HealthFebruary 07, 2020

Is group medical practice for you? Pros and cons of having medical practice partners

By: Whitney J. Palmer
Joining a group medical practice is a great option for some physicians. Here’s what to know when deciding whether it’s right for you.

A group medical practice is a professional option you can consider at any point during your career. Whether you’re not up for the work of starting your own solo practice or you want to get out of a hospital setting, a group practice comes with its share of benefits and drawbacks, each of which you should know before making a move. Here are the considerations to keep in mind.

The pros and cons of group practice

Before deciding whether group practice is for you, there are several things you should consider. Be sure to weigh both the positive and negative attributes of having several medical practice partners prior to signing a contract.

Positives

  • Multiple specialties – In many instances, joining a group medical practice gives you the opportunity to work with providers from other specialties. According to money management publication PocketSense, this one-stop-shop model can attract a significant number of patients because it’s a convenient way for them to receive all their care in one location.
  • Increased strength – With more medical practice partners, you’ll be in a stronger position to negotiate with insurance companies. Together, you and your colleagues can brainstorm the best ways to work with insurance providers to ensure the best reimbursement rates. Additionally, more veteran providers can share their experiences and accumulated knowledge with younger group members.
  • Shared costs – In a group, doctors also share expenses, limiting one another’s financial liabilities. The cost of expensive equipment that performs diagnostic screening or patient treatments is distributed among providers, as are administrative costs and risks. This way, should the practice experience a downturn, everyone loses less money.
  • Diversity – With more medical practice partners comes a wider variety of perspectives and skill sets. While you might excel at managing the practice’s money, your colleague could have a particular strength in marketing. A larger number of voices also increases the likelihood that your group will be able to identify and weed out bad practices.
  • Shared personnel – Nurses, lab technicians and administrative staff work with every doctor in a group medical practice. Consequently, if someone calls in sick, the other personnel can step in to cover those responsibilities.

Negatives

  • Conflict – Participating in a group medical practice can sometimes feel like having too many cooks in the kitchen. With so many individuals with an interest in the practice, disagreements can erupt. Mainly, these problems surface over potential changes to the practice or over patient referrals. To avoid or solve these problems, it’s critical for every practice member to develop effective conflict management skills.
  • Compensation – This practice model frequently offers less flexibility for you to determine your compensation, particularly if you’re a new group member, according to PocketSense. Long-term physicians set the rules, so it’s unlikely you’ll get to choose whether you’re paid on your productivity and patient numbers or with a set salary.
  • Different patients – Unlike in a solo practice, in a group practice, you’re frequently asked to see patients who aren’t your own. Not only are you unfamiliar with them, but they also don’t know you and might be less trusting of your skill set.
  • More hours – At least in the beginning, it’s possible you’ll have to work more hours than doctors who have been with the group longer. That said, you still may spend less time in the office than you would as a solo practitioner.

Signing on to a group practice

If you’ve decided that joining a group medical practice might be best for you, what’s next? After you’ve identified a potential group practice, according to business attorney Matt Dickstein, investigate whether the group office is in a position to take on a new partner. Can they offer you enough coverage hours, and do they have an existing system for how to share employees and divide money?

Once you’ve determined there’s a place for you, discuss compensation. Does the group offer its medical practice partners a salary, providing the same compensation to every provider, or does it offer productivity payments? In that model, you’ll be paid based on your patient numbers and collections. If the practice relies on productivity payments, get a clear explanation of the formula they use to determine compensation, Dickstein advises.

Additionally, he says, get specifics about the rules surrounding buying into the practice. You might be required to wait a year before truly discussing the partnership. Before that conversation, find out what ownership percentage you’ll be allowed to purchase, how much it will cost, how long you’ll have to pay the purchase price and the extent to which you’ll be able to influence decisions affecting the practice. For example, will you be allowed to serve on the practice’s board of directors?

Even though it’s the beginning of your tenure with a group, you should plan for a potential exit or buyback strategy, too, Dickstein suggests. Get a list of events that could trigger a buyback, such as employment termination, loss of license, disability, bankruptcy or death. Your exit strategy should allow for a buyback of your practice portion should any of these triggering events occur, and it should include the buyback price.

And, perhaps most importantly, review the specifics of any noncompete clauses in your potential contract before signing. In most buyback cases, a group practice can limit your competitive actions in the same geographic area for a certain period of time. Know exactly what the limitations might be.

Working with practice partners can offer a number of benefits, but consider all your options carefully before embarking on this next phase in your medical career.

Whitney J. Palmer