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Alternative practice, payment models have growing appeal
e-Reports, Nov. 17, 2014
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The last issue introduced you to ISMA member physicians who are practicing in a way that is different from traditional fee-for-service medicine (See here). In this issue, Andrew Hector, M.D., of Honey Grove Concierge Medicine in Center Grove and Carmel’s Matthew Priddy, M.D., of Priority Physicians PC offer some solid advice for their colleagues who may be considering alternative ways of practicing medicine.

Cautions and considerations

Dr. Priddy
Matthew Priddy, M.D.
Priority Physicians PC

Dr. Priddy pointed out that direct pay is not a good option for winding down toward retirement. “It’s not easier, just different,” he said. “I do it because it is more rewarding.”

Adding caution, Dr. Hector said, “Count on losing money for a while.” You must be able to support yourself while building up the practice, though he noted more of his patients are now returning. “Some patients seek care elsewhere initially, but the higher level of care we offer often leads them to return,” he said.

Dr. Priddy agreed that in the first year, income will decline. However, he said long term, income would be similar to what you earned previously. “Long, long term, you will do better than someone who is an employed physician. Doctors I know who are doing this all earn more than the MGMA (Medical Group Management Association) average.”

Before you commit to changing the way you practice, he suggested you consider:

  • How you want to practice and what exactly you want to do. Many models exist and you can decide what suits you best. “The doctors I know who were not successful did not know what they did not know from the beginning. They did not know what to offer and so they did everything,” said Dr. Priddy. If you become too busy and cannot sustain the service, patients will leave.
  • Contact someone who has made the switch. You can contract with national companies, such as MDVIP and SignatureMD mentioned previously, but you’ll give up some autonomy and pay franchise fees.

    The American Academy of Private Physicians (AAPP) also has a list of consultants with proven track records in practice conversion. Contact Drs. Priddy or Hector for advice or talk to other physicians who have made the switch.
  • Obtain good legal advice. The ISMA and the AAPP can connect you with attorneys who specialize in this process.
  • Communicate with your current patients. Consider whether $25 or $40 a month would keep most of your patients from continuing to see you. Failure happens when doctors don’t handle this communication properly.

Business and marketing

Dr. Hector
Andrew Hector, M.D.
Honey Grove Concierge Medicine

Dr. Hector advised, “If you’re changing to this kind of practice, it is very helpful to have a good sense of how to run a business. The more you have to rely on outside consultants, the more expensive it will be for you to start your practice.”

He noted that new direct pay practices often have to market their services since patients will no longer be picking the practice from an insurance book – and often are unaware of the benefits of direct pay practices.

Dr. Priddy has not personally accepted new patients for the past five years, and many of his patients have been with him for the full 12 years he has done direct pay. His practice continues to grow, and they have recently added a fifth physician. Dr. Hector noted that some of his patients moved into the area and found him online because they specifically wanted to continue with a concierge practice.

Changes have been coming for a while, accelerated by the increasing prevalence of high-deductible health plans, and Dr. Hector sees these changes leading to more innovation.

“While increasing deductibles are increasing the burden to many patients, at least they are spurring innovation. Savvy patients are now shopping for the best value for their health care dollars,” he said. “These patients are rewarded with higher quality, lower cost or a combination of the two.”

Why are these doctors ISMA members?
Physicians like those at Honey Grove Concierge Medicine and Priority Physicians PC don’t need the coding and claims assistance that the ISMA provides daily to its members. So why do they renew every year?

They tell us it’s important to be part of their state medical society for the information they receive and the exchange of ideas the ISMA facilitates. That’s in addition to ISMA’s advocacy on behalf of patients and physicians. But there are other important and useful benefits.

The legal questions answered on the ISMA website can save hundreds of dollars in hourly legal fees. And a legal kit the ISMA offers details the steps members can take to set up a new practice.

ISMA’s Physician Assistance Program can address concerns you may have about yourself, your patients or your colleagues. The program is both highly regarded and highly successful.

If you need more reasons to renew your membership, listen to this message from your colleagues.

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