09/16/2014    Lawrence M. Rubin, DPM

Doctoring in the Age of Obamacare (Michael J. Ryan, DPM)

Thanks, Dr. Ryan for pointing PM News readers to
the WSJ article, Doctoring in the Age of
Obamacare. The problems podiatric physicians face
impact especially hard on those who are in solo
and small group practice. Even if articles like
this one in the WSJ and other means create enough
public outrage for the burden Obamacare puts on
the shoulders of physicians, it would take years
to untangle the mess of clerical responsibilities
and other compliance requirements that are
preventing us from spending our time doing what
we should be doing -- diagnosing and treating
patients who have foot and ankle problems -- and
earning a respectable livelihood doing it.

But, we do not have to sit by and do nothing to
help ourselves. If you agree that, "There Is
Power In Numbers," consider the fact that
podiatrists in solo and small group independent
practice have a way of staying independent in
their present practice locations, while joining
together with other podiatrists in order to gain
a practice management and marketing advantage.

When podiatric practices in any locale network
together (as has been done in the past and is
presently being done on a very limited basis),
each practice gains the tremendous power of
numbers. Each podiatrist gains the ability to
share costs involved in the creation and
operation of a local foot health care cooperative
management and marketing network. When
podiatrists take the first step to accomplish
that, many of their practice problems begin to
get solved. For example, costs of one or more
employees who work exclusively on compliance
matters can be shared, freeing up at least some
of each network podiatrist's time.

Additionally, as other practices continue to
decline due to shaving down of insurance
networks, those podiatrists who network together
can create and agree upon gaining and retaining
patients through a marketable menu of preventive,
quality assurance, and cost-containment protocols
that they provide in each of the network
locations. Yes, it does mean competing with other
podiatrists in your area for "foot care
business," but all podiatrists in any area have
an equal opportunity to network and compete as
well. Knowing how to compete for the the "foot
care dollar" is now, regretfully, as important to
the financial survival of a podiatrist in solo or
small group practice as knowing when and how to
avulse a toenail.

Of course, forming a network does not happen with
just a snap of the fingers. In particular, there
are some legal requirements that have to be
considered. But once they are complied with, even
a network of just a few geographically dispersed
practices can assign an "agent" who, following
legal guidelines, meets with employers, insurers,
unions, HMOs, medical homes, and Accountable Care
Organizations and represents all practices in the
network. The objective is gaining and/or
retaining network-wide podiatric practice
inclusion and special reimbursement fee schedules
in insurance plans.

Additionally, the cost of advertising the network
locations to the public can be shared. So, if
this sounds reasonable, plausible, even possibly
doable to you, why not be the podiatrist in your
locale who starts that ball rolling by discussing
possibilities with a few other DPMs in your area?
For insurance contracting and other reasons, keep
in mind the need to have practice locations that
are dispersed in order to provide geographic
accessibility to patients. Once you have some
like-minded podiatrists who all want to explore
networking together, there are attorneys who can
help you understand your options and make it all
legal.

Lawrence M. Rubin, DPM, Las Vegas, NV,
lrubindoc@aol.com

There are no more messages in this thread.