healthcare, a world in which patients are not aligned with physicians but are aligned with the hospital. That's because hospitals can use a relationship with a national group as an intermediary step in their plan for domination.
By contracting with a national group as a sole or preferred provider, a hospital can displace existing independent and local group providers or give those physicians little choice but to become employees of the national group at significantly lowered compensation.
Once compensation expectations are sufficiently reduced and once competition in the practice area is consolidated, the next step can be the hospital's decision to bring all practitioners within that specialty into the ranks of hospital employment, thus obviating the need for the national group. Or, the large group can be allowed to remain in place for the time being, to be pressured for growing concessions under continuing threat of being replaced.
Conclusion
If physicians do nothing, the default position will be increased displacement by these so-called national groups.
Unless a giant step backwards in terms of income and control is your idea of an ideal future, you must implement an ongoing program within your practice's structure to create intertwining relationships that cannot easily be broken or duplicated by the so-called national players. You also need to target, duplicate and deliver the several touted benefits on which national groups claim to compete.
Whether you can and will rise to this challenge will determine whether you will have any real equity in your practice or will be relegated to the position of an implementer, that is, a highly skilled technical worker, as opposed to a true professional.
Contact me today to start protecting your practice, your patients and your profits.
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