Myth #2: Private Equity Dictates How I Practice

One myth around private equity in Dermatology is that the PE backers will want to tell Dermatologists how to practice medicine—which services they should push, which equipment they can use, how many PAs or NPs they should employ.

For the Forefront Dermatologist, practicing with complete clinical autonomy is non-negotiable: we control everything that takes place in the walls of our clinic, from the curtains to the chair and from the people we hire to the amount of time we spend with each individual patient. As one Forefront Dermatologist recently put it, “Having joined Forefront after working in a large, hospital-based, multi-disciplinary group practice, I can say that I’ve never had the amount of practice autonomy that I have now. In my clinic—and I do call it my clinic—I’m the one making the decisions that matter to me. Yet I don’t have to make the decisions that I could care less about.”

Elsewhere I’ve cautioned people to avoid using a “broad brush” to describe private equity-backed group practices, and I want to avoid doing the same here with respect to individuals. I know that not every Dermatologist wants to practice with the same degree of autonomy. There are plenty of exceptional Dermatologists who are happiest with a hospital structure, for instance, and who provide excellent care within the constraints of that setting. And there are others who might not even consider working in a group practice setting. Autonomy, for them, extends well beyond patient care to the administrative nitty-gritty and back-end minutiae. Forefront Dermatologists have determined that they can provide optimal care by offloading many of these administrative tasks. For them, autonomy means freedom from these stresses as well as the freedom to make all clinical decisions.

The ultimate goal in any medical setting is to care for the patient in front of you in the way that best serves that patient. In enabling Forefront Dermatologists to do just that, clinical autonomy also supports the long-term viability of our group practice.

Think about it this way: more than most any other specialty, Dermatology depends on the expertise and ingenuity of its practitioners. We rely on laboratory results and imaging tests for diagnosis far less than other areas of medicine. More often than not, too, we work without the aid (or encumbrance) of mechanized assistance. Accordingly, the value of a Dermatology practice boils down to the sum of our Dermatologists’ expertise and the care they provide their patients.

Most Dermatologists understand the value they provide. At Forefront, we also understand the responsibility that comes with it. Unlike the complex financial landscape of a hospital, for example, the economics of our practice are simple: we earn what we collect from seeing and treating patients, minus our costs. We know there is no “Forefront” beyond ourselves, no magic pot of money beyond what our practices generate. And because we know how unique it is to be part of a physician-led, single-specialty group practice, our Dermatologists connect the dots between complete clinical autonomy and responsible practice management. Like my colleague above calling it “my clinic,” we all think like owners.