Designing Independent Physician Practices

September 30, 2015

by Dan Greenfield, reprinted with permission

There was a time when a solo practitioner or independent small group practice was the norm. Today it’s becoming the exception.

Even while the American Medical Association (AMA) reported that a majority (60.7 percent) of physicians were in small practices of 10 or fewer physicians, a growing number of doctors are opting for hospital employment.

Consider the Physician Compensation and Production Survey findings of the Medical Group Management Association.

Five years ago, its member survey of 2,348 participating groups found that 39 percent were physician owned and 57 percent were owned by a hospital or integrated delivery system. Fast forward to 2014 and 19 percent of 3,847 groups reporting were physician owned and 76 percent were hospital or IDS owned.

Ever-increasing administrative burdens of paying staff, rent and equipment can put a heavy strain on the bottom line. Practices must also deal with the rising costs of installing electronic medical record keeping systems and decreasing Medicare and insurance payments.


So how can independent physician practices survive in the face of what the AMA called “profound structural reforms to health care delivery?”

To remain competitive, physicians must be mindful of the value they deliver their patients. And that requires constant vigilance with regular, comprehensive internal reviews.

That was one key takeaway from a presentation delivered by Reed Tinsley at the Austin chapter of the MGMA that I attended this past summer. Reed is a nationally recognized, healthcare accountant and business advisor to physicians and medical practices.

But what is value and how do you assess it?  Reed pointed to the “triple aim” based on improving the health of your patients, controlling or reducing costs, and enhancing the patient care experience.

As a CPA, Reed deals in numbers, but I appreciated his acknowledgement of the intangible role that patient perceptions play in improving the bottom line.

Physicians essentially need to give patients a reason to seek them out when alternatives and in-network restrictions abound.


After years of being in practice in one space, it’s easy to get complacent and glaze over details that tend to stand out for patients.

That’s where interior design comes into play in shaping patient perceptions of the quality of care and driving employee morale.

My own analysis of Austin practices supports Reed’s contention the age of the equipment and comfort and maintenance of the practice space factor into a patient’s decision to come back and refer a physician to others.

It’s important to ask the following:

  • When was the physical facility been last updated?
  • Is it accessible and easy to find?
  • Is the workspace efficiently planned for staff to best serve patients?

And the physical space extends to not only the chairs in the waiting room, but to the age of the equipment used to diagnose and treat patients.

People notice and increasingly are not shy in sharing their observations on online.

Interior design doesn’t need to break the budget.  It’s about providing comfort, safety and well being which are at the core of any physician practice.


That focus on assessing the patient experience is critical regardless of practice size.

Given the pressures of remaining a solo practitioner, joining a larger group practice is proving to be an attractive alternative for many physicians who don’t want to be employed by a hospital. The strength in numbers approach certainly provides financial muscle and numerous advantages that come with economies of scale.

But I offer a word of caution. The size of the practice or the number of physicians doesn’t guarantee success.  It only spreads responsibility over more doctors.

The same rules apply. Even in large practices, physician partners must share the commitment to providing value to the patient.

And that includes the practice space.

Worn furniture and dated equipment in a bigger facility with many physicians are still worn furniture and dated equipment.


Dan Greenfield is co-founder of Health Space Design and heads up marketing and business operations. He is a marketing strategist and business development executive with more than 20+ years of experience in politics and corporate America. He has organized more than a dozen conferences around the country on social media, which featured some of the world’s largest corporate brands and his articles have appeared in numerous marketing publications.

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