CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

October 28th, 2011

Joining the Fishbowl

CardioExchange welcomes this guest post, reprinted with permission, from Dr. Westby Fisher, an electrophysiologist practicing at NorthShore University HealthSystem in Evanston, Illinois, and a Clinical Associate Professor of Medicine at University of Chicago’s Pritzker School of Medicine. This piece originally appeared on his blog, Dr. Wes.

It’s a strange thing, this practice consolidation.

Imagine: one minute the guys over there are your competitors, then the next thing you know, they’re part of your group.

Before, you were SURE you offered patients something better (at least that’s what you told yourself). Now, they are us. How do you differentiate yourself any longer? Can you? Should you?

Before, you worked for your practice, them for theirs. People unhappy with them could come to you across town and vice versa. Where will your patients have to travel for an independent second opinion now? Or will those second opinions just occur with another colleague? As it stands now, we all work for One Practice and The Man. If the new guys screw up, we all screw up. They do well, we’ll do well. (At least that’s what’s promised, right?) And what if The Man screws up?

It can’t be easy being the new kids on the block: do you trust them? Do they trust you? Were there incentives to join? Were there not? What deal was cut? There was a deal, right? An now: what will be the impact of their presence be on patient volumes? On pay?

We’re like formerly incompatible tropical fish that are now being thrown in the same fishbowl. We look and feel so pretty now, don’t we? But you have to wonder: who will survive and who will die off when the fish food is in short supply? And as the bowl gets more crowded, will there be enough oxygen to support us all?

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