When to add—or subtract—physicians

The era of bigger is better is over. There's no one-size-fits-all when it comes to expansion decisions, but here are some guidelines.

By Wayne J. Guglielmo
Senior Editor

Was it really less than a decade ago that doctors, worried about the power of managed care, sought safety in numbers by forming larger and larger group practices?

"The mid-90s were a very unusual time, when emotion overwhelmed business sense," says David C. Scroggins, a practice management consultant with Clayton L. Scroggins Associates in Cincinnati. "But mergers, like anything else, need to be based on sound business reasons if they're going to work."

Consultant Jeff Denning from La Jolla, CA, agrees. You need to ask yourself "what problem am I trying to solve or what goal am I trying to achieve," he says.

Now that the bigger-is-better mania is over, it's time to ask those questions again. Depending on the answers, some practices may need to get larger, adding not only more physicians but more support staff and office space. Other practices can do quite well by simply maintaining the status quo. And still others may need to downsize.