Staying Independent...Together

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   RE: I sold my practice
 From: John Brady
 To: Member Forum
 Posted: 10-21-2017 09:00
 Message: Thanks for this post Kris. I am heading down the exact same path and will become part of a multi specialty group on November 1st and the Village Doctor will become TPMG—The Village Doctor. I did not have staff turnover, but even though I have not accepted any patients in the past 2 years, my workload has steadily increased and my income has steadily decreased. Family medicine of today is way different than 15-20 years ago. Morbidity is higher, administrative burden is much higher, and to fulfill all the (un)necessary requirements, you almost have to immediately jump on your agenda instead of the patient’s (breaking a cardinal rule of family medicine). I have yet to see an insurer in my area willing to alter their payment model substantially to adapt to what we are being asked to do (no CPC+, best quality program is $2/member/month which does not cover the time to do the reporting).
Though I am losing some autonomy, it is not a ton (I still get to hire/fire and I can still see fewer patients/day than average—if I am willing to take a lower salary) and there are some immediate “group” benefits—my malpractice premium is going to drop about 25% and my health insurance premium will go down $500/month for a slightly better plan! Everyone I have met at the group is incredibly professional and has a great grasp on their area of expertise (meaning I should be able to continue to improve what I do without having to do a lot of the detail stuff). Similar to Kris’ experience, they are also intrigued about my processes and are interested in implementing some of them. But my first hurdle is changing to their EMR (the dreaded NextGen :().
Merging with the group has been an incredibly difficult decision with lots of anxiety and emotion. I keep reminding myself that the system is dysfunctional, but it still feels very personal. I will keep you posted as things move forward.

------Original Message------

For the past 2+ years I had been approached by various "corporate" medicine opportunities in my area, Columbus, Ohio. We have 3 big health systems and one very large physician owned organization. The physician owned organization is actually the largest doc-owned company in the country.

I have had a really full schedule now for years, I have been careful about contract negotiation and not accepting insurances with poor reimbursement and I have a really good reputation in my community. As a result of this reputation, the physician owned organization has been asking me to partner up with them.

I loved my practice, I loved the incredible amount of flexibility with my time and the ease with which I could make changes. I did not love the fact that I worked so hard for so little reimbursement. For the longest time when my 5 kids were younger it was worth it, my office was between all 3 schools (elementary, middle and high) and 4 blocks from our home. But now, my youngest is in High School, 2 kids are straight up grown, one is in college, another in med school, it turns out I don't need the flexibility QUITE as much. I am too spoiled by having had it for so long to work for a hospital system though.

In the past year I had multiple set-backs: My nurse of 12 + years left, my daughter, who did my reception/collection/patient care coordination moved away and the last straw was the EMR I had for 11 years went out of business. I had a hard time finding good employees (of the three I've hired this year only one has really worked out).

I sold my practice to the physician owned corporation. They do a really good job with quality work. The EMR is EcW, which is a huge learning curve. The good part is I don't have to be tech support, biller, paperwork submitter etc.... It's so weird to see my patients and answer messages and then GO HOME! Amazing! I'm a shareholder in the corp. and an owner in a practice with 3 physicians, 3 NP's. The corporation has its own diabetes educators, physical therapy, labs, mri, xray, cardiology, visiting physicians and float pool to fill in for sick staff members.

I'm really hoping this will be a good change but I want you all to know, it was a really sad one for me to no longer be an IMP.
The new organization heads tell me all the time they are impressed with all the innovative ways I did things and want me to bring that to their 300+ physician groups and the truth is all those ideas came from this group, so I'm hoping to continue to learn from you all and bring those ideas to the big guys.

Kris Oaks
Kristin L. Oaks D.O. Inc.
Worthington OH

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