Time to add a partner to your practice?

August 1, 2007

Busy urologists seeking relief from the demands and responsibilities of running a practice are likely to entertain the possibility of bringing in a partner. But a rush to judgment can lead to mistakes that might otherwise be avoided.

Consider your motivations

Begin with a careful examination of your motives for bringing a new doctor on board. There are lots of reasons that make perfect sense, but here are the reasons I hear most frequently from physicians:

Start by examining the data. How many patient visits and procedures are you doing each month, and how has the production varied over the past year? If production has risen continuously and a comparison to the previous year reveals an increase of more than 20%, it's likely that your need for help is real. On the other hand, circumstances might have led you to believe the workload has increased when there is only a slight shift. This perception can happen if your best nurse was out for an extended period and you haven't been able to delegate as much.

Demand may also show a temporary spike when a physician has been out of the office. This is even more pronounced if one or more physicians took more time off than is typical over the course of a year. Graphing monthly production will make these spikes evident, and you can then use the data to help understand your practice's needs better.

Delayed access and uneven appointment patterns are other indicators. If new patients must wait for an appointment or if you are double-booking patients to meet the demand, pent-up demand may be compromising both patient care and service.

Plans to add another physician aren't always related to increased volume. Other possible scenarios include a physician's slowing down in preparation for retirement and the desire to expand market presence and capture a bigger piece of the pie by opening satellite facilities or perhaps adding a subspecialist to the existing service mix.

Know thyself

Don't start recruiting for another physician without considering how it will affect the practice's existing physicians. A decision about adding a new physician will have effects on the others in a wide range of areas, including practice finances, shifts in their roles, changes in the service mix, and patient service issues, to name a few.

For solo physicians, this is a critical consideration. If you've been the "lone ranger" for a long time (and feel fairly comfortable making all the decisions), adding a partner will definitely be a jolt to your practice style. It requires quite an adjustment and a lot of compromise.

The time it takes to mentor and guide a new partner comes at quite a price if your purpose for bringing in Dr. New is to get needed relief from clinical demands. It will be important to recognize and plan for this inevitable demand. Mentor the physician, introduce her to the community, and help staff make the adjustments required to accommodate the new doctor. The results of this are likely to be reflected in the numbers. While Dr. New is getting her production up, there may be a downward shift in one or more of the existing physicians' numbers.