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Superstars Surgeons: Join a Group or Be Independent?

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While it is possible for independent specialists to leverage their networks for success when going it alone, consolidation has made it increasingly difficult for independent physicians to remain in business, according to Fred Davis, MD, and Louis McIntyre, MD, in their panel titled "The Outlook for Independent Specialists" at the 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + Future of Spine on June 12, 2014 in Chicago.

Dr. Davis is a physician within a group practice, while Dr. McIntyre runs a solo practice.

"Provider consolidation is happening at a breakneck pace. With that comes a loss of referrals from other medical doctors, which is a huge challenge. Doctors refer in to their own entities, in the narrowing of networks occurring with healthcare reform," said Dr. McIntyre. "Being on your own is daunting."

To improve solo practice viability, Dr. McIntyre recommended building a referral network of other private solo providers as well as partnering with a private institution such as a school to recapture some referrals that might otherwise be lost. Marketing also plays a key role in the life of the solo practitioner, so those who wish to make the move must accept the reality: "Marketing is something you have to think about if you're going to be smaller. You can't hide your light under a basket," Dr. McIntyre added.

For physicians who don't want to be solo practitioners but are apprehensive about joining a larger group, Dr. Davis says it's all about organizational DNA. "It's possible to remain a superstar in a larger group," he said. "Company brand is the largest driver." There is a place for excellent clinicians with personal skills in large groups, though ultimately the physician company determines whether the physician in question will be more valuable alone or under a group brand, he added.

Ultimately, whether group or solo practitioner, Dr. McIntyre noted the bigger issue was one of control. "The grass is not greener, though both groups think so. Physicians want control over their own destinies," he said.

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