VBS VI: Fellows' Foraya
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 ModelsThe 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.
Clinic FlowScheduling 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.
Private EquityThe 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 SpecialistsLastly, 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