Resources used at these practices include product pamphlets, non-sponsored informational handouts, ACR publications and more.
The Biggest Challenges
Working as a community practice rheumatologist has challenges, some of which are faced in academic and research settings and others that are more specific to private practice. For example, the staffing concern in rheumatology is a real issue because of a growing population in need of this specialized care, Dr. Chatwell says. “Younger rheumatologists often have never had any exposure to private practice and the benefits that it can offer. We are the front line of rheumatologic care,” he says. This is one reason he thought it was important to participate in the ACR’s new Community Practice Council, made up of rheumatology professionals from small or independent practices, as well as two slots for fellows.
Dr. Magnano also sees staffing as major challenge, in addition to inconsistent practice income and navigation of the insurance contracting landscape. “I think that contracting with payers may be the ultimate demise of private practices, simply because private practices lack the leverage of larger, more corporate groups to negotiate evaluation and management reimbursement that keeps pace with inflation,” she says. She notes that overhead costs have increased 6–8% annually since the pandemic but that reimbursement is stagnant or falling. “To continue to provide excellent care, we need to be able to negotiate more lucrative contracts or become more creative in our efficiencies and overhead cost containment,” Dr. Magnano says.
To help address the challenge of overhead costs and running a business, Dr. Daugherty’s practice is a member of American Arthritis and Rheumatology Associates/Bendcare, a group of independent practices that are owners and customers of a rheumatology cooperative operating in 23 states with more than 300 providers. “This organization understands our needs in a way that hospital-based systems do not prioritize and simply don’t understand. We access many services from our supergroup,” he explains.
The Rewards of Community Practice
Rheumatologists in private practice can still follow research avenues or special areas
of interest. Learn more here.
Despite the challenges of working as private practice rheumatologists, there are also many rewards. Dr. Daugherty sees a leadership role for private practice rheumatologists in such areas as precision medicine and healthcare economics.
“Having the flexibility to go the extra mile for my patients is the most rewarding aspect of private practice,” says Dr. Magnano. “Because I have the ultimate autonomy in patient care, I have the time and flexibility to make extra calls to patients late at night or circle their other doctors together to develop a thoughtful care plan. I think that patients really value this extra effort and are truly appreciative for my care.”
