Aleksandar Curcin, MD, was born in Novi Sad in the former Yugoslavia and eventually made his way to the East Coast where he studied medicine at the University of Maryland. He performed his orthopedic residency at Brown University in Providence, R.I., and spine training at the University of Maryland, where he remained on the faculty for seven years at the University Maryland Shock and Trauma Institute.
“That education has been priceless to me over the years,” Dr. Curcin says. “My background and education has allowed me to engage the management in whatever practice I’m engaged in.”After working for a group practice in Baltimore, Dr. Curcin moved to Coos Bay, Ore., three years ago. There he joined South Coast Orthopaedic Associates, a group practice that includes six orthopedists and a pain management specialist. They practice at their own ASC, South Coast Surgery Center, and Bay Area Hospital, an 80-bed facility that is the largest coastal hospital between San Francisco and Seattle.
Here he offers seven best practices that have helped him build his successful spine practice.
1. Take care of your patients. “The dynamics of success are wildly different in an academic setting than in the real world,” Dr. Curcin says. “But the common denominator in both settings is taking good care of patients. My success stems from the fact that the vast majority of patients I treat or operate on have good clinical results and tell their friends and family.”
2. Don’t neglect your referral sources. Dr. Curcin says learning that developing and maintaining good relationships with the physicians who refer their patients to you, primarily internists and other primary care, was vital to his practice’s growth and success. “Spine surgeons and all specialists must become good networkers,” he advises.
3. Be available. “Sometimes in this profession we get numb to that whole concept of what it’s like to be a patient waiting for a doctor in an office or waiting months for an appointment,” he says. “It’s not that difficult to schedule appointments appropriately so patients don’t have to wait.”
His eyes opened to the patient experience when he was in an attorney’s office for a legal proceeding and waited nearly an hour, feeling the frustration of patients stuck in an office indefinitely.
“I thought: what the hell is this?” he says. “It was a valuable experience for me.”
He says it’s also important to be available to physicians referring patients. “They need to know you’re responsive to them and to their patients.”
4. Explain things to patients. “I can’t tell you how many times a primary care doctor has called to tell me that I was the first specialist to sit down their patients and explain their condition and my recommendation for what should be done,” he says. “Taking the time to explain pays off in so many ways, particularly in this day and age when 80-year-old patients are telling me they researched things on the Internet.”
5. Ask the right questions before joining a group practice. Dr. Curcin says young physicians completing their fellowship training need to decide which practice to join. He says the most critical business question is to learn how the group makes business decisions.
“I’ve had both personal experience and also when I was the fellowship director at the University of Maryland and I’ve heard similar tales of woe,” he recalls. “In my case, I went to the practice and saw a nice office and great group of guys. But once I got there to work I realized that the decisions they made were not equitable.”
He says the practice had decided to branch out into physical therapy, MRI and a satellite office within one year.
“The problem is I was a first-year partner in a group of 16,” Dr. Curcin says. “We had physicians at both ends of the spectrum. A guy doing this for 30 years doesn’t have cash flow problems. But for the young guys cash flow was a problem. There was bitter fighting and emergency weekend meetings. We’d come to an agreement and the next day we’d be back to square one. These factors pointed to a group that was dysfunctional when it came to making business decisions. I couldn’t see myself here long term.”
He says it is considered acceptable in the later stages of negotiating to ask for financials. “But seeing last year’s books isn’t enough,” he advises. “They need to know how financials are reported to doctors on a month-to-month basis. I was told I couldn’t see the books, that I was just an employee. Young physicians need to ask how conflicts are resolved within the group.”
6. Don’t ignore the business side of your practice. “My advice for young and old physicians is not to fear looking into the business side of your practice,” Dr. Curcin says. “Don’t have this aloof mentality that this is something you shouldn’t be concerned with. Roll your sleeves up and examine how well your practice is running. Be engaged with your management team. In transitional medical training we don’t get exposed to the business side.”
7. Bigger isn’t always better. Dr. Curcin says group size is a significant issue. He says specialists leaving their fellowship training to seek out group practices to join should consider the size of the group. He says his former group in Baltimore had 16 doctors and ballooned to more than 20.
“The decision-making processes in groups that big are dramatically different than the group I’m in now,” Dr. Curcin says. “We make decisions much faster and more efficiently to implement ancillary revenue services. In a big group there is so much debating and discussing that slows the process and causes rancor.”
Contact becker@beckersasc.com.