Being an independent practitioner was once a source of pride and respect. Now, it is becoming the exception rather than the norm. More and more, surgeons are being employed by larger and larger hospitals and groups. What was once a condition of strength in numbers with other independent surgeons, is now a condition of the lone wolf in a cold winter storm.
There are some common financial dangers that await many independent practitioners.
- Non-Compete Clauses: Many surgeons used to be part of a larger group practice, and decide later that they are better off on their own. More and more, larger groups, and hospital employed physicians are asked to sign a “Non-Compete Agreement” at the time of their employment with that hospital or group. This can be a real problem when and if a surgeon decides to break away from hospital employment or large group practice. In my opinion, these types of clauses should never be signed. It’s only purpose is to prevent your success if you decide to go out on your own by blocking your ability to practice in your region, where you worked so hard to establish patient relationships and patient flow into your practice.
- Too large of a staff: Today’s independent surgeon must be fiscally lean in managing a practice. A large multigroup practice, or hospital base practice, can spread the financial stress among many partners, or a large hospital corporation. The independent surgeon must run “lean” to survive in today’s market. Electronic medical records help in this by allowing a doctor’s office to simply be on a mobile laptop, rather than run by multiple office managers and employees.
- Brick and Mortar Buildings: The independent surgeon is tempted to “compete with the big boys” in large multispecialty groups or hospital corporations with deep pockets. The temptation is to build a building, and invest capital, often on loan, to have the practice appear to be solid and stable. The truth is, a surgeon’s worth is in the quality of work that they do, and not in the size and luxury of the office. With reimbursements on the decline every year, these brick and mortar investments can be a major source of stress and risk for the independent surgeon. The careful use of the electronic medical record can allow the surgeon to go most anywhere. Short term lease, or subleasing space offer the ability for a surgeon to see patients, and still be mobile with their practice. This allows surgeons to survive the many financial tides that ebb and flow during the course of a surgeon’s career.