Would Merging Medical Practices Work for You?

Dr. Lessin's group has one large central office and five other offices in the area, so any patient in the region is only about 15 minutes from one of the offices. The central office is open until 8:30 p.m. “We have at least one office open every day of the year,” he said.

Part of the scheduling job involves deciding which doctors will work in the evening or work on weekends. The practice also will have to decide which doctor is on call and who is the backup. A master scheduling coordinator develops job streams that juggle appointments by season, by provider, and by time and creates a template for each doctor.

A partner-level doctor in Dr. Lessin's group sees approximately 43 patients each day and a non-partner-level doctor sees approximately 35 a day. Efficient support and the use of 10-minute slots make it possible, since doctors do “nothing but doctoring,” Dr. Lessin explained.

All of the paperwork and nonphysician tasks are done by nurses and administrative personnel, and referrals are handled by a referral department.

However, flexibility is important as well. “We're always modifying the schedule, because some people work faster than others,” he said. In addition, 10-minute slots can be combined for a more complex visit.

The bottom line is, once you have decided to be part of a practice merger, the group must have goals—business goals, medical goals, and quality goals. For example, Dr. Lessin suggested setting a time frame for where you want to be in the next 5 years and next 10 years, and then executing that plan. “What gets measured gets done,” he said.

A large enough practice can afford the infrastructure to make this kind of system work, Dr. Lessin said. He has 150 employees, which means the practice has high overhead. Although a large payroll raises overhead, the ability to see more patients more effectively will raise revenue as well.

In addition, a group practice has the resources to develop a sophisticated Web site that can serve as a recruiting tool for new doctors and also as a valuable resource for patients who want to make appointments, refill prescriptions, or obtain additional health information.

“The way we are being squeezed in pediatrics, management is very important, regardless of the size of your practice and whether or not you are part of a group,” Dr. Lessin said.