While mergers provide an advantage under managed care, they can also make sense in any environment. An efficient merger will reduce rent and staff size. Remember, if the office is efficient, charges are being posted at the point of service into the computer and follow-up services are scheduled at the point of service, requiring no new personnel. If the doctor uses electronic medical records, you no longer need a file clerk to file and move charts. Mergers require careful planning of the new business infrastructure, otherwise potential savings can evaporate as group decision-making begins to add unnecessary costs.
Focused strategies lead to better outcomes and lower costs.
It is no accident that the best outcomes and lowest price for open-heart surgery are achieved where the highest volume of these is performed. The higher the volume of similar procedures, the more skilled the doctors become at performing them, and unit costs decline as more procedures are spread over existing fixed costs. Treating every condition provides neither the highest quality nor the highest profit. In some offices, applying a cast may set the entire schedule back, while in others it is a routine, fast process. Some doctors enjoy treating certain conditions more than others, and narrowing the focus of a practice may revitalize a burned out practitioner.