Why the Healthcare System Needs Small Medical Practices

March 31, 2014

A strong healthcare ecosystem needs multiple components, with its smallest at the very core.

The idealized American healthcare ecosystem cannot survive without the independent medical practice. Before that’s pushed off as some obvious statement, each of us as Americans should think of independent practices in the same way that we think of this nation’s small businesses.

No matter your political stance, the American small business is both the engine and the driver of a strong economy. Heck, the idea of a specific day for small businesses has been heavily commercialized. The bottom line is that a strong healthcare ecosystem needs multiple components, with its smallest at the very core.

How do we as a nation rally around the independent practice?
To start, I’m not making the argument that hospital-affiliated practices are a negative part of the healthcare equation, nor am I making the point that all independent practices are doomed. To think either concept would be both irrational and not helpful to the greater, nationwide conversation around healthcare.

The reason many doctors are giving up on their medical practices is because they feel out of control, but once they go to work for someone else they quickly realize they have no control. I recently heard of a health system that laid off 18 of its doctors. Remember, this is a business after all.

In my view, rallying around the independent practice starts with the concept that all businesses (reminder: medical practice = business at core) need to rethink the way they are organized. There are actually some business models emerging where doctors retain their independence and partner with an organization to manage the compliance and apply business processes, all while reducing the complexity and cost of running a medical practice. This hybrid model allows doctors to retain their medical decision making and control over their practice. This model is rapidly becoming the viable alternative to giving up control. 

Investment - that thought brings me to a point that describes the true essence of simplicity in the practice. When I speak to physicians, I am often overcome with the most disappointment when I hear that they are "over the latest regulations," or that they "don’t see a bright future for the practice." While they are describing statements that are laced with emotion, what they are truly saying is that they are not involved in the full ownership of the practice results. This describes a lack of full investment, and a troubling evil when we consider how a practice can be thrust into success in a more simplified world.