Starting and maintaining a private practice isn’t easy. Coding, billing, documentation and state regulations can be complicated, but being accurate is essential, according to Kathleen Blake, MD, MPH, the AMA’s vice president of health care quality and a cardiologist who worked in private practice for many years.
In addition to considerable clinical skills and acumen, physicians in private practice also need management and marketing know-how to build successful and sustainable practices, she said.
“These aren’t skills they teach you in most medical schools,” she said, “but they are essential for anyone in private practice or even considering starting a private practice. According to AMA research, about 44% of physicians are in private practice, and they have needs that are not just associated with delivering medical care.
“You hear this all the time. The best referral is an existing patient asking, ‘Would you see my family members?’” she said, but private practice physicians need more than just referrals to build their patient panels. They also need to create an efficient management structure, establish a positive patient experience, and build a personal online brand, she added.
Help in pursuing private practice medicine
Working with the new AMA Private Practice Physicians Section (AMA-PPPS), Dr. Blake and her colleagues helped aggregate resources for physicians at all stages of private practice: from those completing their training who are exploring practice options to midcareer doctors managing an established practice.
“We felt it was important to identify and understand the various challenges physicians face in private practice and publish in one place what I like to call news you can use to help them have a sustainable practice and enduring, positive relationships with their patients, families and communities,” she said.
The result was a collection of AMA private practice sustainability resources . The resources cover vital issues such as how to get started in private practice, managing business operations, and developing a positive patient experience. Content includes curated webinars, research and recent AMA news articles on private practice, including profiles of physicians who are succeeding in this vibrant practice mode.
Exploring your first practice
Dr. Blake recommends that physicians who are a year from completing their residency or fellowship training consult the resources as they explore their first practice arrangement. The webpage supplements AMA-PPPS and is available to residents and medical students who are not yet eligible for membership in the section.
“It is important that physicians in the early stages of their careers look at their first practice as the beginning of a long-term relationship,” Dr. Blake said. “This is a different type of relationship than what they may have had while becoming a doctor. . Previously they were a member of a cohort in medical school or residency and the terms were standard.”
“This may be the first time a physician has to review and sign a contract that is unique to themself,” she noted. “Now their compensation and terms of employment are negotiable, and they need to understand exactly what they are agreeing to.”
Read about the eight steps physicians can take when deciding where to practice.
Understanding contracts and ownership
Physicians should also expect to be a party to a wide range of relationships within their private practices, as an employee or partner, and as a result of agreements negotiated by the practice with health plans, health systems and employers. Not all practices are alike, and the recent rise of practices owned by venture capitalists and private equity groups adds to the kinds of relationships physicians may consider entering into and will want to understand, Dr. Blake said.
“Though only about 4% of practices are owned by these firms, the number is increasing,” she said.
Dr. Blake noted that medicine is a highly regulated field, and AMA resources in the online collection are a good starting point to understand, among other things, the E/M coding-and-documentation guidelines overhaul that took effect this year.
The webpage also offers advice on improving the patient experience, a progressively more important issue in contemporary practice. The reference material guides physicians in building a patient-experience program and establishing a patient-and-family advisory council that can help practices deliver more patient-centered care. Resources also include guidance on understanding and addressing social determinants of health.
Learn more about the shifting practice landscape by reading the AMA Policy Research Perspectives report, “Recent Changes in Physician Practice Arrangements: Private Practice Dropped to Less Than 50 Percent of Physicians in 2020.”
