Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher
It is amazing what one can glean while monitoring the medical publications. Not surprisingly, the medical profession is facing many of the same challenges as the chiropractic profession. As you might expect, their reactions to these challenges usually fall between the interesting and the amusing. Regardless, we can always benefit by learning from their successes and mistakes.
The October 24, 1994 issue of Medical Economics contains the thought provoking cover article, "Grabbing the bandwagon of change." Yes, the medics are going through major changes that you may find interesting.
The article states that 22 percent of private practice MDs have "made one or more practice changes in the past year," and another "44 percent plan to do so in the next 12 months." That's a whopping two-thirds of the medical profession changing the way they practice! Imagine 400,000 MDs scurrying to respond to the changing health care market.
What Are They Doing?
"About 38 percent of the office-based MDs and DOs responding to our survey intend to merge their practices; sell them to a hospital, HMO, or health care company; and/or join a physician hospital organization (PHO) or group practice without walls. Only 16 percent had made one or more of those moves during the prior year."
According to the survey, 15 percent plan to sell their practice to hospitals, health care companies and HMOs. More than a third plan to join PHOs. Twenty-two percent will join group practices without walls and 18 percent have merged or plan to merge with other physicians. Not surprisingly, the numbers are even more severe for the specialists.
Why Are They Doing This?
"They're selling out partly because hospitals are pursuing them and, in many cases, paying top dollar for their practices. But it's also because many primary care physicians are tired of declining reimbursement, ever-rising paperwork, and hassles with utilization reviewers. They'd just as soon work for an institution where they have no entrepreneurial risk, get complete call coverage, and can leave the administration to others."
Sound Familiar?
Depending on where you practice, you can't help but notice the changes taking place in health care. Health care providers are repositioning themselves, hospitals are merging and managed care organizations are spreading the risks through prepaid care. What you do over the next few years could greatly effect your future.
But What Should You Be Doing?
The article is very careful not to offer advice. On the contrary, it simply tells MDs what other MDs are doing rather than attempting to make any suggestions.
The truth is, no one is certain about the future. Your situation is impacted by where you live, your years in practice (or perhaps the number of years until you retire), and the practice style that best fits you.
Only one thing is certain. To leave your future to the changes and chances of our evolving health care system is nothing short of irresponsible. You do have choices. Have you explored them? There are changes taking place in your state. Does your state association keep you appraised of them?
The chiropractic profession will ultimately be recognized as an important part of good health care. The form of practice may be something very foreign to us. Managed care may evolve into something completely different and unimaginable.
Don't ignore the changes: face them straight on.
Chiropractic will prevail. What you need to do is modify your practice to meet the needs of your community.
DMP Jr., BS, HCD(hc)
