Prethy Rao, MD, MPH
Vitreoretinal Surgery Fellow
Associated Retinal Consultants/William Beaumont Hospital
Derek Kunimoto, MD spearheaded the 8:00 AM session on Day 2 of the 6th annual VBS meeting. The session covered various real world practice management strategies with panelists Jay Duker MD, Reginald Sanders MD, and Gaurav Shah MD. Topics ranged from the use of 25 modifiers, management models, scheduling, and advice for the first 5 years of practice.
Compensation and Management Models
The panelists began the session about different compensation models in academics and private practice, which ranged from RVU to incentive based payment structures. Management models varied. While academic centers (Jay Duker) have a traditional chairman based structure, the important question is who takes the ultimate responsibility for decision making and outcomes (physicians versus department). In some large private practice structures, such as Retina Group of Washington with Dr. Sanders, a physician-elected executive board is in place.
Scheduling patients and controlling schedule structure also matters. The key is to not have the schedule control you and your practice flow. In both Dr. Shah’s and Sanders groups, new patients are referred to newer associates/partners. Dr. Shah organizes his schedule by ensuring the postoperative patients are the first or last 4 patients of the day with more complicated referral-based or drug authorization-based patients during the middle of the day to allow ample to for authorization approval. However, the bottom line with same day referrals: always say yes.
The panel also addressed a growing trend in the ophthalmologic community: private equity purchasing practices. Private equity groups buy practices with the goal to add value and sell within 3-5 years. The panelists encouraged self-education before considering and/or joining these practice models with respect to understanding where profits are coming from (physician salary) and non-compete clauses.
Advice for Young Retina Specialists
Lastly, advice for the first 5 years in practice can be summarized with the following:
- Don’t demand: while fellowship is a great base, it is important to know that not all of what you learned may be the best way to practice
- Get to know referring physicians; call them up
- Invest in relationships: family, partners, patients
- Learn from your partners
- Analyze your outcomes during first year
RETINA Roundup VBS VI Coverage:
3/27/2018 VBS VI: Historic Delivery of Gene Therapy for LCA
3/27/2018 VBS VI: Surgical Adventures – Curing One Eye at a Time
3/26/2018 VBS VI: Retinaws
3/26/2018 VBS VI: Complications Session
3/26/2018 VBS VI: Women of VBS Breakfast
3/26/2018 VBS VI: Endophthalmitis Session
3/25/2018 VBS VI: Retina Caliente
3/25/2018 VBS VI: Lifetime Mentorship Award: Jay Duker
3/24/2018 VBS VI: Surgical Adventures – Bridging the Gap
3/24/2018 VBS VI: Real World Retina – Practice Management, Private Equity, Advice for Young Retina Specialists
3/24/2018 VBS VI: Medical Retina
3/24/2018 VBS VI: Live Surgery Session
3/23/2018 VBS VI: Fellows’ Forray
3/24/2018 VBS VI: Welcome to Miami