Here are seven points for orthopedic practices when considering whether to add another physician partner.
1. Physicians are overwhelmed with patients. If the practice continually has a backlog of patients waiting for visits or surgery, it may be time to consider adding another partner. Depending on where the need is, a new physician partner may be helpful to cover call at the hospital or share the patient load, says Richard Lim, MD, a spine surgeon and partner at Midwest Orthopaedic Consultants in Orland Park, Ill. If the overflow in patients is occurring at the clinic, consider bringing on a non-surgical physician partner instead of a surgeon. That way, existing surgeon partners can spend more time in the OR.
2. Surgeon in the community leaves. If a prominent surgeon in the community moves to another location or a practice shuts down, your practice may accumulate more patients and the need for additional surgeons arises. Assess the potential for patient volume in your community before pushing forward with a candidate search to make sure another surgeon would stay busy, says Dr. Lim.
3. Strategic succession planning. When one of your senior partners becomes close to retirement, you may want to begin searching for someone who will fill the space. "If you want to be a full service practice, you may need to fill the gaps in that subspecialty," says Dr. Lim. "When you are ready to retire, the smart thing to do is have a succession plan in action." As part of the succession plan, senior surgeons can share call with their younger partners and mentor them before and shortly after retiring.
4. As community needs dictate. Communities change and the needs of potential patients also shift, which could leave gaps in coverage of a particular subspecialty. For example, there is presently an increased workload and decreased reimbursement for a workers' compensation cases. "Hand surgeons often deal with workers' compensation patients, and because of the changes in the healthcare market your practice may not want to add someone in that subspecialty," says Dr. Lim. "To make this decision, it's important to have a concept of the changes in the healthcare market. You have to do your due-diligence homework and really examine it."
5. Don't do it just to decrease overhead. Some practices may consider bringing on an extra partner to decrease overhead expenses per surgeon, but this tactic often isn't the recipe for success. "If you aren't willing to invest in a new person that comes into your practice, the arrangement won't work out," says David Ott, MD, president of the nine-physician group Arizona Orthopaedic Associates in Phoenix. "You want to find someone who will fill a gap in your practice and fits your culture. Statistically, the chance of a new graduate leaving their first practice is more than 50 percent." It's costly to bring a new physician on board and the practice loses when physicians decide to depart, so minimizing these moves is profitable for the practice.
6. Present a financially attractive deal for incoming physicians. In some scenarios, junior partners or new partners bare the brunt of the work and receive low compensation from the practice. This can be frustrating, and may drive some of the best prospective physicians away. At his practice, Dr. Ott says the practice covers new physicians' expenses as they begin their practice and guarantee a base salary. The new physicians are also able to keep what they earn. "We assess the revenues of new physicians against their expenses and when they move into a positive value situation, we allow them to keep the profit," says Dr. Ott. "We want to avoid a situation where they are working for us and we keep their money."
7. Allow new physicians to take partners without paying a penance. A supportive culture is important to most physicians, and creating that environment at your practice could give you a competitive edge among new physicians. This means treating the new physicians on equal ground with the senior partners in many situations, including new patient referrals. "We don't cherry pick the patients and just give the new physician the less desirable patients," says Dr. Ott. "The new physicians joining our practice need to feel like they have our support. If someone calls to schedule an appointment with me but I'm booked, we offer the next available physician, regardless of whether it is the new guy."
The new physicians at Dr. Ott's practice are also spared the penance that some physicians are forced to pay when they begin seeing patients at a new practice. "A lot of practices feel a new person is coming in and taking away patients, [and] therefore they should pay some type of compensation to the more senior partners," he says. "When you don't ask for this compensation, surgeons are very quick to establish a practice and grow out of the financial hole."
Related Articles for Orthopedic Practices:
5 Red Flags for Orthopedic Groups Recruiting New Physicians
5 Things to Do Before Beginning New Orthopedic Surgeon Recruitment
Successfully Attracting and Recruiting the Best Physician Partners: Q&A With Tony Edwards of Orthopedic Marketing Group
When is the right time?
