Advantages, Disadvantages of Private Practice Ownership for Rheumatologists

Rheumatologists in private practice make their own professional destinies.
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When he worked for a multi-specialty practice, Jonathan M. Greer, MD, FACR, FACP, president, Arthritis and Rheumatology Associates of Palm Beach, and affiliate clinical professor of medicine, Nova Southeastern University, Boynton Beach, Fla., found that there were too many restrictions and controls and no way to enhance the revenue stream for rheumatologists. So he moved on to a private rheumatology practice in 1997.

When Elizabeth L. Perkins, MD, rheumatologist, Rheumatology Care Center, Birmingham, Ala., was interviewing for positions in 2009, she learned about a strong area need for additional rheumatologists. “The medical community, rheumatology colleagues in town and referring doctors supported my start up and growth,” she says. “I was excited to develop and brand a rheumatology practice.”

Advantages Abound

Working in a private practice allows you to control your own destiny. It’s perfect for entrepreneurial rheumatologists.

Having the ability to develop ancillary services that would give his patients better access to care was important to Robert L. DiGiovanni, DO, FACOI, FACR, Suncoast Internal Medicine Consultants, Largo, Fla., who became the eighth member and first rheumatologist of the small multi-specialty internal medicine group in 1987. “For us, that meant investing in plain radiography in 1988 and later upgrading to digital radiography,” he says.

“In 1993, we added dual-energy X-ray absorptiometry, and we have upgraded our instrument twice since then. We established a CLIA-certified laboratory on the premises and added low-field magnetic resonance imaging and two ultrasound units. We built an infusion center, which has allowed us to participate in Phase 3 studies.”

Dr. Greer finds that physicians in private practice can maintain their independence and integrity and, therefore, best serve their patients. This means they can order tests as they deem necessary, prescribe treatments as they see fit, decide which insurance plans to accept and collectively bargain with insurance companies. “We are able to control our own destiny,” he maintains.

Being in private practice also fosters entrepreneurship. “We can decide which revenue streams we want to incorporate, such as offering digital X-rays, having an infusion center and participating in clinical research trials,” Dr. Greer says.

Disadvantages

Although the perks of owning your own practice are apparent, anyone who contemplates opening their own practice should consider the disadvantages, too.

For Dr. Greer, handling payments has spawned many headaches. “Private practices have much more administrative work (than hospital-owned practices),” he says. “We have to deal with every single contract with every single payer, as well as the daily operations of prior authorizations. We have to be advocates for our patients.”