Is your practice a social service or is it a business?
These are two entirely different goals and if a definitive answer doesn’t immediately pop out of your mouth you’re in trouble. A dog may have four legs, but it can only walk in one direction at a time.
Today, with the communal notions of the “We” society in full swing, physicians are, in essence, being told by politicians, pundits and the press that you are in social services: They don’t see a healthcare market; they see a healthcare system, one that exists to serve the public, a significant portion of which believes that healthcare is a right and that it should be as free as air — or at least free to them . . . the “rich” should pay for it.
Of course, not everyone that says this believes it. Some say it just to get votes. Some say it just to get free stuff. And hospitals that want to herd you into an ACO or want to employ you at bargain basement (oops, I mean fair market value) compensation tell you that you need to economically align with them in order to deliver quality care to the public — that’s our mission, isn’t it?
Now I’m not saying that you should not be focused on delivering quality care, but you first have to make the decision if, for you, you’re doing this as a viable business in which you have control over your future or whether you’re doing this as a cog in the wheel of the healthcare factory run by the hospital or the government.
If it’s the former, then you need to become much more active in conducting your practice as a business, both in order to compete with the large groups operating in many of the medical specialties which absolutely operate as businesses, as well as to push back against the trend toward the socialization of healthcare.
There is another alternative of course, there always is. And that’s that as opposed to going back to school, as so many physicians did, to get MBAs to understand how to run practices in the face of managed care, perhaps you should go back to school and get a masters in social work.