05/05/2016    Joseph Borreggine, DPM

Solo Practice is Doomed (Tip Sullivan, DPM)

Private practice is not doomed yet. Yes, many
can still make it. And yes, an experienced
independent podiatric practitioner can make on
average $500K a year. This is true. I have been
in practice for 25 plus years and still staying
afloat, but for how much longer I cannot say.
Many changes have occurred over the years. Most
of these have not been friendly to private
practitioners. Outside of EHR, Meaningful Use,
and now with MACRA and MIPS, payment models and
reimbursements will change to a more
performance based and incentive system. This
will be a game changer for those remaining in
private practice and financial independence as
a physician is certainly in jeopardy.

Whatever changes occur in the future, business
adaptation and diversification are the keys to
financial success. But, that may not even help
in the long run. As more and more physicians
become employed, the less and less independent
doctors have the camaraderie that they once had
as when physicians were on their own. As time
has progressed in my practice, this fact is far
too evident.

Unfortunately, the physician referrals have
waned to a point of almost non-existent. The
patients that we do get referred to our office
are the one that no one wants to see because
that are on Public Aid or are difficult
patients. Regardless, we see them and provide
them the care they need and communicate our
care to the referring provider.

I honestly believe that no matter what a
physician does in private practice to make ends
meet, it is still going to be hard to make a
decent living in the years to come. Therefore,
it is just better not deal with any of the
craziness that is upon us all and just find an
employed position as a podiatrist in corporate
or hospital setting.

Having a set salary with a contract providing
benefits and future performance incentives is
just more financially sound. This is the
reality that we all need to face and stop
trying to put the square peg through the round
hole. And you know what they say about doing
the same thing over and over again and
expecting a different result?

Joseph Borreggine, DPM, Charleston, IL

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