A Decision-Making Guide for Merging Your Clinical Practice
Guest post by Michael J. Cameron, PhD, BCBA-D, chief clinical officer, Pacific Child and Family Associates.
You’re passionate about helping people. It’s why you got into this field and what drives you to do your best. But it’s very likely that your day-to-day life is filled with paperwork and admin tasks instead of spending time doing the clinical work that you love.
As a side effect of your success, you’ll find yourself consumed by the quotidian responsibilities as an administrator, including:
- Invoice preparation and billing
- Managing timely and accurate payments from school systems, insurance companies, private and governmental payer sources
- Completing applications for insurance companies in order to become an “in-network” provider
- Managing ever changing staff schedules
- Managing issues related to human resource (e.g., hiring, payroll, progressive discipline and employee rights issues)
- Managing public relations
- And more
Should I Stay or Should I Go?
The more successful your practice becomes, the more these tasks eat up your days. You’re pushed away from the reason you entered the field – and you come to a point where you need to make a decision.
All successful small business owners have been at this point of realization. They are suddenly faced with a “stay or leave” decision about the business. If they decide to stay, an infusion of additional capital and resources is necessary to build or maintain the quality business they envisioned at the start. A decision to leave will mean a significant shift in their perceived autonomy and sense of success.
It’s a difficult decision to make, but it’s essential. Staying in this state for too long can have a negative impact on your professional life, relationships with friends and family, personal health and overall quality of life.
If you don’t have the capital and resources to add, you need an exit strategy for the situation you’re in. But your exit strategy doesn’t always mean selling or closing the business.
Why Not Choose Option 3?
Opting for a merger relationship with a larger entity can help a practice expand without putting additional pressure on your individual practice’s time or resources. There are multiple benefits to a merger decision that can help you do the work you’re passionate about and reduce the administrative load.
You gain access to an infrastructure for clinical excellence.
As a clinician and business owner, you encounter complicated circumstances that need to be managed expeditiously and responsibly. You need a “clinical home” to handle the circumstances involved in managing treatment resistant behavior disorders, complex behavioral presentations (e.g., a child with an anxiety disorder) and sensitive family situations (e.g., families impacted by psychiatric problems, separation, divorce, substance abuse and domestic violence).
At Pacific Child and Family Associates, our clinical home provides continuous access to board-certified behavior analysts, speech and language pathologists, occupational therapists, psychologists and physicians. They form an interdisciplinary review team that is client-centered, accessible and focused on clinical quality and safety. In “grand rounds” fashion, the team creates an environment where clinicians (and the clients they serve) are treated with respect, dignity and compassion, which enables trusting relationships and ongoing mentoring. The review team is available at the right place, at the right time and in the manner that best suits a clinician’s needs.
You can keep quality assurance high.
As a busy business owner, you need access to reliable quality control mechanisms that are in place to ensure that the quality of the services you envisioned at the start of their business are actually translated into practice.
Quality assurance can be facilitated by an auditing team – and that is only possible when there is a broad based infrastructure. By merging your practice with a larger organization, you can gain access to both flash audit and comprehensive audit systems that keep quality assurance a priority. They can instill trust and confidence in the fidelity of every level of service delivery (e.g., assessment, programming, progress evaluation, overall outcomes, and report writing).
You become part of a learning organization.
Your professional development and ongoing learning improve your skills as a clinician and as a business owner. However, this can be challenging when you have a busy practice and are overwhelmed with administrative tasks. You know that you should be seeking out learning opportunities, but you can never find the time or organize a schedule to address your ongoing educational needs
Merging with a larger organization can provide a system for generating, acquiring and disseminating knowledge. This makes learning more manageable, and effective. This can take place through formal webinars and courses, or with a MasterMind group that meets on a rotating basis to generate and share ideas and review extant literature on a topic. All of this increases your opportunities and to contribute your knowledge to your peers.
You can create a parent-centered environment.
As part of a larger organization, you can put a premium on the role of the parent. Because administrative, quality assurance and learning systems are taken care of, the family can be the focus of your attention – which is where it should be. You can gain access to sensible, individualized, evidence-based family assessment and parent education systems that can help you help families.
You can access a foundational business structure.
There are thousands of details that go into running a successful business. These logistics can be a drain on your time and energy, as well as pull you away from the family-focused clinical practice. Merging with a larger organization, like Pacific Child and Family Associates, can provide coverage for these logistics. For example, we have:
- An effective and efficient system for scheduling staff
- Systems for billing diverse payer sources
- Data management and customized “dashboards” for informed decision-making (using both qualitative and quantitative data)
- The capacity to benefit from Big Data
- A Human Resource department that manages a wide range of issues
- A foundation for Information Technology (IT)
With these critical business needs taken care of with the merger, you’re free to spend your time helping people and working in your clinical practice.
You can actively take part in developing an envisioned future.
If you want to become part of something bigger that could change the future of service, merging with a larger organization is the right move. With a merger relationship, you’ll tap into the core ideology and envisioned future that drives the organization. You’ll also gain access to information that will impact the future of clinical practice and change the way services are delivered in terms of effectiveness and focus.
With more resources and a broader base of knowledge, larger organizations can use more advanced technology for service, evaluation, collaboration and communication than one could use in a small practice. There are also dynamic and “self-auditing” systems in place for clinical excellence. Logical, documented and accessible clinical procedures are available to facilitate rapid responses for care.
By merging, a solo clinician, or small group, can collaborate with multiple specialists that provide new treatment options for ASD. Clinicians can work with pediatric bio-scientists to provide novel methodologies (e.g., Maternal Antibody Related autism testing) for the diagnosis and treatment of autism spectrum disorder. Or collaborate with technology entrepreneurs who are developing systems like Autism Acumen that offer rapid detection on a smart-phone-enabled system.
There are multiple opportunities for your practice when you opt for a merger relationship. By putting the administrative burden on the larger organization, and tapping into their offered resources, you don’t have to give up the practice you love or settle for spending your time on paperwork instead of with clients. You’ll get back to the work that you’re passionate about.
Dr. Michael J. Cameron, a Board Certified Behavior Analyst(Charter Certificant 1-00-0010) is the chief clinical officer for Pacific Child and Family Associates (PCFA) and experienced in the area of behavioral medicine, behavioral health assessment, intervention for diverse populations and higher education. PCFA offers clinic based, in-home, and at-school services that include applied behavior analysis, parenting training and speech therapy for children and adults with autism and other developmental disabilities. To learn more, visit http://pacificchildandfamily.com/.