As the consolidation wave sweeps through Connecticut’s physician landscape, small practice doctors face tough choices about ceding their independence.
A main reason Connecticut has, and still is, dominated by small physician groups is because doctors enjoy their autonomy, said Matthew Katz, CEO of the Connecticut State Medical Society. They are, in a sense, entrepreneurs who like calling their own shots.
“A lot of doctors want to remain independent but need some assistance,” Katz said. There are several large group models that exist and doctors looking for a partner must choose one that fits their and their patient’s needs and interests, Katz said.
For some physicians, particularly older doctors nearing retirement, ceding independence to join a hospital staff is an attractive option. It allows doctors to avoid the hassles of running a business and focus more on patient care.
Many younger doctors too are opting for hospital employment, Katz said, as they seek a greater work-life balance.
Joining a large, hospital network, however, can lead to a significant loss of freedom, said Douglas Arnold, CEO of Middletown’s Medical Professional Services Inc., which has more than 450 medical providers in its network.
“Doctors that get purchased by hospitals are much more constrained on where they can send patients,” Arnold said.
Jarrod Post, CEO of Hartford’s Connecticut Multispecialty Group, said his organization appeals to doctors who still want to maintain some independence but be part of larger group that shares resources. CMG is owned by its doctors, who have formed a democratic organizational structure. Every specialty department has equal representation on the board — called a medical senate — to help shape policies and decisions.
CMG has adopted a physician’s bill of rights, which outlines what its members should expect from the group’s leadership, including the ability to be innovative and adaptive to new industry trends.
There is also flexibility and accountability ingrained in the culture, Post said. Doctors, for example, can work at their own pace; if they see more patients, they can earn more money and vice versa.
All doctors, however, need to adopt the same quality metrics and electronic medical record and be willing to work in a larger culture, Post said.
“There is a limit to being completely autonomous,” Post said.
Mutual trust is a key ingredient for any merger to work, Post said. When CMG recently acquired six cardiologists from Cardiac Care Associates, they held after-hour pizza meetings to integrate skill sets and clinical philosophies. Merger challenges included combining divergent electronic medical records, back office services, and pay scales and benefits packages.
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