10 Tips for Considering Joining a Group Practice

Find the “Perfect” Location

Choose a group practice in an area with high demand for spine services that is not oversaturated with competition. Areas with growing populations of middle-aged workers, preferably close to industries with high risk for spine injuries and favorable business climates are ideal.

Key Question
  • Is the practice location convenient to the hospital, outpatient services, and ambulatory surgery center (ASC), if present?

Clinical Excellence

Realize that patient outcomes and patient satisfaction rates are increasingly becoming criteria for reimbursement, so make sure you are joining a quality team. Speak with referral sources and former patients to determine the community’s perception of the group. If you have a desire to participate in research, ensure your participation fits in the group

Key Questions
  • Do the goals of the group match your clinical quality standards?
  • How do the individuals within the group support each others’ clinical interests?


It is critical to your long-term success that you weigh your chemistry with the group and its individuals carefully. In particular, look at the group’s history, as past history can be a good indicator of future behavior.

Key Questions
  • Does the group have a high rate of physician turnover? If so, why?
  • How does the group make decisions?
  • Do individuals within the group hold long-term resentments against the group or other individual physicians, or does the group move on together once a consensus is reached?

Understand your Compensation Plan

Be able to quantify and investigate the compensation package, corporate structure, overhead allocation structure, buy-in requirements for partnership, and group benefits.

Key Questions
  • Have your attorney, CPA, and business advisors thoroughly reviewed all documents?
  • Is there is an opportunity to be part of a syndication group for ownership in the facility? If so, explore these options carefully

Does the New Group Understand Reimbursement?

Staying abreast of new coding, regulatory, and ICD-9 changes can make a big difference to your bottom line—an average collection rate of more than 60 days could be a red flag.

Key Questions
  • Does the new group invest in the right employees to reduce denials and improve collections?
  • Is there a continuing education program for staying abreast of changes in reimbursement?

Contracting Issues

Learn what you can about the group’s payer mix and fee schedules.

Key Questions
  • Do they have a high percentage of managed care, Medicare, and workers’ compensation patients?
  • Do they have any carve-outs for specialty surgical procedures?
  • How do they support new technology?

Is it a Group Practice or a Group of Practices?

Politics and competition among practice partners can hurt the group as a whole. New patient referrals for all providers is a MAJOR indicator of practice’s reputation and overall health.

Key Questions
  • Are referral sources shared amongst the partners, and does the community respect the entire group?
  • Is the group marketing against one another or is there group-think and consensus?
  • What is the system for rotating new patient referrals?

Medicine is a Business—Are You Joining a Qualified Team?

Key Questions

  • Does the group have the systems and personnel in place to manage the business side of medicine?
  • What are the qualifications of the key administrators: practice manager, attorney, CPA, RNs, PA/NPs, etc.?

What Marketing Services Can They Provide?

Marketing is a way to educate patients, payers, referring physicians, and the community about you joining the practice and will play an integral part in your success.

Key Questions
  • Is the group willing to invest time and resources into marketing you?
  • Does the group have a strategic marketing plan including a mission statement, specific goals, objectives, actions plans, and the necessary budget to accomplish these goals?

Make an Informed Decision

This is a career-changing decision. Ask the right questions and take the time to make sure you have all the facts.

Marcy T Rogers, MEd, is President and CEO of the SpineMark Corporation, Management Technology Resources, and American Pain Management. Located in San Diego, California, she can be reached at www.spinemark.com.

Updated on: 01/12/10

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