Giving, and getting, back to your practice and community

June 10, 2011

When 34 very diverse primary care physicians join together into a single group, some differences of opinion and varying styles of practice are bound to occur.

Our problem arose in trying to determine how to compensate individual doctors for nonrevenue-producing work.

Besides seeing patients in the office and providing quality care, our mission statement says that we will be community-oriented.

Our goal was to find a way to reward these nonpaying services provided by our doctors to the community or to the group itself.

A MIX OF PERSONALITIES

We joined together a conglomerate of personalities, of which not all participants agreed that "community service" was a worthy endeavor. In addition, not all of the physicians were that interested in helping to run the group itself.

For a large group to survive in today's competitive medical environment, much work needs to be done that does not involve a doctor-patient relationship. We have several committees to help guide our medical practices, such as a clinical committee and a strategic planning committee, just to name a few, that all need to be chaired and run by the physicians.

The business of medicine is indeed serious business, and not all doctors are as skilled in office politics or insurance negotiations as others. The idea was to come up with a way to reward the doctors for nonrevenue-generating work, to encourage the group members to volunteer to get the jobs done to run our practice, as well as to keep our name out in the community as a medical group that cares.

Each and every member of our group has one or more distinct skills.

The one doctor with the inferiority complex turned out to be great at negotiating for more money from the insurance companies, but he is not a "warm and fuzzy" clinician. The "granola" doctor wanted to focus on not using paper plates in the break room, but she wasn't very interested in meeting with the local hospital representatives in regard to forming strategic alliances.

Another physician said he didn't care if his patients smoked, and he wouldn't participate in a smoking cessation booth at a community fair. The arrogant doctor who always puts himself before others refused to attend meetings, because he needed to go fishing. The fellow who was unabashed by his "natural body functions" in the office was a very savvy 401(k) representative with the bank.

Two part-time doctors couldn't make morning meetings because they were committed to getting their children onto the bus, so the committees to which they belonged met at lunch or on Sunday nights.

With this mismatch of personalities, and collection of differing priorities, we had to come up with a solution to make it all work.