1. Physicians are overwhelmed with patients. If the practice continually has a backlog of patients waiting for visits or surgery, it may be time to consider adding another partner. Depending on where the need is, a new physician partner may be helpful to cover call at the hospital or share the patient load, says Richard Lim, MD, a spine surgeon and partner at Midwest Orthopaedic Consultants in Orland Park, Ill. If the overflow in patients is occurring at the clinic, consider bringing on a non-surgical physician partner instead of a surgeon. That way, existing surgeon partners can spend more time in the OR.
2. Surgeon in the community leaves. If a prominent surgeon in the community moves to another location or a practice shuts down, your practice may accumulate more patients and the need for additional surgeons arises. Assess the potential for patient volume in your community before pushing forward with a candidate search to make sure another surgeon would stay busy, says Dr. Lim.
3. Strategic succession planning. When one of your senior partners becomes close to retirement, you may want to begin searching for someone who will fill the space. "If you want to be a full service practice, you may need to fill the gaps in that subspecialty," says Dr. Lim. "When you are ready to retire, the smart thing to do is have a succession plan in action." As part of the succession plan, senior surgeons can share call with their younger partners and mentor them before and shortly after retiring.
4. As community needs dictate. Communities change and the needs of potential patients also shift, which could leave gaps in coverage of a particular subspecialty. For example, there is presently an increased workload and decreased reimbursement for a workers' compensation cases. "Hand surgeons often deal with workers' compensation patients, and because of the changes in the healthcare market your practice may not want to add someone in that subspecialty," says Dr. Lim. "To make this decision, it's important to have a concept of the changes in the healthcare market. You have to do your due-diligence homework and really examine it."
5. Don't do it just to decrease overhead. Some practices may consider bringing on an extra partner to decrease overhead expenses per surgeon, but this tactic often isn't the recipe for success. "If you aren't willing to invest in a new person that comes into your practice, the arrangement won't work out," says David Ott, MD, president of the nine-physician group Arizona Orthopaedic Associates in Phoenix. "You want to find someone who will fill a gap in your practice and fits your culture. Statistically, the chance of a new graduate leaving their first practice is more than 50 percent." It's costly to bring a new physician on board and the practice loses when physicians decide to depart, so minimizing these moves is profitable for the practice.
How to reel in good candidates
6. Present a financially attractive deal for incoming physicians. In some scenarios, junior partners or new partners bare the brunt of the work and receive low compensation from the practice. This can be frustrating, and may drive some of the best prospective physicians away. At his practice, Dr. Ott says the practice covers new physicians' expenses as they begin their practice and guarantee a base salary. The new physicians are also able to keep what they earn. "We assess the revenues of new physicians against their expenses and when they move into a positive value situation, we allow them to keep the profit," says Dr. Ott. "We want to avoid a situation where they are working for us and we keep their money."
7. Allow new physicians to take partners without paying a penance. A supportive culture is important to most physicians, and creating that environment at your practice could give you a competitive edge among new physicians. This means treating the new physicians on equal ground with the senior partners in many situations, including new patient referrals. "We don't cherry pick the patients and just give the new physician the less desirable patients," says Dr. Ott. "The new physicians joining our practice need to feel like they have our support. If someone calls to schedule an appointment with me but I'm booked, we offer the next available physician, regardless of whether it is the new guy."
The new physicians at Dr. Ott's practice are also spared the penance that some physicians are forced to pay when they begin seeing patients at a new practice. "A lot of practices feel a new person is coming in and taking away patients, [and] therefore they should pay some type of compensation to the more senior partners," he says. "When you don't ask for this compensation, surgeons are very quick to establish a practice and grow out of the financial hole."
Related Articles for Orthopedic Practices:
5 Red Flags for Orthopedic Groups Recruiting New Physicians
5 Things to Do Before Beginning New Orthopedic Surgeon Recruitment
Successfully Attracting and Recruiting the Best Physician Partners: Q&A With Tony Edwards of Orthopedic Marketing Group