Medical Practice Growing Pains

For those that have following this blog for some time, you know that we’ve had our practice for 7 years.

We started very strong. Since the beginning, it has been an upward trend. About a year after we opened, it was evident we needed a new doc. It took us a year to find someone, so 2-years after opening our doors we hired a physician. The growth continued after that. More people, more computers, more space, more work hours.

As the data started to come in, we realized that since the trend was upward, we could really benefit from bringing in a third doctor. Not to mention we would start to create synergies that would otherwise be difficult to achieve with just 2-doctors.

Two and a half years after our second doctor joined, we hired a third doctor. And the timing was perfect. The third doctor joined in the middle of the 2009 swine flu season. I padded myself on the back for having timed the hire perfectly.

Then, the well dried up. After the swine flu scare died down a bit, the practice became almost a ghost town. With the exception of the senior doc, nobody else was busy. Our junior MD was seeing 7 to 8 patients a day. And our 3rd physician would see 2, maybe 4 patients a day.

I told everybody not to sweat it. The patients were going to come back. It was February and we were right smack in the middle of our traditionally busiest season, so I assured people that “things are going to pick up.” It didn’t.

To make matters worse, we were in the middle of an intense negotiation with our junior doc. The issue? Money, of course. The doctor believed she deserved more money, and I believed we were already being too generous. After about six months of going back and forth, the junior doc and the practice parted ways. We could not find a way to make it work.

We regrouped, learned from the experience, and moved forward.

The economy, the lack of access to capital, the increase in Medicaid patients and the negotiations with the doctor actually made me think completely different about how to better manage the practice. I realigned our priorities, drafted a plan and began to execute it. And the adjustments we made actually made a big difference, at least financially.

It took us a while to bounce back financially from the patient drought we had after the 2009 swine flu debacle, but we came back strong. I would even argue that we came back stronger than ever. Things were looking up for us again. We even started to look to replace the physician that had left the year prior. But something else was brewing.

Despite the practice getting back on its feet from a financial standpoint, on the employed physician front, things were starting to crumble. It was evident after several meetings with the doc that remained,  things weren’t going as well as we thought.

The issue this time? Honestly, I have no real idea. I thought everything was going fine and one day, it wasn’t. Thus, this past February, we parted ways once again. And as a result, we’re a solo physician practice once again. In other words, we are back where we started seven years ago but with the infrastructure of a 3-doc practice.

I share this with you all for several reasons. For one, it is humbling. Secondly, this blog is about sharing the good and the bad (not sure which category this one falls into yet. As they say, it is better to be alone than ill accompanied). Lastly, the blog is also intended to give you all a glimpse inside a small practice and what it takes to run it. Or maybe subconsciously I know that people love drama. We have decades of reality TV to prove that theory.

I don’t have a lesson, something to point out or a word of advice. Just a developing story.  However I do think that talking about our shortcomings can bring value to both the readers of this blog and myself .

As the months go on I’ll share with you all what we are doing as a result of our new developments and how we plan on moving forward. As a teaser, let me jus say that Rome wasn’t built in a day; or seven years for that matter…

To be continued…

1 thought on “Medical Practice Growing Pains”

  1. Hopefully, dissecting out the last 2 years helps you to see things that could have been dealt with differently. It sounds like your ‘financial restructure’ should have come before you became a 3 doc office, and this could have led to downslope of the practice. I have learned from running my own business for the last 5 years, that the patients are what ‘makes and breaks’ the practice. If you aren’t keeping your customers happy, then the business can’t grow, no matter what the economy. And this job is not just for your docs, but for you, so you can make the proper financial and management decisions. And if your employees aren’t happy, your customers pick up on that. But now, this will give you , as a practice a chance to restructure your priorities and vision. Good luck this time around.

Comments are closed.