The private practice revival

Over the past 18 months, technologies once considered innovative have become imperative for success in private practice. From administrative applications like online scheduling, patient portals, and refill requests to clinical care functions performed remotely via telemedicine, COVID-19 has forced massive disruption in the healthcare industry. The pandemic, and subsequent progress regarding interoperability, have reinforced the importance of maintaining the care continuum to improve health outcomes.

Private practice physicians are primed to provide this continuity — particularly in the face of pressures to merge or consolidate with big industry players — because they are now able to provide more personalized care and deeper patient engagement via digital technologies. While challenges in healthcare persist, today’s climate is an opportunity for savvy physicians to leverage the tools available to them with a focus on continuity and growth vs. consolidation or mere survival.

Optimal care for positive outcomes

The pervasiveness of healthcare consolidation has led to a general misunderstanding, or perhaps misrepresentation, about how acquisitions impact the patient. Healthcare consolidation has created a “deli-counter-like” environment where patients are numbers. Often, particularly in outpatient clinics such as urgent care, a treating physician sees the patient once for the acute event. There is little opportunity for a provider-patient relationship or time investment to understand the nuances of the entire patient journey. As medicine has begun to shift from quality to quantity, danger lurks: clinicians treat patients inconsistently and disconnectedly with no lasting support, which leads to increased readmission and costs.

Alternatively, private practice physicians often care for people with chronic diseases and comorbidities like diabetes and asthma, and of course most recently, COVID-19. This continuous treatment translates to better patient care and stronger long-term benchmarks in the ambulatory environment. But these physicians, too, require support. Technology provides that foundation to help them meet the individualized needs of a given patient or patient demographic, enabling the practice to grow and prosper.

Technology as the key

For both providers and their patients, the digital world of healthcare is engaging, efficient, and productive. There will be no going back to the “old way” of providing care. Convenience and ease of use which industries like banking, e-commerce, and travel have prioritized for years are now part of the expectation held by healthcare consumers. And practices that have learned to communicate digitally with their patients and offer user-friendly care management functions like easy online bill pay, seamless scheduling, and touchless patient visits via telemedicine are helping to keep costs down across the entire healthcare system. Furthermore, federal officials have taken steps to help small practices by including advancing Medicare payments and expanding coverage for virtual health services. 

With many new technologies in play, physicians, physician groups, and other well-managed group practices are coming to understand the efficiencies that bloom from an investment in practice management, patient engagement, and smarter billing tools. Machine learning technology in healthcare helps ensure coding is tight for payers, which increases the overall return as well as the speed of returns. The ability of patients to bypass the front desk in favor of online execution of tasks is both empowering for them and frees the staff to perform other essential duties. From billing to messaging to patient follow-up calls, these tasks ultimately help the practice create a better overall experience for the patients and caregivers. In the post-pandemic world, work-life balance and quality allocation of employee time will improve staff retention and reduce turnover.

Almost all healthcare workers, including physicians, struggle with workplace discontent or burnout at some point in their careers. Today’s private practice opportunity is one that leverages tools and technology for better balance. Implementing telemedicine services for non-acute visits allows a provider to have that critical after-hours chat with a patient from the comfort of home. While flexibility in after-hours work may seem like a small thing, this can drive huge relief for physicians. Additionally, the ability to reduce the pressure—or occasionally chaos—of the office setting by allowing patients to self-serve can similarly reduce pressure on all staff. Furthermore, if physicians can worry less about managing business-critical applications and other obligations of the practice, they can focus more on doing what they do best: practicing medicine.

Interoperability gains have further enabled the application of specific tools and technologies to support private practice physicians. With continued focus on FHIR as well as the government’s information blocking rule, physicians have greater access to the most pertinent facts about patient health. This positions them to drive the once nebulous concept of continuity of care into an actionable and practical reality. This persistent drive will be a game-changer, not just in terms of patient health, but in the way we manage cost and value in healthcare.

The greener grass vs. a revival

The application of technology as the opportunity today requires a courageous vision and commitment to follow through. Consolidation is a “flashier” option, but one to beware of. Over my three decades in healthcare technology, I’ve personally witnessed three distinct waves of health systems acquiring numerous private practices that, on paper, appeared to be “slam dunks.” The economies of scale and financial benefits seemed a “sure thing,” but failed to materialize with both parties — provider and hospital — ultimately agreeing to part ways. The disparities between hospital operations and private practice functions are too great. And when those hospital-based physician practices must operate as a large group with standards that don’t allow them to cater to individual patient needs, they fail or get abandoned by their most valuable resource: their staff. The grass is not always greener. Most recently, private equity firms are playing a role in acquisitions, having moderate success by optimizing a particular thin slice of patient demographic. It remains to be seen if this trend will have staying power in ambulatory care.

In the meantime, successful private practice physicians are able to engage with patients and treat them with continuity and personalized care. By embracing technology that has proven so successful in other industries, essentially, they are identifying how specific tools can facilitate various steps of a predictable healthcare model: patient needs care, seeks care, acquires care, pays for care, and has care followed up on. Physicians committed to digitizing the functions of this model are embracing the opportunities of today for a bright, independent future.

Stephen Dart is VP of Engineering at AdvancedMD, based in South Jordan, Utah, a healthcare technology company that supports independent physicians and their staff with a comprehensive suite of solutions including practice management, electronic health records, telemedicine, patient relationship management, and business analytics reporting. The company serves an expansive national footprint of more than 40,000 practitioners across 13,000 practices and 700 medical billing companies.