Solo practitioner Paul Sueno, MD, had a good idea of the challenges he would face when he opened his private practice in Tacoma, Washington, in 2012. His late father, also a physician, had practiced in the same community, and Sueno grew up helping his father and learning about medicine.
Immersing himself in every detail, from filing insurance claims to selecting equipment, Sueno has built the four-employee practice from the ground up. But now that he’s gotten a handle on the business side and made it through some “nerve wracking” moments, Sueno says the practice is doing well—and he is glad he didn’t become an employee of a giant organization.
“I want to go to work every day enjoying what I do,” Sueno says. “I don’t want to go in thinking I have a little more money in my pocket but dreading the work experience, knowing I’d have to work for a certain bottom line.”
As Sueno has found, it is possible to maintain your independence without going broke, even in an environment that is increasingly challenging for physicians who own their own practice. But we won’t kid you: You’ve got to become the equivalent of a mixed-martial arts champion in practice management.
As our list of the top 15 challenges for 2015 underlines, physicians will need to navigate some tough obstacles in the coming year. These include the increased costs of operating a practice, time-consuming regulatory burdens, and hassles with getting paid by insurance companies.
The pressures are not likely to abate any time soon, thanks to a trifecta of regulatory changes impacting physicians. Starting January 1, 2015, physicians’ payments will be increasingly tied to providing higher-value care under the Affordable Care Act. In February, financial penalties kick in for practices that could not attest to meaningful use. Then in October, the ICD-10 transition deadline finally arrives.
Perhaps it shouldn’t be surprising that, in this constantly changing ecosystem, more practices are struggling to maintain financial homeostasis.
“It used to be that physicians made enough money that they could let a lot of things slide,” says Cindy Ackrill, a non-practicing physician based in Alexandria, Virginia, who coaches physicians in areas such as leadership and stress management and sees some suffering from burnout. “It used to be that physicians made enough money that they could let a lot of things slide. The margin is so much thinner now. You do have to micromanage the money. No one taught us to do that.”
That’s the bad news. The good is that it’s possible to maintain a viable, even thriving practice if physicians confront challenges and identify fixes that can improve their lives and the health of their patients.
There are concrete steps physicians can take to minimize the burdens of these challenges. When it comes to ICD-10, for example, physicians can engage their staff now to build training, testing, and documentation protocols that will best serve the practice when the transition occurs.
As Sueno has found, it is possible to learn—and still take good care of patients. The following coverage details the 15 challenges every primary care physician needs to master to succeed in 2015.