This article is more than 5 years old. Information may no longer be current.
Society for Innovative Medical Practice Design: What can we learn?
All through my career whenever I explored or entered into a new or rapidly changing area in orthopedics, I found great benefit in hearing the experiences and thoughts of my peers. Openly sharing ideas with creative thinkers and having others with in-depth interest critique my thinking has always been helpful.
|
|
I found that the format of short, informative presentations followed by in-depth discussions with my colleagues to be particularly beneficial. A few times when I faced new challenges, I joined small special-interest groups that could meet once or twice yearly to share success or failures in a specific area. The concept behind these meetings: We would learn from each other’s mistakes and build on each other’s insights.
The most unexpected innovations and applications often developed from these sessions. The progress was usually incremental, without major changes being made in any one session. If we did not make steady progress, we disbanded our collective efforts.
Increasing overhead
The loss of autonomy and decreasing reimbursement are big factors impacting my practice style. However, increasing overhead is also making it difficult to maintain the manner and style in which I would like to practice my profession.
In the 1970s and 1980s, overhead was less than 40% for many of us. After 1992, I found it difficult to keep it under 50%. In California, I have heard from several colleagues that it is now becoming hard to keep it under 60%.
If my overhead approaches 70% or more, it is not worth the stress, responsibility, liability and effort needed to maintain a private practice. This, of course, is an individual matter, and I’m sure that many of you disagree.
Once again, I would like to hear from other orthopedists on how they are coping. It would also be beneficial to hear more details from our colleagues in other specialties. For example, some primary care physicians are trying to use “concierge medicine” as a way to escape third-party controls and decrease their overhead-to-revenue ratio. While I do not feel this boutique approach will work for our specialty, we may benefit from hearing what they are experiencing.
SIMPD
One example of physicians working together to address a common challenge is the Society for Innovative Medical Practice Design (SIMPD), which was formed by a group of primary care physicians. Initially it was called the American Society of Concierge Physicians. One reason for the name change may have been to seem less self-serving and to open up possibilities for establishing more variations for less third-party regulation and dependence.
SIMPD President Thomas LaGrelius, MD, stated that while the organization has a couple hundred members, he projects there are 1,000 potential members experimenting with third-party-free approaches.
On its Web site, the group states, “The Society for Innovative Medical Practice Design is an organization of physicians promoting a direct financial relationship with their patients in order to restore the integrity of the patient/physician relationship. It is our mission to ensure that physicians and patients retain the right to design and implement practices that enhance the effectiveness, efficiency, service, and value of health care.”
Orthopedists joining together
My current orthopedic group is struggling to come up with practical and efficient approaches to minimize the impact of decreasing reimbursements and third-party interventions. We are finding more third-party plans to be unacceptable, and we have been dropping the plans we feel to be most egregious and offensive.
Those of us who value our private-practice relationship with patients and are concerned about its future might benefit from joining together in a formal manner to share our failures and successes. We surgeons, along with our office administrators and advisers, might even discuss and compare innovative orthopedic practice designs. As a group, we could explore various organizational structures that could focus on differing ideas for patient/physician relationships and learn from each other’s past experiences, both good and bad.
It appears that the other option is to accept the changes we are seeing and struggle individually. I feel that not taking a more proactive approach portends a future that is not bright for the private practice of orthopedic surgery.
At Orthopedics Today Hawaii 2009, we will spend a full day discussing practice management concepts and the experience our faculty has acquired. One session will address innovative orthopedic practice strategies. The presentations will include attendee participation and follow-up discussions. In addition, we will hold Banyan Tree Gatherings, where attendees can discuss these innovative ideas in a more relaxed setting with the faculty.
Douglas W. Jackson, MD
Chief Medical Editor
For more information:
- Orthopedics Today Hawaii 2009 will be held from January 11-14, 2009 at the Fairmount Orchid on Hawaii’s Big Island. For more information on Orthopedics Today Hawaii 2009, go to www.vindicomeded.com/meetings/OT/hawaii/default.asp.
- The Web Site can for Society for Innovative Medical Practice Design can be viewed at www.simpd.org.