BLOG: Is your practice large enough? Part 3

In a practice eager for sustained growth, there are usually one or more defining incentives. These usually take the form of personal financial rewards for the surgeons, although there are prominent exceptions. I have more than one client for whom profit growth is mainly an opportunity to fund their charitable work. For most, old-fashioned competition is a common motivation: “Dr. Winters has just eclipsed my case volume — I’m no longer the No. 1 surgeon in town.” However, if this is your motivation for being competitive today, have a backup plan for what’s going to motivate you once you edge into first place.

Solo practices can often run circles around larger group practices on a per-doctor compensation basis because soloists know that all the rewards and all the punishments will flow to them directly. Nothing motivates like a perceived “monster” in your closet, and there have certainly been enough of these to evoke your sustained efforts to keep growing, if only to stay even in profit terms: managed care, fee erosion, competition, technologic obsolescence, optometric encroachment and rising wage demands. Group practices can be paradoxically unwilling to leap into opportunities, even those with small individual risk. This is especially true if there is no imminent threat to the status quo of earnings and if there is not at least one doctor in the practice willing to step forward and lead. Many voices pulling the practice back and forth will often result in the practice staying squarely where it is.