Explore This Issue
January 2014
“Partnerships are like marriages. You need to trust your partner, that he’ll back you up no matter what.”—Drew M. Locandro, MD
In life, forging the right alliances is crucial, both personally and professionally. For physicians, this typically means finding the right partner, or group of partners, who will help you build and grow the kind of medical practice you envisioned for yourself during those all-too-common late nights in residency and medical school.
But, how do you weed out the frogs from the princes when it comes to finding a professional mate? It’s not just about choosing a fellow physician whose surgical skills you admire. What matters more, say professionals and search firm experts, is finding someone with compatible professional values, a common work ethic, and a similar approach to patient care.
“I was looking for someone who I thought was honest and had integrity, a good work ethic, and personal stability,” said Donald C. Lanza, MD, a private practice otolaryngologist and director of the Sinus and Nasal Institute of Florida, based in St. Petersburg, about his decision earlier this year to make his former fellow, Alla Y. Solyar, MD, a junior partner. “I think you have to find someone with similar philosophies to the physician group toward patient care and ethics in general,” he added. “With Dr. Solyar, I saw qualities that were genuine.”
Winston Vaughan, MD, an otolaryngologist of California Sinus Centers based in Northern California, said his partnership with fellow otolaryngologist and sinus surgeon Karen Fong, MD, works because they share the same philosophy of care. “Our surgery patients have our cell phone numbers, our emails, and they can reach us,” Dr. Vaughan said. “If I go to Jamaica to see my parents, Karen can take calls for me, manage questions or any urgent issues, and when she goes to Los Angeles to see her parents, I do the same for her. Our patients know we are in sync when it comes to their care. They know that Karen thinks like me and I think like her.”
Being able to rely on a partner is paramount. “Partnerships are like marriages: Trust is important,” said Drew M. Locandro, MD, an otolaryngologist and president of Northwest ENT and Allergy Center, a six-physician otolaryngology practice based in Marietta, Georgia. “You need to trust your partner, that he’ll back you up no matter what, that he’s doing the right thing in terms of patient care, and that he’s someone you can count on who can take care of your own patients if the need arises.”
Recognizing common values when choosing a physician partner has become increasingly important, said Tommy Bohannon, divisional vice president at Irving, Texas-based Merritt Hawkins and Associates, a professional physician recruitment firm that specializes in matching job-seeking physicians with opportunities. “The whole concept of a good fit: That’s what we’re seeing our clients focus more on,” said Bohannon. “It’s no longer questions like, ‘Do you do this procedure? Do you do that procedure? Are you okay with this frequency of calls?’ It’s more like, ‘Are you going to buy into the philosophy of the group?’ It’s become more about making sure that [physician partners] have the same goals.”
Structure
Once partners are found, structuring a partnership can be more science than art, as models range far and wide. In limited liability partnerships or corporations, physician partners typically share in profits, but the division of those profits can vary based on the number of shares a physician holds in the corporation or on a productivity formula designed to reward physicians who yield the largest gains for the partnership—or see the most patients.
Likewise, physician partnerships may be structured differently in their approach to practice management. At Northwest ENT and Allergy Center, physicians divvy up administrative work among them while still maintaining ample time for clinical work.
In contrast, Dr. Vaughan formed an alliance with a physicians’ management group in California, Sacramento Ear, Nose, and Throat Surgical and Medical Group, to oversee electronic medical record management, handle human resources concerns, and perform billing, coding, and collections services for his practice with Dr. Fong. In return, Dr. Vaughan pays the group for its services and his practice becomes a cost center in their group.
Gaining in popularity are structures in which multi-physician private practices are integrated into larger hospital systems, making physicians employees of the hospital, said Jeff Milburn, an independent consultant with Medical Group Management Association (MGMA), a membership association for professional administrators and leaders of medical group practices based in Englewood, Colo.
“Working for hospitals [that are] looking for physicians has become the bulk of our business,” added Bohannon. “The market is moving away from physician-owned practices because it’s harder for physicians to make money that way; however, there are certain specialties where you can make a decent go of it in a private practice, and ENT is one of those.”
Cost and Other Benefits
Despite the work that’s involved in finding and forging a productive union with the right professional colleague, the benefits of partnership are multi-dimensional, ranging from cost savings to new growth opportunities for your practice.
Dr. Lanza said bringing Dr. Solyar on board has helped his practice expand to allergy therapy and allowed him to follow some academic pursuits. Dr. Locandro agrees that partnering is beneficial because it can reduce start-up costs and spread the burden of office expenses and staffing over several physicians, rather than just one.
“I think doctors feel more comfortable joining existing groups for many reasons: guaranteed patient flow, support of staff that’s experienced, having other doctors that are more experienced in your group who can provide help or advice—that’s a big factor. And of course, there’s less [financial] risk, rather than starting out by taking loans and hoping it works,” said Dr. Locandro.
Regardless of how carefully physician partners are selected or multi-physician practices are structured to maximize career goals, job satisfaction and benefits for participating doctors, partnerships sometimes dissolve. Dr. Vaughan said an inability to reach accord when it came to staff was behind his decision to break off from one group. “We just had different views on how to run a practice,” said Dr. Vaughan. “There was a divergence of opinion in how to approach staff between myself and the other group.”
One of the most valuable elements of his current partnership is a healthy ratio of professional give-and-take and the ability to take advantage of shared expertise among physicians, said Dr. Vaughan. “In our group, we push each other to validate our opinions, both subjectively and objectively,” he said. “You can find business partners, but what you really want to find are brothers and sisters and mentors, because they become this family on a professional journey with you. They help you learn from your mistakes. If one of us fails, it’s all of our faults, and if one of us succeeds, it’s all of us succeeding.”
Donna Petrozzello is a writer and editor with Wiley.