Pressures Private Practice Physicians Face Today

Practicing medicine today is more challenging than in past years due to increased administrative burdens of operating a private practice, time-consuming regulatory burdens, and hassles with getting paid by insurance companies. The year 2015 has proved to be particularly challenging with increased Medicare audits, ICD-10 implementation, and the focus on Meaningful Use 2 (MU2).

The table below details several of the pressure points facing physicians in private practice today and the solutions to help mitigate these pressures.

Pressure Points	Solutions
ICD-10	·      Engage staff to build training, testing, and documentation protocols. ·      Install an electronic health record (EHR) system that is user-friendly and able to be used by various staff members.
HIPAA	·      Implement policies to prevent staff and patients from using cell phones in the practice setting to prevent the transfer of photos, video, and other data to sources outside the practice. ·      Monitor the practice’s social media to ensure patient-identifying information, such as photos, videos, and other data isn’t being transmitted to the public. ·      Implement a security risk analysis to identify risks and record security.
Meaningful Use 2	·      Implement EHR technology and a patient portal. ·      Use only EHR vendors that have obtained 2014 certification. ·      Patients are more likely to use the patient portal when asked to do so by the physician. At the end of every patient visit, mention the portal and its purpose to patients. Include information on how to access the portal.
Maintenance of Certification (MOC)	·      To better understand the program’s requirements and to prepare for examinations, the American College of Physicians  (ACP) has developed the interactive tool ACP MOC Navigator, which is available at https://www.acponline.org/mocnavigator/.
Administrative Burdens	·      Streamline prior authorization policies to save time. ·      Record dictation notes into a hand-held recorder outside of each examination room to save end-of-the-day dictation time. ·      Consider hiring a scribe to record the patient history, physical examination findings, and provider notes. ·      Install desktop computers in each patient examination room to save time documenting at the end of the workday. ·      Type the patient history, assessment findings, and provider notes into a tablet, laptop, or desktop computer while in the room with the patient.
Independent Practice Burdens	·      If the costs and administrative burdens of running a private practice are overwhelming, consider joining a larger practice or hospital network. ·      Join an independent physician association (IPA) to align with other physicians. ·      Hire a practice consultant to help save on property, employee, and other practice costs. ·      Revamp billing and collections practices to increase income. ·      Recalibrate fee schedules to increase income.
Payer Audits	·      Document everything within reason. Print the information and keep it in a binder in a safe place in case of future audits.
Patient Satisfaction	·      Be kind to patients and take time to understand them. ·      Encourage patients to address concerns with the physician instead of posting negative information on physician review websites (PRWs).
Staff Retention	·      Hire a successful practice manager to manage staff. ·      Address workplace issues regardless of how minimal. ·      Maintain competitive pay. ·      Reward employees in meaningful and creative ways by providing extra paid time off, gas/gift cards, and tuition assistance for dependent children.
Liability	·      Patients don’t sue physicians they like and trust. Build rapport with patients and exercise a positive bedside manner. ·      Maintain boundaries with patients and don’t give in to unreasonable requests for medication and diagnostic tests. ·      Use “reasonable care” when dealing with patients.

As the table demonstrates, there are workable solutions to help overcome the challenges physicians in private practice face today. If the burdens of operating a private practice are overwhelming, consider hiring a consultant to help streamline policies and costs. Another option is to work for a large hospital system. Physicians who are leaving private practice behind and joining hospital systems is on the rise. Large hospital systems are acquiring more patients due to the influx of people from the Affordable Care Act (ACA) and are directing these patients to their physicians. This means that those physicians who are outside of the hospital network may be losing out on market share. Physicians may stand to make more money if working for a large network, but keep in mind that independence and autonomy may suffer.

“Being a physician today has its challenges, but most of us would not trade medicine for another profession. Being able to care for and educate patients is what drew most physicians to a career in medicine in the first place. Being a physician is who I am, and I am committed to helping patients to the best of my ability,” states Dr. Cockerell.

Please read the article Financial Pressures Facing Physicians Today to learn more about the financial challenges physician practices face today.

References

Cockerell, C. (2015). Lessons for Dermatology from the Tao Te Ching,. Retrieved September 28, 2015, from www.dermpath.com.  

Medical Economics (2015). Top 15 Challenges Facing Physicians In 2015. Retrieved September 24, 2015, from http://medicaleconomics.modernmedicine.com/medical-economics/news/top-15-challenges-facing-physicians-2015?page=full.

Medical Economics (2015). Top 5 Challenges Facing Physicians In 2015.  Retrieved September 24, 2015,  from http://medicaleconomics.modernmedicine.com/medical-economics/news/top-5-financial-challenges-facing-physicians-2015?page=full.