Gone are the halcyon days of the kindly doctor making routine house calls to his patients. And soon, the industry might be saying the same thing about private practice doctors.
Since 2012, there has been a 100 percent increase in hospital-owned physician practices and a 63 percent jump in hospital-employed doctors, according to a study from the Physician Advocacy Institute. The AMA conducted similar surveys in the 1980s, illustrating how much things have changed: In 1983, by comparison, 76.1 percent of physicians were self-employed, private practice owners.
Further, it’s possible that an entire generation of doctors won’t even be able to envision a future where they own their own practice. A 2016 Medscape survey asked whether medical students anticipate owning a stake in a practice, and only 22 percent of those surveyed said they do, down from 26 percent in 2015.
The rub in all of this is that independent physicians demonstrate they deliver quality care for a fraction of the cost of care delivered in a large system setting. So, although the physician employment trends are clear, in the interest of increasing quality care and decreasing costs, it might behoove many physicians to reevaluate whether working for a hospital or hospital-owned practice is the right career move.
Here are six ways to know you’re ready to make the move to physician-owner.
You want the freedom to run a practice your way
There are a million tiny decisions that go into running a medical practice. And all of them add up to the overall satisfaction and engagement of front office staff, nurses, doctors, and ultimately patients. At large systems, those decisions — such as what EHR to use, whether you can use social media, how many patients you need to see, etc. — are mostly centralized in the name of operational efficiency.
If there’s even a hint from your inner-voice that you desire more control and freedom to run a practice the way you want, then this is the first sign that self-employment is worth exploring.
You're being backed into a corner
Hospitals often institute systemness on their physicians; they want every doctor to practice medicine in a similar way. This includes everything from how routine exams are performed, to scheduling surgeries, to diabetes checks. It takes the expertise of the practicing physician out of the equation by instituting a rigid approach in the name of improving certain quality measures.
Additionally, providers are often asked to sign noncompete agreements promising not to see patients within a geographic area and time period after they leave an employer. Hospitals and larger health systems see “noncompetes as a means to protect valuable investments in physician practices and top-ranked specialists,” writes Healthcare Dive, “but critics say they are anticompetitive and not in the best interest of patients.”
Regardless, being forced to sign a noncompete severely limits your options as a physician.
You have a solid patient base that will follow you
If you haven’t signed a noncompete, then there’s a good chance many of your patients will be willing to follow you to your new practice. Patients can be as loyal to their doctor as they are to a health system because they want to keep continuity with their care.
Knowing you have a reliable patient panel that will follow you also provides revenue forecasting and a known runway for launching your new practice. Then, by leveraging online marketing for doctors and practice growth software tools, you can grow your patient base and revenues sooner rather than later.
You've found the perfect location for an office
Location, location, location: It’s the old adage in real estate, and it’s something that urgent care centers have learned to perfect from consumer goods franchises like Starbucks. If you identify a great location that is convenient for patients, has good foot traffic to attract new patients, and offers ample parking, then it’s almost too amazing to pass up.
You have a far-reaching online reputation
Even if you have a loyal patient base and a great location, there’s another aspect to consider before striking out on your own: online reputation. Today’s patients approach healthcare with the same expectations for ease of use and convenience that they have in their everyday life. A physician that can’t meet those expectations will suffer a poor online reputation.
Your online reputation is everything from reviews written about you, to your social media presence, to whether you can be easily found in search engines and even having a responsive website that works well on mobile browsers. Reputation management services can help get you in tip-top shape before striking out on your own. An upside will be the ability to better promote your move to self-employment and, thereby, attracting new patients along the way.
You want to be happy
Life is too short to be miserable. Someone who commits to practicing medicine is committing their life and many hours per day to their work. And as it turns out, self-employed physicians are by-and-large happier than their salaried counterparts at hospitals or large groups. According to a 2016 Medscape report, 70 percent of self-employed physicians report being happier after making the switch, while only 49 percent of employed physicians report being happier.
No one will pretend moving from a reliable salary and comfort of a larger organization to the unknown of being self-employed is an easy choice. But recognizing the signs that you are ready to move on and strike out on your own is just the first step. The second step is identifying the right partners to help make the transition as easy as possible.