None of us knows what the future holds for physicians and the practice of medicine.  Of course, many physicians are, by entering into various contractual arrangements with hospitals, ACOs and other networks, placing their bets on the practice model they think is most likely to prevail under the Affordable Care Act.  I caution my physician clients to take a different approach, however.  Rather than scrambling to sell to the local hospital or link up with the first network to come knocking, I continue to suggest that practices focus on developing into real, sophisticated, business entities so that they will be prepared to adapt to whatever model or models emerge.

How does a practice prepare for the future when no one knows what that future will look like?  My suggestion is to identify possible scenarios and be prepared for all of them.  And what would the successful medical practices of the future look like?  I expect that they would have some or all of the following characteristics:

-Greater business sophistication and management expertise;

-Sophisticated information management systems that they know how to use;

-Staffing and systems to manage and ensure regulatory compliance;

-The ability to do real strategic planning and implement those plans;

-Economic depth; and

-Increased efficiency.

I also think that that larger medical practices will have the greatest chance of developing the above qualities and systems.  As the delivery of healthcare becomes increasingly complex and expensive, we can reasonably expect that small practices will continue to struggle to keep pace with the larger, better-funded, players in the marketplace.

While we don’t know what the future holds, few would argue that those medical practices that can evolve from mom-and-pop shops into sophisticated provider entities will stand the best chance of not only surviving, but thriving in the new healthcare environment.