Learning the business of medicine on dangerous waters

To quote Allison Pearson's novel, I Don't Know How She Does It (also a movie I plan to hit this weekend), "Becoming a parent was like having to build a boat while you were at sea."

For the vast majority of doctors, the experience of running a practice is largely the same. If it were only as simple as just providing care, having compassion, and exercising the ability to heal, either job would be a whole lot simpler.

Just like new parents who lament babies don't come with instruction manuals, so too do newly trained doctors often feel tossed into the sea without so much as a life raft.

Sound like an exaggeration? According to the latest recruiting survey from Merritt Hawkins & Associates, a mere 9 percent of medical residents surveyed said they felt prepared to handle the business of running a medical practice. Almost half--48 percent--said they felt unprepared.

With this lack of preparation, combined with the fact that the healthcare waters keep shifting with the ferocities of health reform, potential long-term cuts or freezes to Medicare reimbursement, a relentless push toward adopting (but first paying for) new technology, new forms of competition, and more, it's not a huge surprise that only 1 percent of Merritt Hawkins & Associates' 302 respondents said they wanted to go into solo practice.

But despite the increasing appeal of the ‘safe harbor' of hospital employment, that doesn't seem to be a panacea for physicians or patients either. According to the HealthLeaders Media Hospital-Physician Alignment Survey released this week, only 11 percent of employed physicians surveyed reported being fully engaged in their work.

"Some markets are in an all-out race to recruit physicians based on the thinking that primary-care doctors will be the linchpin in the healthcare system of the future," said JR Thomas, president and chief executive officer of MedSynergies, in a statement. "But increased employment does not translate into increased engagement. Hospitals and health systems need to work with doctors side-by-side in meeting the healthcare needs of the marketplace both in the hospital and in the field - it's a symbiotic relationship."

While hospitals and health systems are indeed working hard to figure out how to sail smoothly alongside physicians, independent groups are left to navigate the endless challenges on their own. Most of you reading this are in the position of having to learn to do so on the job.

Lucky for you, though (whether you are from a practice or an organization trying to run one), you do have a guidebook of sorts. FiercePracticeManagement can keep you updated on how to navigate around the rocks and shoals on an ongoing basis. This forum also gives you a place to help one another. For those of you who've been at sea a while, what's your advice to new physicians who feel unprepared? What are the most important ways we at FPM can help make the journey less treacherous? - Deb