Katherine Farady, MD

When I left the Navy in 1995 and started a solo dermatology practice, it was hard, but it was also exhilarating. I had to learn coding, billing, how to run a business, and many other things, but it was doable. I took care of my patients, worked 8 hour days, and made decent money. Twenty years later, I found myself working 10 hour days, even though I was seeing the same number of patients. And my income had barely budged. What happened? Many of the contributing factors will be familiar to most of you. EMR, PQRS (now MIPS/MACRA), Meaningful Use, ICD-10, HIPAA, OSHA and others all clamored for my time and attention.

I just wanted to take care of patients, because that is what I was trained to do. Instead, I found myself spending evenings and weekends on practice administration: learning the latest MIPS requirements, dealing with employee issues, benefits, and evaluations, maintaining HIPAA/OSHA programs and always worrying about revenue and expenses. I watched as expenses steadily increased every year, while reimbursements failed to keep up. As a solo practitioner, I was helpless to negotiate decent insurance contracts. I was on an endless treadmill of work, with the occasional crisis thrown in for extra stress. I had so many balls in the air, I lived in fear of letting the administrative duties get in the way of good patient care. Gradually, my outside life started to disappear. My practice had totally consumed me. I did not want to live this way anymore. Further, I needed an exit strategy, as I was now approaching the final stretch of my career.

DMP was actually not the first DSO I talked to. I started looking at the possibility of merging with a larger group 4 years ago, when I realized that my quality of life was suffering. I talked to some of the larger players but was not happy with their approach. One group was fixated on “helping” me grow by adding a PA or a Mohs surgeon and getting a bigger office (none of which I wanted to do). A second group was going to require me to rebrand and start referring to their Mohs surgeon, whom I had never met. Another group wanted to take over my scheduling from another state. I heard stories about groups that would come in and lay off employees and mandate changes in workflow. I still wanted my autonomy, so I passed on these groups.

I was not sure if I was ever going to ever find the right fit until I met Steve Pohlmeyer, the president of DMP. I liked him right away, and it was clear that DMP was sincere about wanting to make dermatologists’ lives better. It was also clear that they valued quality and were not going to just partner with anyone. Their due diligence process was more thorough than anyone else’s and I could tell that they wanted to make sure that I met their high standards. That was reassuring, as I wanted to be associated with good practices.

This decision was a major move for me, probably the biggest of my career, but I took the leap and have not regretted it. In the past six months, as we have transitioned, the DMP team has taken over accounts payable, accounting, payroll, health benefits, and 401K. They have provided backup for my biller, and helped us with our PQRS filing. They have taken over my HIPAA and OSHA training programs, and helped me with several practice management decisions. I can call them any time with problems or questions, and they help me solve them. I love having a partner who is there for me, yet at the same time is invisible to my patients. I get to keep my name and my brand, which I have worked hard to establish. I practice medicine the way I want to, and DMP is there in the wings dealing with all the back office headaches. I have gotten my weekends back, and am starting to get my life back.

I also have the relief of having a 10 year plan for the rest of my career. This was the right time to monetize my practice, and I know that when I’m ready to retire, DMP will be there to help me ensure a smooth transition for my patients and staff. That peace of mind is priceless.

Tim Kelly, MD

If you are reading this, then you did not do what I had been doing for the last year or so—automatically throwing away letters from large dermatology groups looking to pad their numbers. I am in my mid 60s and I had been thinking, “What will happen to my practice when I retire?” I have worked very hard at building my practice for over 30 years and I was concerned about the future care of my patients and the well-being of my staff as they transition into a new practice setting.

As a solo practitioner, I chose to concentrate on delivering high quality, compassionate care to all of my patients. My preference for a transition into retirement was to have some input regarding who might replace me and ideally find someone who had a similar clinical practice style. I also realized that many small dermatology practices (consisting of one or a few physicians) have been pursued by large multi- practice groups who were willing to offer significant remuneration for joining. Because of my concerns about getting a quality replacement for my practice and not knowing how long my practice would hold its value, I started researching my options.

It did not take long to see a common theme of negative characteristics associated with these acquisitions. The purchasing groups—which almost always consisted of dermatologists adding to their practice—come in and micromanage the practice, change staff without approval from the selling dermatologist (often firing loyal staff members with years at the practice), rebrand the practice name, use aggressive collection techniques, and make changes to the PM and EHR software. They would also mandate the use of their specialists (e.g., dermatopathologists and Mohs surgeons), requiring a change in referral patterns. These changes usually result in a significant decline in office morale. Because I planned on retiring in 3 to 5 years, I decided to choose the least antagonistic one, hoping at the very least I would be involved in selecting my replacement.

