Why I Left Private Practice

After 20 years, I have left private practice and joined with the Cleveland Clinic.  To those who know me and this blog, this development may seem surprising, if not shocking.  On many levels, I’m shocked at this unexpected denouement of my career.   Let me explain.

First, these past two decades in private practice have been fabulous.  Our amazing staff and my partner worked hard every day to provide concierge level care to our patients.  We survived only because we provided a level of service that the surrounding competitors simply could not rival.  We provided customized and personal attention.  Our patients were happy and satisfied.  And, so were we.  So, why did we make a change?

Over the past few years, my partner and I had become uneasy about our practice’s ongoing viability.  The economics of a 2-person private practice are increasingly challenging.  Consider the math.  There is ongoing downward pressure on reimbursement with inexorable upward movement on expenses.  We cut every expense that we could – including the physicians’ salaries.  The only expense that remained sacred was our staff’s compensation.  We knew that if we didn’t retain our outstanding medical and administrative staff- the crown jewels of the practice - that the enterprise would decay.  

The math was against us.

Additionally, my partner and I were on-call for hospital work and emergencies every other weekend and every other holiday.  And, this schedule became more burdensome when one of us was on vacation.  This was our situation for years and we were unable to solve it.

And finally, we worried that if our still independent community hospitals were acquired by a larger entity – which we think will happen – that this could herald the abrupt demise of our practice. 

So, this was our mindset when the Cleveland Clinic approached us and expressed interest in our practice.  Twenty meetings or so later, here we are.  My new office is just down the street from my prior practice and I am honored that my former patients are following me.  Of course, it’s a transition from being president of my practice to becoming an employee of a large medical enterprise, but my partner and I correctly judged that this was the right decision at a most propitious moment in the life cycle of our practice.   Frankly, we got lucky.  We saved our practice and much of our staff have joined us.

Our staff and us had some sad goodbye moments.  But, there were some joyful goodbyes as well.  Imagine my mirth and euphoria in saying goodbye to working on weekends, nights and holidays!  Yes, I deserve a lighter load after nearly 3 decades of hard core specialty care; but life isn’t fair and we don’t always get the fair shake we merit.   Conversely, sometimes we catch a break that we didn’t earn.

If the Clinic and I remain happy with each other – and so far we are – then this will be my final gig. I’ll keep you posted, from time to time.