“It may not necessarily be part of your design, but if your overall goal is to be large enough to be a force in the specialty in your region, then you [need to be] mentally prepared to work out such acquisitions, mergers or expansions because they serve that goal,” says Dr. Baraf.
Benefits of a Large Practice
Both Dr. Baraf and Dr. White have worked in large practices for several years and cite several advantages to being one of many physicians in a practice: the economic cushion, access to services and the opportunity to easily consult with fellow practitioners.
“I have easy access to colleagues in a number of fields. I have easier communication with them since we have a unified EHR [electronic health record], and being in a large group affords me advantages like being able to go to interdisciplinary conferences,” says Dr. White. “I think there’s a bit of a buffer, or you might call it a bit of insulation, between me and some of the economic forces, which are felt more directly by people who are in solo practice or practice in small groups.”
Many direct benefits also exist for a patient seeing a doctor who works in a large practice. The doctor can provide a better range of services in one location.
“A larger number of physicians can justify the presence of ancillary services, whereas a [practice with a] small number of physicians can’t, so that … makes delivering a fuller complement of services to the patient more economically feasible,” says Dr. Baraf.
This is, of course, also a benefit to the rheumatologists, who are better able to do their jobs when having access to these services, including on-site X-rays, laboratories and bone density testing.
“Our model of practice is we feel that rheumatologists provide the best service when they can provide most of the ancillary services themselves. So a rheumatologist should look at their own X-rays; they should have their own laboratory,” Dr. Baraf explains. “It sort of dilutes and degrades the nature of the service that we are able to provide if we don’t have our hands on, and our arms around, these services.”
Challenges to Bridging the Gap
The benefits of merging practices, however, should not obscure the difficulties and hard work it takes to make a smooth transition. The challenges that come along with bringing on a partner range from agreeing on a set of goals to working out compensation formulas.
