Entry & Exit
by Stephen C. Fitzer
BCMS Executive Director
Physicians have asked me what the
Bexar County Medical Society is
doing to help them retire, take on
partners or start up practices.
With the baby boomers (born
1946-1964) beginning to consider
retirement, the whole field of medicine
is changing.
Many new physicians are entering
the workforce to replace retiring physicians,
but also to serve the growing
American population that now totals
more than 300 million.
Some of these new physicians will
work full time, while increasing numbers
will only work part-time.
The next 10 to 20 years will see the
largest rotation in physician faces ever
in the history of our fair country. With
all these changes afoot, younger and
older physicians alike are looking for
advice on how to enter, exit and addon
to their practices.
What is a practice worth if it is sold?
What happens if a physician just closes
down the practice upon retirement?
Does it make more sense for younger
physicians to buy into a practice, start a
practice or work as an employee of an
existing practice, or for a hospital, clinic,
university or insurance company?
Depending on a physician’s practice,
many of these questions have likely
been already asked. The good news is
there are quite a number of options for
new physicians, as well as for physicians
who are beginning to scale back or
change the way they practice.
Understanding the decision points
in each scenario is crucial to making
the right decision. It’s a little different
for everyone. Physicians all have different
skills, personalities, likes and
dislikes, as well as tolerance for risk.
We will be considering those
options, along with collateral issues,
in this upcoming series of articles in
San Antonio Medicine magazine.
The content of this series will come
from a variety of sources. The first
source is my own personal experience.
I was prompted to write about this
subject due to my many years as
President and Chief Executive Officer
of a few different medium-sized
(1,000-3,000 employees) commercial
companies, where I evaluated hundreds
of companies for potential
acquisition, ultimately deciding to
acquire 22 of them.
Considering companies for acquisition,
then buying them and seeing
what makes a good or bad acquisition
were life lessons. The option of growing
businesses from start-ups or from
an existing base of business by hiring
skilled people presented its own set of
lessons. Being an employee or owning
a practice carry with them specific sets
of pros and cons.
The commercial businesses I managed
in my career before joining the
medical society were not medical
practices but they were all service
companies, most of them with a mix
of highly trained professionals and
less educated, yet trained individuals.
While physician practices are
unique, business principles apply
because, after all, the practice of medicine
is a business.
Other sources I will drawn upon in
writing these articles will be interviews
with medical practice consultants,
published articles on valuations, laws,
ethics, experiences of other individuals
in this arena and current trends in
practice transition and management.
The desired result will be a better
understanding by new and experienced
physicians of how to consider
workable alternatives. Learning from
the successes and failures seen or
experienced by others will be valuable
to physicians as they consider practice
entry, exit or change.
If you have any experiences, expertise
or advice that you would like to
share, please call me or send me correspondence
with your input. A pooling
of experience will be useful to all. I
can be contacted at 210-301-4393 or
Steve.Fitzer@bcms.org.
