This post may be a bit self-serving; one of the things we do here is medical practice management, and I’m going to talk about a very large problem that many doctors have in running their practices.

We’re hearing more and more stories of doctors who “can’t make ends meet”. And the stories are true, to a point; established businesses are getting into trouble because the manner in which they DO business is collapsing in on them.

Why? Because their business is changing and they don’t know how to use those changes in their favor.

This is an old story. Most doctors didn’t see medicine as a business when they were 20 years old or so and decided to be doctors, and the ones that did see it that way thought they could do business the way existing doctors do it, without making any kind of change. Oops.

But look at the way medicine (as a business) has changed:

Fifty years ago, most people didn’t have health insurance. They went to a doctor, they paid the doctor, and that was that. In the short time that’s passed since then, doctors went from comfortable-but-not-usually-wealthy members of the community to really rich guys to struggling business people who didn’t know what had went wrong changed. Now look at what happened to make this change take place. In short order:

  • Insurance Companies starting paying most of their bills
  • The Insurance Companies Starting telling doctors how high low their bills could be
  • HMOs came along and pushed those payments even lower as a precondition for having access to “their” patients

History lesson aside, when doctors talk about making the same dollars now that they made 15 or 20 years ago for working harder, but having much higher expenses, they’re telling the truth, but remember: the doctors got in bed with first the insurance companies and then the HMOs voluntarily, and now they’re complaining about the outcome.

Now, more and more doctors are deciding to simply not play. And those are the doctors who are succeeding. Several different methods of “not playing” have popped up, and they all work better for both the doctors and their patients than the existing system. If you’re a doctor and want to talk about this, contact us any time.

If you insist on sticking to the old way of doing things, you’re going to have a problem. If there’s a true public option put in place as the USA enacts health care reform under President Obama, you might get away with this (and be paid the kind of salaries doctors earned fifty years ago but also not have to be business people any longer).

But if you fight change by refusing to change, you’re going to be in a lot of trouble.

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