The night before I was set to sign a Letter of Intent with them, I received a fortuitous call from a local dermatologist friend who suggested I speak to a company called Dermatology Medical Partners. I called their President, Steve Pohlmeyer, and after a 45 minute conversation, I realized the difference was remarkable. Dermatology Medical Partners (DMP) is a dermatology support organization focused on making the life of a dermatologist less stressful. Their claim was there would be NO changes in the way I run my practice. All medical decisions would be made by me alone. Staffing would remain the same unless I needed more support staff and any hiring would be approved by me after DMP did the recruiting work. They would also handle the accounting and financial aspects of the practice. DMP did their due diligence in an extensive vetting process which included many face-to- face meetings and conference calls with their entire team. This process allowed me to get to know and feel very comfortable with the people who would be helping me make my transition into retirement. I feel they are truly interested in me as a member of the team and not just another practice added to the group. This whole process turned out to be such a positive experience that I am now planning on continuing to practice for at least 5 more years.

Since joining DMP, there has been no change in the way I care for my patients except that I feel less stressed about the administrative side of the practice. DMP’s staff has been easy to work with and has promptly help me solve non-clinical issues as they arise. As an example, I have promoted one staff member to be a clinical coordinator for our back office and—with the help of DMP’s HR specialist—I have recruited another experienced MA to help my practice run more efficiently. Instead of coming in and telling me what needs to be changed, DMP asked me what areas I feel they can help me improve and make the practice run better. I have not regretted my decision to join DMP for a second since becoming a member. One last important point—the practice name on my door is unchanged. As far as my patients know, I am still an independent practitioner. Whether you are considering a transition to retirement in the next few years or would like to enjoy the medical side of your practice more by eliminating the headaches associated with dealing with the business problems, I would highly recommend talking to DMP to see how they can make your life better. I am delighted that I did.

Isaac Zamora, MD

This letter may change your life so please read on. I have been a solo practicing dermatologist for over 35 years. The gratification for me is in seeing patients and helping to improve their health. I still feel that way and hope to be doing this for many years to come. I have built a successful and rewarding practice. Recently, however, the government has dotted the landscape with land mines such as compliance, coding changes, new payment models, countless initials such as PQRS, HIPPA, CLIA, etc., and blatant intrusion into our private practices. This has undoubtedly contributed to the current epidemic of physician burnout. I was at the end of my rope in having to deal with this so I started looking at affiliating my practice with a larger group.

I met with several of the large groups that are taking in private and group practices. Some of these are run by physicians. The bottom line with all of them was that they wanted to incorporate my practice into their system and tell me how to run my office. Most wanted to add physicians, extenders, and staff that they would select and they wanted to take my name off the front door and replace it with their logo. This did not sit well with me and was not the direction I wanted my lifetime of work to take. I was looking for something better.

Fortunately, I received a letter at an opportune time introducing me to Dermatology Medical Partners (DMP). After one phone call and a face to face meeting, I knew that this was the perfect fit for me. DMP is run by professionals who have an interest in partnering with dermatologists – not in controlling them. They have offices in Tampa and are backed by a family investment firm in Chicago. Their President, Vice- Presidents, and everyone else who I've met with are honest, smart, caring and have my best interests at heart. Throughout our conversations it was obvious that they are completely transparent. Our negotiations were straightforward and involved extensive due diligence on both sides. It was clear to me that they weren't just interested in acquiring as many practices as they could and then controlling them. Rather, their interests lied in partnering with me and allowing me to remain autonomous but also providing as much or as little support as I require. Obviously, there is also a strong financial incentive to join. Throughout the process they answered all my questions and were fair and flexible on all the issues. The process went smoothly and quickly. The day I signed the final agreements was a day that I look back upon with great pleasure.

I have been affiliated with DMP for a while now. I cannot be happier and I know that I made the right decision. DMP is here for me whenever an issue comes up concerning the practice. They have taken over, at my request, all the administrative, financial, HR, IT, compliance, coding, PQRS, and other issues that I was personally dealing with all these years. It is important to note, however, that if you have a particular interest in managing some of these areas you have complete freedom to do so. There will not be anyone standing over you and looking over your shoulder. This has freed me up to do what I do best – seeing patients and being a dermatologist. The staff has been professional, creative and very easy to get along with. They are just a phone call away and are frequently visiting the office to offer whatever help they can. I look upon them as personal friends. At no time have I felt that someone else was running my practice. My name remains on the front door and the telephones are answered by my staff. The patients are not even aware that I partnered with a dermatology support organization.

It is hard to explain the sense of relief that I have from joining a larger, "umbrella" group. I feel that I can cope with all the coming changes and mandates in private practice without succumbing to burnout because DMP is there to do all the work that I cannot or do not want to do. I know they are a stellar group of professionals who will stand by me through the coming years. When I decide to step down and possibly retire, they will be there to come up with a plan to keep my practice going and make sure the patients are well cared for. After all, that is why we all went into medicine to begin with.