Weighing The Pros And Cons Of Podiatry Supergroups

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Lowell Weil, Jr., DPM, FACFAS, MBA

   Part of the success of supergroups is to create institutional consistencies, even in the delivery of care. In doing so, there can be less freedom for individual physicians to choose patient care but instead follow “best practices” established by the group. While this can improve patient outcomes and reduce healthcare costs, physicians who join the supergroup often resist.

   Consistency of care is also important to the staff. As the staff has to deal with more physicians, there can be confusion about the needs of the physician, which leads to chaos and poorer patient experiences. Consistency of care is paramount to the success of supergroups. As the group becomes larger, the level of consistency must be even greater to ensure that the brand is delivering what it promises. Some physicians are just not capable of working within these parameters.

   All supergroups have processes in place to divvy up patients to the physicians. However, as a group becomes larger, there is an inevitable confusion as to which doctors are to see which patients. There has never been a supergroup that hasn’t had issues and arguments about the way in which patients are distributed and this can often lead to rather significant problems among the physicians, management, staff and patients.

   Furthermore, the larger the group, the greater the risk of losing the “personal touch” associated with a doctor-patient relationship. For years, patients had been used to calling the office and talking to the person they have known forever. Now this person will be replaced by an impersonal voice without a face that asks terse questions about insurance and other things never discussed on the telephone before. Some people are not ready for Home Depot replacing their local hardware store. There is a danger that some patients will become dissatisfied with this new delivery of care and seek their medical treatment elsewhere.

   The process of joining a supergroup is usually not easy. The practice will have to adjust its way of performing medical records, answering the telephone, ordering supplies, delivering patient care, billing and getting their paycheck. For sure, there will be employee attrition with possible temporary or long-term unhappiness for employees and, in some cases, the physicians with the change of culture.

   Creating a supergroup is expensive. There is the highly compensated management team, legal fees, capital investments and the cost of transition. If the group is not managed well and there is not buy-in by the physicians, then these costs will outweigh any expected increased profits. In fact, if poorly executed, the supergroup can be a financial disaster.

   Lastly, the cost of a failed exploration into a supergroup can be quite expensive. Legal fees can add up quickly. Additionally, if the new venture does not meet a person’s expectation, the extraction of a practice from a supergroup can be painful and expensive. As one considers joining a supergroup, do as much “dating” as possible and find out if the supergroup is right for you. Additionally, understand terms before getting attorneys involved. Paying attorneys can be the most maddening part of any business deal.

In Conclusion

Private and small group practices are at a crossroads due to the rapidly changing healthcare environment. Issues such as payment reform, capital investment and technology are causing many private practice physicians to reevaluate their futures. For some, the future is creating or joining a supergroup. Those who choose to remain independent will face significant obstacles.

   To survive and thrive in the new world of healthcare, practices must have strong physician leadership, solid management and good governance. Many will choose to take on these challenges alone while others will band together and form a strong, unified group that can effectively weather the storm that lies ahead.

   Dr. Weil is the President of the Weil Foot and Ankle Institute, which has 18 physicians in 16 Chicagoland locations. He is a Partner of Foot and Ankle Business Innovations, an organization that helps practices realize their full profitability. To find out more, visit www.FABI2014.com .

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Dr.Alberto Rivera Zenteno,MDsays: December 3, 2013 at 8:17 pm

I really appreciated this wonderful info and guide to work better as group or working with partners-friends in Mexico.

Have a good day! Thanks again.


Alberto Rivera, MD

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Dr DPMsays: December 26, 2013 at 11:28 am

One of the perks about working in a multispecialty supergroup medical clinic (of more than 10 physicians) is that if you represent podiatry as a minority in a sea of many MDs, MBBSs, and DOs, it is inevitable how much you, as a BE/BQ/BC licensed podiatrist, have to educate the BE/BQ/BC licensed allopathic and osteopathic physicians about your profession. I myself have the unique experience of doing this. It is the best part of my job!

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