13 May Healthcare’s Changing Business Landscape: A Successful Independent Physician’s Perspective

Healthcare is rapidly changing and more is being required of independent physician-owners to navigate healthcare.

We sat down with one of speroMD’s founding owners and independent physicians, Dr. Susan Sirota, to pick her brain about the ever-changing field of healthcare.  In the following interview, Dr. Sirota shares personal experiences, insight, and advice that we hope will be of use to other physicians and practice managers.

spero: You have been an independent physician for over 20 years, what significant changes have impacted the business of running your practice in recent years?

Dr. Sirota: “The most significant change over recent years has been the rapid consolidation of healthcare.  For the first 15 years I was practicing, there was never a need for me to question how my practice was structured.  When we started our practice, the local hospital actually encouraged us to open our practice and provided financial support to develop our independent practice.  In the early years our concerns were solely about improving the quality of care for our patients and expanding the business.  Now we have to also consider how we are going to change our practice to fit into the consolidation landscape created by the practices and hospitals around us.

Many of my colleagues have sold their practices and now work for hospitals.  As an independent pediatrician, I am now competing with hospitals’ outpatient care facilities for patients and for employees.

If a practice wants to remain independent today the physician owners have to be proactive about improving the quality of patient care while seeking to provide better customer service, cut costs, improve the efficiency of the operation, and develop new revenue streams.  A physician owner needs to be more aware of the business of the practice.

spero: What changes have you observed that directly affect an independent practice’s revenue cycle?

Dr. Sirota: “In general it is more challenging to run the business of an independent practice because costs have increased over time, federal mandates have created more stress on time and resources, and in the case of primary care, insurance companies typically pay less for preventative care than for procedures.  A practice is challenged to reduce the major contributors to overhead such as vaccines, rent, and staff.  In fact, it has become even more important to enhance the efficiency of a practice’s revenue cycle.

spero: Why is it critical for independent physicians to understand their practice’s revenue cycle?

Dr. Sirota: “A common weakness among independently practicing physicians can be limited knowledge of the business of their practice and its revenue cycle.  Often times a physician owner will hire as a manager, a family member or someone who might not recognize inefficiencies within a revenue cycle when they occur.  A practice manager needs to recognize trends within revenue cycle reports and have a clear understanding of every step of the revenue cycle process as well as who is accountable for each step throughout the medical billing cycle.

spero: What type of information do you seek from your revenue cycle to know more about your (revenue cycle) business operations and why?

Dr. Sirota: “The starting point is to know what care has been provided and know if the practice has been paid for providing the care.  It is important to monitor and analyze reports to evaluate clinical (coding) and payment trends.  A/R reports indicate if and when a practice is being paid.  A change in key indicators can signal a problem within a practice’s revenue cycle.  Consistent monitoring of insurance payments through payer reports is essential. After all, these payments represent our largest source of income.

spero: Do you have any interesting stories or tales about revenue cycle or the business side of practice management?

Dr. Sirota: “Like many practices, we had an eye-opening experience with a manager who wasn’t doing the job well.  We realized that we lacked some necessary financial controls that could have jeopardized our practice. The experience taught me that owning a practice included the responsibility of learning to run the practice and investing time to gain knowledge about the administration and management of independent practice.  While I might be happiest only taking care of my patients day to day, I learned that if a physician owner isn’t closely monitoring the revenue cycle, we can not be successful in our practice.  At the end of the day, as a physician owner, no one will care more about your business than you.


Dr_ Susan Sirota_independent physicianDr. Susan Sirota has been a practicing pediatric physician for over 20 years.  In 1993, she founded Pediatric Partners practices in Highland Park and Vernon Hills, Illinois, which later merged with other practices to form PediaTrust, LLC.  Dr. Sirota is an innovative business leader with expertise in running a successful and efficient physician-owned practice.  She also serves as the Chair of the PediaTrust Board.  Long recognized for her business expertise, Dr. Sirota has been showcased as a speaker at the American Academy of Pediatrics’ (AAP) National Conference and Exhibition (NCE), and is an active participant in the AAP’s Section on Administration and Practice Management.  Dr. Sirota is also a longstanding board member for the Children’s Community Physicians Association (CCPA) and the CCPA Purchasing Partners, and is an active member of the Lurie Children’s Health Partners CIN Finance and Contracting Committee.  Dr. Sirota received both her undergraduate and medical degrees from Tufts University.  She completed her Internship and Residency at Ann & Robert H. Lurie Children’s Hospital of Chicago (formerly Children’s Memorial Hospital).  Dr. Sirota is an Assistant Professor in Clinical Pediatrics at Northwestern University’s Feinberg School of Medicine.  She volunteers as the attending faculty for continuity clinic, teaching pediatric residents at Ann & Robert H. Lurie Children’s Hospital.  Dr. Sirota is a member of the Advisory Board for the Center for Jewish Genetics, and maintains affiliations with four hospitals in the Chicago area. 
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