Fresh perspective for financial success

4 Questions To Help You Decide If It’s Time To Add A Partner

Most practices will eventually need to add another physician, either due to increasing demand or in order to maintain capacity. You are busy, seeing more patients than you can really handle. You think it is time to add a partner, but how do you know?

Can we afford to add a partner?

Adding a new partner is an expensive proposition that may require you to add salary, personnel, equipment, and supplies. And early on, it is likely you will spend more than you take in. The quicker your new partner becomes busy and productive, the faster your practice will break even and begin making money. Increased revenue is more likely to happen sooner if:

  • One of the members of your practice is slowing down or retiring
  • Wait times for routine appointments or procedures are lengthy
  • Your practice is unable to add needed surgery days due to clinic responsibilities
  • You are frequently referring surgical procedures outside your practice
  • You are frequently referring subspecialty cases outside your practice

One additional possibility to consider is ancillary services. While your group may not be able to support certain radiological or other procedural services that are commonly used in your specialty, additional physicians create the need for additional ancillary services. More physicians joining your practice may create an opportunity to own that technology, rather than referring patients outside of your practice for those commonly used services.

How efficient is your practice?

Do you have so many patients in your waiting room that you cannot keep up? Do you need to add another physician or are there other ways that you could be more efficient and see more patients that are less costly?

One simple way to see if you could be more efficient is to ask yourself “Would I pay another physician to do this task?” If the answer is no, maybe you should not be doing that task.

Are you doing work that others could be doing? For example, do you generally discuss with patients what results you expect from a lab test and let them know that your nurse will call with next steps if those results are as expected? Could you delegate some data collection tasks to your staff? If you choose to do this, you will need to teach your staff how to collect quality information and make sure they know what sort of information you need to be made aware of.

Additionally, you can create protocols that will allow you to make the most of your time with patients. Nurses can potentially perform tests for specific conditions. This will save you time and allow you more time with the patient. For example, nurses can perform throat swabs for a rapid strep test in patients presenting with a sore throat, A1Cs for diabetes monitoring, and urinalysis for UTI symptoms. All of these scenarios represent opportunities for you to improve efficiency that may obviate the need for a new MD.

Could we add a mid-level provider instead?

Adding a new partner will be an expensive process. It may well be worth asking yourself if adding a nurse practitioner or physician assistant might allow you to achieve your goals at a lower cost.

One strategy allows a mid-level provider to see lower acuity problems, such as coughs and colds, so that you can focus and spend time with more complicated cases. Mid-levels can also increase patient access, provide same day appointments, interval visits or do routine follow-ups. Finally, you could allow a mid-level to focus and develop competency in a specific area like diabetes or acne.

Would merging practices be a better option?

Merging your practice with another may allow you to create economies of scale, such as sharing staff, ancillary services and technology costs. The cost of lab, billing, and accounting processes can potentially be reduced. Mergers can improve quality of life by decreasing the amount of time on call per practitioner. Larger groups may be able to more effectively use non-physician providers as well, by generating patient volumes that can support other services, as previously mentioned. In addition to radiologic services, a larger practice can support specialty personnel such as diabetes educators, physical therapists and counselors.

While it may seem that adding a new physician is needed at your practice, you need to get clear about your goals and ask appropriate questions in order to determine whether you can justify the expense.

Dr. Pat Bass

Dr. Pat Bass is a physician, writer, educator and scientist that cares for both adults and children. Currently an Associate Professor of Medicine & Pediatrics at Louisiana State University Health Science Center in Shreveport, he participates in an active clinical practice, medical education activities and health literacy research. View full bio on authors page