Doctors across the country are struggling to maintain their independence. According to RevCycle Intelligence, 31.4% of doctors identified themselves as owners or partners of independent practices in 2018. This is the lowest number since the survey was started in 2012. Anesthesia practices are no exception to this trend.
It’s a challenge to remain independent as national organizations continue to gobble up smaller anesthesia group practices.
It’s Challenging to Remain Independent…
As healthcare continues to change, this continued consolidation isn’t surprising. Independent practices are faced with increasing regulation, declining reimbursement, and the psychological price of bureaucracy. Many anesthesiologists feel like they are working so hard to remain independent, that they have become an employee of their own business and might as well sell out.
…But Some Independent Anesthesiologists Are Thriving
While it may sometimes feel like an uphill battle to remain independent, it is not just possible but highly rewarding. The fact is, although it takes a lot of dedication, remaining independent means you have significantly more control over your compensation and working conditions.
Here are 4 key reasons to hold onto your independence:
1. Practice Leadership
Independent anesthesia group practices get to decide how things are run. This includes the ability to decide the governance structure, who will lead the group, and who the group employs. Larger groups may promise decision-making power when trying to make an acquisition, but these promises often have little to no enforceability.
2. Practice Operations
When you’re independent you can oversee general group operations like compensation, retirement plans, vacation, scheduling, the use of CRNAs and mid-levels, and general staffing levels. However, if you become an employee, all that decision-making power goes away.
The bottom line is that the only way to control your destiny is to maintain your independence.
Beware of Promises of Profit Sharing
Some anesthesiologists are enticed into mergers based on a combination of an initial payment and ongoing profit sharing. However, it is surprisingly common for these new owners to do a poor job at billing, collections, and other centralized services. This can drastically impact anticipated payouts for profit sharing. When considering a merger of this type, fully explore the potential impact of lowered profitability before moving forward and consider asking for some kind of guarantee around the performance of critical services like billing and collections.
3. Hospital Contract Negotiations
Hospital relations are challenging, but when you are independent you contract directly with your hospital. You can choose how you want to negotiate and sign contracts that are beneficial for your group and the hospital. As an employee, you have no negotiating power. What’s more, if your new owner ends up losing the contract, you might be forced to leave your home and move to a new region based on the non-compete agreement you had to sign when you joined.
4. Job Security
In general, as a shareholder of an independent group you are protected from being arbitrarily fired. To be fired, you (typically) need a super-majority vote among members. If someone outside the organization wants someone fired, like the hospital, then the group ultimately makes that decision. However, as with everything else on this list, once you are an employee you can be terminated for a variety of reasons.
Who do you want in control?
The main question when it comes to your anesthesia practice group and your life is “Who do you want in control?” Some hospital executive might focus on making surgeons happy and another might be focused on profits. Would you rather have these disconnected individuals making decisions that impact your life or another physician who you get to elect and who understands your top concerns?
Do you want an outside executive in control or one of your peers?
Here’s How You Can Ensure Your Anesthesia Group Practice Remains Independent
Here are four actions your practice can take to stay independent:
1. Strategic Planning
Developing a strategic plan allows you to determine the future of your practice. It involves defining the purpose of your group, setting goals, and coming up with a plan to meet those goals. It’s recommended that you review and refine your strategic plan regularly to determine your progress.
2. Grow Your Business
The evolution of the healthcare market has made it essential for anesthesia group practices to provide cost-effective and high-quality care by growing. Many groups feel they can achieve these requirements with slightly larger practices. Single-specialty mergers can be a good solution for small groups who want to remain autonomous but have increased security. You will have to relinquish some control but ultimately can remain independent.
Besides specialty mergers, anesthesia practices should expand their businesses to other locations and systems. Practices who choose to constrain themselves are exposed to increased risk. Expanding to other options like ambulatory surgery centers can improve payor mix and provide less reliance on hospital services.
3. Establish Strong Group Governance
As an independent anesthesia group practice, you need to establish strong group governance. Successful groups create a culture that supports discussion regarding critical decisions. You should aim to develop a system that establishes a decision-making body, determines authority for various participants, and enhances group communication.
4. Find a Team to Support You
Remaining independent as an anesthesia group practice has a huge range of benefits. While there are many elements to consider, the right partner organization can help support you and provide you with the tools you need. We recommend finding a partner, like Fusion Anesthesia, that offers the comprehensive services required to run your practice.
Don’t feel pressured into joining a larger group that promises “more revenue” – you can do it all on your own with the right partner.