As physicians increasingly migrate to employed models, some practices are focusing on prioritizing physician leadership.
Alejandro Fernandez, CEO of San Diego-based Synergy Orthopedic Specialists, joined Becker's to discuss his organization's growth strategy.
Editor's note: This interview was edited lightly for length and clarity.
Question: Your organization prioritizes physician leadership. Why do you feel it's important for physicians to be in the driver's seat?
Alejandro Fernandez: When we are having physicians join our group that were previously in employment programs and with health systems, they feel, in many cases, the frustrations around not being able to have a little bit more control around clinical care decision-making and also around being able to be involved somehow in the decision-making of the operations of the practice. Whereas in private practice, that's the opposite. We are physician-owned and physician-led. We have a board of physicians, and they are the executives that make decisions. As a CEO, I'm really looking for more from the operations business, the finance angle, to make sure the institution is viable and growing and doing all the right things. But in the end, the physicians are the ones that call the shots.
I think that's probably the biggest frustration for employed physicians. But also for us in private practice, you have to build a business. You have to build a strategy. You have to build a practice, and you have to hustle for those referrals, and there's competition.
I think there's some physician roles that fit really well in private practice. If they want to have that control, or at least decision-making, power and voice, being a private practice is extremely important.
Q: Can you talk about your growth strategy?
AF: Realistically, the first thing we need to be able to access in our market is economies of scale, given the high cost of running a medical practice overall. San Diego also just became one of the more expensive cities to live in the United States, which is incredible considering reimbursements are conservatively low compared to other parts of the U.S. So that pressure of the high cost of living with the low reimbursement puts this market in particular in an even greater strain to try to be able to recruit physicians and retain physicians. We've had physicians that have retired and moved to other states.
We are also focusing on insular revenue streams through physical therapy, imaging DME, anesthesia, our ASC, etc. Also key is the payer contract. There are some physicians with peer contracts that we do negotiate directly.