The Future of Medical Practice for the Long Haul

Susan Turney, MD


October 19, 2012

What Did You Want to Be When You Grew Up?

I was in kindergarten when I decided I wanted to be a doctor. My teacher told me that girls couldn't be doctors. But I wanted to be one and I've never regretted the decision.

My professional experience has covered the gamut, from full-time physician to clinical administration, and I'm currently the President and CEO of Medical Group Management Association - American College of Medical Practice Executives (MGMA-ACMPE), the largest membership association for medical practice professionals in the United States. As I prepare for the MGMA 2012 Annual Conference that's just around the corner, I've stepped back and reflected on my path, on what I had envisioned for my future and my drive to care for patients.

Susan Turney, MD

Do you remember why you became a physician? Or do you recall what you thought being a doctor meant before you began practicing medicine? Does it even come close to what your experience has been? With all the transformation that is taking place and the rapidly evolving models of care, where I am now is certainly not what I had originally envisioned.

Today, more physicians are practicing in hospitals than before. There's been consolidation, aggregation, mergers, and acquisitions of groups. One seismic shift in the model of care is the formation of larger and more robust health systems in an effort to provide the breadth and depth of services they believe their patients and communities need.

In the midst of all this transformation, it's evident that one size doesn't fit all. You have plenty of choice -- from joining a fully integrated organization to remaining small or independent. There are benefits and challenges in any model you choose. I encourage you to look closely before deciding on your path.

If you are considering integration, look at the culture you are joining; recognize that you might not have the same autonomy or the same say in governance as you had before. Go into it with your eyes wide open. And if you're considering remaining in a small or independent practice, determine the best and most efficient ways to deliver quality care to your patients.

What You Should Be Thinking About

Although there's no magic, step-by-step formula for success, if you're committed to staying small or independent for the long haul, there are some basic issues I believe deserve your reflection:

  • What are you doing?

  • Why are you doing it?

  • What are the outcomes

  • What do you need to do to improve the outcomes?

  • What are your relationships with other physicians, practice managers, staff, other hospitals, your patients, and your community?

Successful groups have built a solid bridge of communication between the clinical side and the business side of the practice. Throughout my professional work -- in the practice, as an administrator, or as an association executive -- I witnessed again and again practices that lacked that bridge, that understanding. They didn't speak the same language. They didn't comprehend the important role each played in working hand-in-hand to best serve the patient.

I've seen plenty of ways that physician-administrator teams pull together, ways they bridge that communication gap successfully. They've learned that their total value is greater than the sum of their individual parts to ensure quality patient care.

Two outstanding examples of the value of physician-administrator teams are Virginia Mason Medical Center in Seattle, Washington, and Academy Women's Healthcare Associates in Colorado Springs, Colorado. Their team approach has demonstrated value without question for all involved. And in the midst of all the regulatory and legislative changes that are happening, the physician-administrator team approach ensures that physicians are able to do what they do best: care for patients.

Over the long haul, I believe that the future of medical practice is bright. We're doing plenty of things right. And to meet the challenges of the new healthcare environment, we have to be careful not to throw the baby out with the bath water. Forecasts for an aging population suggest that our services will be needed more than ever. If we don't figure out how to keep physicians in practice and to adapt to new models of care, then we're not going to have enough physicians to take care of our patients and best serve our communities.

My vision has changed since that day in kindergarten when I decided I wanted to be a doctor, but my dedication to helping patients has been unwavering. I believe that the future of medical practice is wide open. That means your choices are wide open as well. I encourage you to step back, take a breath, and make your decision with your eyes wide open.