"Medical school and residency don't prepare us for the realities of private practice"

Doctors aren’t trained to be businesspeople. Many are learning on the job:

“Most physicians know nothing about budgeting, marketing, billing and all the tasks involved in running a business.” Dr. Foxman estimated that he spends 25% of his time dealing with administrative issues.

The business aspects of private practice are almost as important as the medicine itself.

Comments

Anonymous
This is no less true if you take a position with a large clinic. These things are never for just a straight salary. Even if they say so at first, when compensation review time comes around they will pop out the spreadsheet with all sorts of numbers labeled with mysterious acronyms. The MBA’s that we have brought into our large group practices and hospitals to bring “bussiness-like” practices to medicine, are, not put too nice and edge on it, a bunch of liars and crooks, predators by nature.
My years in private practice served me well the 10 years that I was in large-group practice. The ability to and practice of going through the spreadsheets, tracking my own numbers and cross checking, verifying practice expense numbers, etc. served me well in calling the spreadsheet jockies on several snow jobs. I still got taken to the cleaners sometime on compensation but they learned not to lie to me about it.
It was, however painful enough, that I am now solo forever, prefering to manage it all myself than to look over my shoulder. Some of the happiest docs I know do the group practice thing, don’t worry about being lied to, never look at the spreadsheets or go to the meetings, just see their patients, assume administration is ripping them off (they are, I have seen their numbers) but decide they will just not think about it.
Okulus
That last paragraph is unfortunately true. The power of denial.
It becomes painfully evident when the group practice manager retires wealthy a decade before the doctor.
Anonymous
I agree with the last paragraph. I am employed by the hospital they’ve showed me graphs for the last 4 years showing a loss of money every month. It’s all a shell game they are making it all back and plus some with Facility Fees and Radiology they pay me 90%MGMA salary and everyone is happy. Never think for a second though that the hospital is “losing” money on you, thats what they want you to think otherwise I would have been long gone 4 years ago.
Med-Source
What do you think about getting an MD/MBA?? I am a medical student with the opportunity to do so, would you recommend it having seen the lack of business prowess among physicians, or would you stay far away?
Anonymous
The purpose of an MBA is to learn how to do things just this side of getting indicted. They do this full time, every hour of the day. Never think that you can outsmart them at their own game.
Wait until you have home court advantage, when they have crushing chest pain.
Happyman
the 2 yrs of extra school to get an mba would be better spent starting up a solo practice with no employees – steep learning curve but will force you to reckon with all the real issues in practice:
1- cash flow in and out
2- insurance hassles (some are great, some are horrible, and business school isn’t gonna teach you which are which ahead of time)
3- who’s getting rich & who’s getting ripped off
4- managing employees (eventually) which b-school won’t teach you either
5- record-keeping
the few people i know with an md/mba aren’t doing medicine at all. if that’s what you want, fine, but save 4 yrs of med school & potentially another 3-6 yrs of residency
Anonymous
There is no need to get an MBA if you want to run your practice or understand how someone else is running your practice. Business is simple if you do not let people blow smoke in your eyes. The purpose of an MBA isn’t to learn how to use numbers to manage, it is how to use numbers to obfuscate, to be a better wolf. To get an MBA is to go to the dark side.
It shows your credentials to join their gang if you want to be doing full time management in 5-10 years rather than practicing medicine, and you’ll learn the secret handshake. As a practical matter, you can learn all you need to know in the school of hard knocks and in a few weekends with some books. I thought of getting an MBA but my son and neighbor did and intervention and stopped me. It may be a useful credential if you are going into the management profession but will add nothing to your ability to manage medical practices that you can’t easily get.
If you want an MBA, you can always get one latter in weekend executive MBA programs while you practice. Lots of docs do. Probably all MBA’s should be obtained midlife as an enhancement for people whose character is already formed or ruined. They only corrupt the young.
Homo homini lupus

"Medical school and residency don’t prepare us for the realities of private practice"

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