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GI private practice success requires leaders, entrepreneurs, ancillaries
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ORLANDO — By staying up to date on practice drivers while incorporating ancillaries and entrepreneurship and encouraging leadership from within, private gastroenterology practices will survive and succeed, according to experts presenting during the 30th Annual Practice Management Course held before the World Congress of Gastroenterology at ACG 2017.
“There will always be a role for the private practitioner,” Caroll D. Koscheski, MD, of Gastroenterology Associates in Hickory, NC, said during his presentation. “We have to figure out how to keep it healthy.”
Koscheski discussed practice ownership and the “vanishing dream.” He explained that the two words that mean the most in this discussion are “autonomy” and “ownership.”
“You know what the driving forces are in your practice,” he said.
Today, Koscheski said the main drivers in gastroenterology stem from government changes such as reporting requirements and health care reform, an increasing volume in Medicare and Medicaid and quality measure directives given by private insurance companies. To own and run an effective practice, a gastroenterologist must keep up and having a staff who can handle the technology of today’s drivers as well.
“You must keep up with what’s going on and keep current,” Koscheski said. “What’s important and what’s manageable is local to you.”
Ancillaries
In looking ahead and ensuring success, Reed Hogan II, MD, from GI Associates in Flowood, MS, and Harry E. Sarles Jr., MD, FACG, founding partner and medical director of Digestive Health Associates of Texas in Rockwall, TX, discussed how ancillary offerings can help gastroenterologists streamline their processes, improve patient experience and turn a profit.
Gastroenterologists today own all or part of hospitals, own their own ASCs, buy imaging modalities for inclusion in their practices. Some have even developed primary care practices for a “built-in referral source,” Sarles said.
“There is lots of opportunity for physicians to hang on to or add remuneration to their practice,” Sarles said. “If you’re going to tackle any of these things, make it patient-centric, value added. We should be able to do it cheaper, easier, faster and institute quality control so that it’s done at a very high level and value added. And, by all means, have fun doing it.”
Hogan explained that he and his partners bought a warehouse space, teased the coming practice and opened at an intersection that sees 60,000 cars daily. At this practice, they incorporated an endoscopy center, a pathology lab and pathologists, sedation, infusion, dietary and weight loss management, diagnostics, radiologists, joint ventures with other health care providers, and brought in a pharmacy that even sells their own bowel prep.
“We should tear down the silo concept,” Hogan said, referring to having a series of smaller practices and services acting independently and separately from one another. “To transform patient engagement, we want to close these fragmented care gaps of silo care and put them into a convenient, efficient customer journey through GI health care.”
Hogan suggested asking yourself the following when considering ancillaries:
All of his current ancillaries together will bring in nearly $1 million in profit and an improved patient experience, he said. The pharmacy alone brings in $250,000. But, it takes time and dedication to get to that point, Hogan explained.
“Ancillary services are like running a marathon. ... Pace yourself doing this,” he said. “If we’re going to survive, we have to become entrepreneurial.”
Leadership
Ancillaries are also dependent upon the leadership within a practice, Hogan said, and he suggested assigning leadership roles to others. Younger physicians and other health care practitioners in the group should take on small goals and become leaders in making those happen.
“Drag them into every project and give them that feeling that ‘I’m doing something for the group,’” Hogan said. “That’s how you bring up new partners.”
Incoming ACG President, Irving K. Pike, MD, echoed the idea of assigning tasks to individuals who are suited to take on a leadership role.
“Stay out of the way. Let them run with it. Gain the confidence. Accept the responsibility. ... Just be available any time they need you,” Pike explained. “People begin to feel a member of the team at that point. ... They understand the practices moving parts and how all this works together – that things don’t just happen. You have to put something into it to get something out of it.”
Then, Pike explained, you have them do the report and explain what worked and maybe what did not and where the practice needs to go next.
“They will feel a real ownership for the practice,” Pike said. – by Katrina Altersitz
Reference: Hogan R, Koscheski CD, Pike IK, Sarles HE. 30th Annual Practice Management Course. Presented at: World Congress of Gastroenterology at American College of Gastroenterology Annual Scientific Meeting; Oct. 13-18, 2017; Orlando, FL.
Disclosures: The presenters report no relevant financial disclosures.