EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1529000
WINTER 2024 | EYEWORLD | 85 P Contact Pinto: pintoinc@aol.com, 619-223-2233 Wohl: czwohl@gmail.com, 609-410-2932 to keep practice business data a secret until the associate is just about to become a partner. This results in an associate who is untrusting, disen- gaged from the details of the practice, and unfit to assume the fiduciary role of a partner. As the senior doctor, you should foster an environment of strategic intimacy. You and your new doctor should openly discuss where you want to take the practice in the future. • The geographic span of the practice • The agreed growth rate and scope of practice services • The provider mix and perhaps the ratio be- tween MDs and ODs • Your relationships with local health systems • Succession strategies Every new doctor, even durable associates who are not on a partner track, should have a few hours per month that they devote to staff education, outreach in the community, out- comes research, protocol writing, and the like. There can be compelling financial, qual- ity care, and lifestyle motivations for a solo surgeon to take on one or more associates. At the same time, there are often deeply personal motivations to remain in solo practice. Adding doctors is not an automatic path to a senior doc- tor's financial success. As many larger groups have found, moderate diseconomies of scale can arise when a practice exceeds around five partners. retained earnings of the practice, personal savings, or a line of credit, you should have access to the equivalent of at least six times your monthly salary and draws. Also, be pre- pared to curtail personal lifestyle costs tempo- rarily if your new doctor takes a little longer than expected to build his or her practice. New associate success factors You should accept in advance that bringing on a fellow doctor and becoming a small group practice will involve more than just near-term financial adjustments. Longer term, and espe- cially if your associate becomes a partner, there will be other adjustments. Chief among these, additional meeting time is essential. Decisions often have to slow down to allow for more com- munication. In the vast majority of cases, as you make the transition from solo to group practice, your new doctor will spend two or three preliminary years as a partner-track associate. During this trial period, they should receive their personal monthly production figures (patient visits, surgi- cal cases, collections, and average revenue yield per patient visit). Ideally, these are graphed to make it easier to spot trends. In addition, we think that partner-track as- sociates in good standing should receive finan- cial and volumetric performance statistics for the overall practice. Some senior doctors elect BASE MONTH PRE-HIRE MONTH 1 MONTH 2 MONTH 3 MONTH 4 MONTH 5 MONTH 6 Number of MDs 1 2 2 2 2 2 2 Base, pre-hire collections 100,000 100,000 100,000 100,000 100,000 100,000 100,000 New doctor collections 0 8,000 15,000 25,000 30,000 35,000 40,000 Total collections 100,000 108,000 115,000 125,000 130,000 135,000 140,000 Base practice expenses 60,000 60,000 60,000 60,000 60,000 60,000 60,000 New doctor expenses, including salary 0 35,000 30,000 25,000 25,000 25,000 25,000 Total expenses 60,000 95,000 90,000 85,000 85,000 85,000 85,000 Profit for senior doctor 40,000 13,000 25,000 40,000 45,000 50,000 55,000 Table 1. Example of cash flow in the first several months after hiring a new doctor Source: John Pinto and Corinne Wohl, MHSA, COE