Editorial: Mergers, audits, and self-inflicted injuries

Key Points

These economic factors are leading many physicians to change their practice situations because they can no longer make a living. To preserve or enhance your income, you need to master the local medical marketplace. If your market presence is larger, you'll have more leverage with insurers in managed care and greater ability to negotiate the fee schedules you need. To this end, practices are merging to form larger groups, or selling to hospitals and other entities. If you're considering or planning such action for yourself, I've written an article providing the key questions you need to ask, and the answers to look for in preparing for a new situation in terms of practice finances, management, real estate, and staffing.

HIRING AND RETAINING the best staff is a constant challenge in medicine, and we're fortunate to have leading human resources/labor attorney Johan Lubbe as our consultant in this issue. His article covers such difficult areas as office romance, medical leaves of absence, employee harassment, and selective hiring. The latter refers to the issue of whether or not you are legally obligated to hire a male physician, for example, or a male nurse, to work in an ob/gyn practice. Understanding the potential pitfalls involved in dealing with any of these issues will protect you as an employer and will help you to manage your staff soundly and sensibly.

AS YOU READ THIS SPECIAL ISSUE, Congress continues to debate whether to continue or reverse the proposed reductions in Medicare reimbursements, and as Medicare goes, so go the private insurers. Universal health care, single-payer financing, and limitations on medical salaries have all entered the public consciousness and may eventually affect you directly. Prepare yourself for change by educating yourself about your options and by taking action to optimize your practice finances and management now. I hope that you'll find the information in this issue valuable in both the short and the long term. Finally, as an ongoing resource, remember that every issue of Contemporary OB/GYN typically contains articles that address the topics we're dealing with today, so check back with us regularly to keep current.

DR. HAYWORTH, Issue Editor, is President and Chief Executive Officer, Mount Kisco Medical Group, Mount Kisco, NY, and Clinical Assistant Professor of Obstetrics, Gynecology and Reproductive Sciences, Mount Sinai School of Medicine, New York, NY.