For physicians pondering a move to private practice, a thorough understanding of the environment one may join is paramount.
A veteran private practice physician who now consults on operational aspects of running a private practice, Asa C. Lockhart, MD, is well versed in the advantages and potential pitfalls of the private practice landscape. During an education session hosted by the AMA Private Practice Physicians Section, Dr. Lockhart offered a few key questions physicians should ask when evaluating a practice’s governance.
What is the governance structure?
Two key things to consider when physicians evaluate a practice are: Who is making decisions? And what’s the ability to reshape a practice when necessary?
“You could be looking at this internally if trying to improve your practice or retain people, or externally if you're looking to join a practice,” said Dr. Lockhart, an anesthesiologist in Tyler, Texas, with a master’s degree in business administration.
“You want to know is the structure—is it an asset or a liability? And if changes are needed, where's the power? How do those changes occur?”
It takes astute clinical judgment as well as a commitment to collaboration and solving challenging problems to succeed in independent settings that are often fluid, and the AMA offers the resources and support physicians need to both start and sustain success in private practice.
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When considering this question, Dr. Lockhart recommends considering whether a practice needs to diversify its services and change its messaging to both patients and potential employees.
“You have PR, whether you call it that or not in the community—and it's your brand,” said Dr. Lockhart, an AMA member who chaired the AMA Council on Medical Servicer in 2021–2022. “Do you have a story that communicates that brand? Especially if you're recruiting or if you're trying to retain [staff]: Hey, these are things about our practice that you need to consider. They don't exist everywhere."
What’s the business plan look like?
Understanding the goals and ambitions of a practice, and its larger financial goals, is knowledge that should make evaluating a practice easier. There are also more altruistic considerations on this front, Dr. Lockhart said.
A practice’s “vision is its preferred self-image of the future, and the values and the guiding principles are the litmus test by how an organization makes a decision.”
Who are your fellow stakeholders?
You want to know who is chiming in on decisions and how their goals align with your own. This is particularly important if you are entering into an ownership arrangement with other physicians.
“From a citizenship standpoint, it’s so important to know if people are engaged,” Dr. Lockhart said.
What’s the staffing breakdown?
Do you have enough staff and the right staff? These are questions that are going to dramatically impact workflow, Dr. Lockhart said.
“If you're all physicians, that situation is pretty cut and dried,” he said. But if practice also includes nonphysician providers, the question becomes: “Do you have the optimal mix? And what do you have in-house? What do you outsource from a scheduling standpoint?”
Find out more about the AMA Private Practice Physicians Section, which seeks to preserve the freedom, independence and integrity of private practice.
