Douglas Won, MD, is the founder and director of Minimally Invasive SpineCARE, based in Texas. Dr. Won is dual-fellowship trained in orthopedic spine surgery and neurosurgery/spine surgery. Here he discusses how spine surgeons can establish a successful independent practice and how they can ensure their practice flourishes as healthcare continues to change.
Q: What is the first step a spine surgeon considering founding an independent practice needs to consider?
Dr. Douglas Won: The first consideration is the same for any physician going into an independent practice. The practice must build a solid business infrastructure. Many physicians do not have much experience running a small business. Hiring the right staff, such as a great business/practice administrator, is critical to the success of a practice.
Q: What are the benefits of founding a spine practice?
DW: A founding physician can create and shape the vision of the practice. A spine practice can consist of a solo practice and/or a comprehensive spine center with multiple specialties working under a same roof. A founding physician can direct the vision to create the best practice to take care of patients.
Q: What are a few of the challenges?
• Setting up a solid revenue cycle department
• Negotiation with payers for reimbursement
• Maintaining referral sources for the practice
• Properly managing human resources
• Compliance with all new healthcare changes
Physicians are not trained in medical school or during residency on how to run a practice. Therefore, they are an easy target to be taken advantage of.
Q: What are a few of the most important things for spine surgeons to remember even after they have successfully established an independent practice?
DW: The surgeons must keep close watch on their business office and be fully engaged in the day-to-day business of the practice. Even though a surgeon may be a great surgeon, if the business aspect of the practice is not well maintained, the practice will fail.
Q: What do you see for the future of independent spine practices as healthcare reform continues to change the world of medicine?
DW: Many challenges will be faced by independent spine practices in the future, as many of the large hospital systems are purchasing the primary care groups to control the flow of patients. Then the hospital systems will control the referrals of the patients to surgeons who are affiliated with their system. Then, the independent surgeons will lose control and will not be so "independent."
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