Orthopedic clinics looking to join a larger group practice should come in with an open mind and be prepared for significant changes, according to Michael Doyle, CEO of Florida Orthopaedic Institute.
The Tampa-based supergroup has become one of the largest orthopedic practices in Florida, with a network of more than 40 physicians, 700 team members, 13 offices and 19 regional hospitals.
Larger organizations such as FOI have become attractive options for smaller practices wanting additional support for growth initiatives and economic challenges.
Mr. Doyle spoke with Becker's about the advantages orthopedic supergroups have over smaller practices, what a practice should expect when merging with a supergroup and how big is too big for these organizations.
Question: What advantages does your orthopedic group now have over smaller practices or hospitals in your market?
Michael Doyle: There are certainly obvious financial and organizational benefits that come with scale. Additionally, our platform is able to afford a management team and certain technologies that smaller groups simply cannot. Our patients love the convenience we offer through 24 market locations as well as being a one-stop shop for all of their musculoskeletal needs. On the hospital front, rather than competing, we have seen a transformational shift in health systems seeking to work with us. They enjoy the convenience of working with one partner and are confident our team can handle the administrative requirements. Also, our expanded physician base allows us to better serve these hospitals without overburdening our physicians.
Q: What were the biggest challenges integrating multiple practices into a single group? What advice do you have for other groups considering a merger?
MD: Much like a marriage, it's a give and take. Groups need to go into it with an open mind and understand there will be significant changes. Best advice would be to over-communicate, meet in small groups and engage experienced legal counsel to walk through every step along the way. Ensuring you have physician alignment is a key success factor.
Q: How will your priorities evolve as you move past your initial years as a supergroup and become more established?
MD: We couldn't be happier with how our group has come together. We established a very detailed integration plan that we were able to complete significantly quicker than expected, mainly due to the level of physician engagement in the process. In this next phase we will continue to grow our practice with several new market de novo locations opening over the next 12 to 24 months. Additionally, we are in discussions with other like-minded independent practices in Florida and across the county that are interested in joining forces.
Q: How big can orthopedic supergroups get? How big is too big?
MD: There is definitely a sweet spot between leveraging scale and remaining nimble in your decision-making process. Ultimately this is dependent upon having the right people, processes and procedures in place. Even in a consolidated world, healthcare remains local. Certain models work in certain markets. Our model was designed to promote local independence to ensure specific needs and market drivers are met. I do not think there is such a thing as too big. Most groups experience difficulties when they fail to build the base infrastructure that provides the solid foundation for growth or diverge from the business where they experienced their initial success.
Q: Do you believe consolidation through supergroups or other mergers will be inevitable for smaller practices?
MD: While orthopedics is still largely fragmented, I do believe you will see practices continuing to consolidate in the years to come. Ultimately, physicians still control their own destiny. Yes, there are several outside pressures making it extremely difficult for the sole practitioner to survive in today's world, but those that are willing to roll up their sleeves are still able to be successful. That said, I don't believe you will see many physicians going out and starting their own practices in the current environment. Orthopedic surgeons coming out of fellowship today seek stability. Stability in the form of a pipeline of patients as well as clinical and administrative support. Staying independent can be the right plan, but having a plan is the most important initiative that a lot of practices lack.
Q: How do you plan to grow in the next five years? Are you planning to add more physicians and/or practices?
MD: FOI was built around the foundation of clinical excellence through education and research and is home to some of the highest regarded orthopedic surgeons in the world. Our focus will continue to be on partnering with like-minded best-in-class surgeons across the country who share a common desire to advance the practice of orthopedics and build a multigenerational business that is the destination of choice for highly skilled orthopedic surgeons.