How do financial considerations affect our clinical decision making?

Editor’s note: this article is written by our colleague and friend Sharam Danesh, MD who started a solo retina practice and became so successful and busy that he recently hired a associate.

For better or for worse, many folks in academics hold their nose against private practice and solo docs, believing that private practice is the Wild West, where docs over treat patients and do unnecessary procedures to line their own pockets.

Nothing could be further from the truth. In fact, many of us went into solo practice to be able to practice and order tests and determine whether surgery is indicated using our best clinical judgement- not because the practice owner is pressuring us to do so for his passive income.

Read this article from the New York Times to see how private equity has affected dermatology. Here’s what he has to say about private equity and Ophthalmology:

At Phoenix Retina Associates, we have achieved over 25% organic, year over year financial growth since our inception. Yet, financial considerations have never influenced our clinical decisions. In our practice, there is a firm separation of patient care decisions from financial considerations. We believe this separation between clinical and financial decision making is essential to providing excellent and ethical patient care as promised in our Hippocratic Oath. 

Many of our clinical decisions have resulted in short-term financial loss but they almost always culminated in long-term financial success. A long term time horizon is essential to reap the financial benefits of ethical patient care.

It has become fashionable to use phrases such as “excellent patient care” in slogans of private equity owned medical practices. But, lets get real. Lets look at some specific examples from our practice:

1) Testing and Imaging

We perform tests and imaging only when necessary to make a diagnosis or determine treatment options. For us, tests are not merely money-making instruments. 

A typical example is performing fluorescein angiograms in patients with Age Related Macular Degeneration. 

To finish reading please go to this link and do Sharam a favor and like this article.

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