Multiple Choice

May 1, 2013 – In The News
Dermatology Times

Todd Rodriguez was quoted in the Dermatology Times article "Multiple Choice." While the full text can be found in the May 1, 2013, issue of Dermatology Times, a synopsis is noted below.

Many physicians are jumping the solo practice ship due to the rising regulatory and practice administration costs and reimbursement woes. While many physicians are seeking refuge in a bigger environment, it is still possible for dermatologists to thrive in small private practices.

There are good reasons to be in larger practices Todd A. Rodriguez says. “Certainly there are…opportunities to improve the delivery and quality of care because you have a larger patient population, and you can share information among doctors in the group practice. You can analyze patient statistics and see what kinds of treatment modalities work better than others. And you can do all that in an integrated basis…that’s one of the big pushes for healthcare reform…to integrate the delivery system,” Rodriguez says.

“So, if you have to buy a half million dollar electronic medical record system and you spread that over 20 doctors, it’s certainly a lot more tolerable than bearing that cost yourself or sharing it with two or three doctors,” Rodriguez says. “You can generally hire more expensive advisers… You may be able to hire people who specifically focus on compliance within the practice. Smaller practices can’t afford a compliance officer, for example.”

“The common thinking with multi-specialty is that you have a built-in referral base,” Rodriguez says. “On the other hand, all the other primary care doctors in the community may not want to refer to you because they are afraid of losing their patients to your partners who are in primary care.”

“I have seen situations where there can be some contention over how different specialties in a group practice should share in practice profits,” Rodriguez says.

Dermatologists who want to start or remain in small practices should explore a model not largely dependent on insurance reimbursement according to Rodriguez. “(Try to) situate your practice in a well-to-do area of the country or in a community where people are going to pay out-of-pocket for high-end kinds of care – what’s commonly referred to as concierge,” Rodriguez says. “This includes cosmetic and greater access to the physician by telephone and email. But you have to be in an area of the country where people are willing to pay for those kinds of things.”

Rodriguez advises that rather than try to predict the future, physicians should aim to thrive in whatever climate there might be. “For any medical practice to survive, no matter, what specialty, they have to become more sophisticated,” Rodriguez says. “They have to learn how to run a business and focus on running a business and running a business profitably, and being able to evolve as the marketplace changes.”