American College of Physicians: Internal Medicine — Doctors for Adults ®

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The two sides of selling

I was disappointed to read the article, A look at life after selling a practice, (January ACP Observer, p. 1). When I saw the second title, 'A blessing and a curse,' I thought there might be some balance. Since the author was unable to say anything substantially positive of practice acquisitions until the last two paragraphs of her lengthy report, however, I know that balance was not on her agenda.

My partner and I sold our 16-year-old general internal medicine practice to the University of Pennsylvania Health System two-and-a-half years ago, and our experience has been wonderful. The physicians who run the network have been the most professional people with whom I have ever been associated. I earn more now than I could in private practice, the fringe benefits are far better, my office is better equipped and I have much easier access to quality continuing medical education, telephone consults and electronic communication. I'm busier than before, and the office runs more efficiently.

I'm not boasting, and I know things can change, but I do not think my experience is unique.

Charles Cutler, FACP
Merion, Pa.

I read the article A look at life after selling a practice with a good deal of interest. In our small town of about 25,000, at least eight physicians have sold their practices to different hospitals in the past year.

I was a salaried physician from July of 1987 until May of 1995, when I decided I was ready to try private practice. My experience has been very positive; I am far more motivated to care for patients and doubt that I will ever return to salaried practice. I am working 12 to 14 hours a day just to make ends meet, I make a lot less money and face a lot more management hassles, but the personal satisfaction and autonomy I enjoy have been worth it.

What articles never seem to mention about physicians who sell their practice and work for someone else is that no matter who is managing the practice, the bills have to be paid. Physicians have to work the same amount regardless of whether or not they personally manage the practice.

In fact, if someone else is being paid to manage the practice, that salary (or some portion of it) must come from the practice's income. To pay for professional managers, physicians either have to work harder to make the same income or receive less compensation. As appealing as a steady paycheck and paid leave might be, the cost of these things is more than the loss of controlling one's own immediate and long-term destiny can justify.

Henry J. Frechen, ACP Member
Goshen, Ind.

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