Listen Up

Wednesday, May 27, 2015

THE DEATH OF MEDICAL PRACTICES

NEW DOCs  'Practice Closing"  "Practice for Sale"


At one time medical graduates would scour medical journals or other sources for this announcement.

Consider the chagrin and desperation of many physicians who have worked for 35 or more years building a medical clinic or practice. One that on the surface is thriving.

The solo practitioner is at a serious disadvantage when retiring. He has several options:

1. Close the doors, walk away and sell assets at auction or to another physician
2..Sell the business to a young physician, hospital or a large group.
3. Bring in an associate several years prior to retiring, and work part time for the new graduate.

Advance planning is critical, however given the volatility of marketplace economics and the rapidly changing environment even the best plan may fail.



It is a SAD fact. Most physicians take great pride after they have built a medical practice, developed a stellar reputation, work very hard for  30 or more years, and leave a legacy business intact for a community  At one time a retiring MD had not only the assets of the practice, it also had considerable cash value in "goodwill"  The ongoing inertia of a practice and the implied recommendation by the former physician are enormous. It carries with it a cash flow from ongoing patients, their family and friends. In some cases  'goodwill' was larger than the capital assets of the medical business.

Today 'goodwill" is almost meaningless. Health Reform and the rise of group medical practice is like the battleship of medicine vs the PT boat. While the PT boat can be nimble on it's feet and change direction according to circumstance, it can easily be rammed or swamped by the battle ship.

The legacy of a medical practice may wind up in a classified ad, or an auction block.

Today many older physicians fade away, remembered only by colleagues and grateful patients.

Knowledgable physicians know they will not become rich as MDs.  They will always be in demand, however they may or will become the civil servants of society,paid a  handsome wage compared to most workers, and will have sacrificed their autonomy in a rigid oppressive heath system.

Other businesses such as restaurants, tire dealerships, fast food franchises, and thousands of mom and pop enterprises can sell and use their business as a considerable retirement asset.

Most people do not know that many many physicians are unable to save for retirmenent due to increased operating expenses, decreased reimbursements, or early disability.

Earning and using an M.D. is no longer the  guarrantee of life long security..

It's the patient's loss as well.


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