Dissension in the ranks
How to knock out physician conflicts

It’s sad to say, but not all doctors in physician practices get along. Whether they’re haggling over administrative matters or a partner’s job responsibilities, the strife it creates can turn a normally congenial practice into a potential war zone. But there are ways to coexist peaceably.

Elect a strong leader

Many partnerships consist of one partner who leads the practice. The other physicians may have appointed this leader because the articles of incorporation require them to pick someone. Or they did so because that physician seems like the only one who has the interest or skills to run a business.

Subsequently, the leader becomes the administrator responsible for daily practice issues. The problem? He or she is left holding the bag while other partners focus on issues that affect only them — not the practice as a whole. Elect a strong leader and pay a monthly compensation for handling administrative matters.

Unfortunately, physicians often downplay the importance of leadership instead of emphasizing it. Define partners’ job responsibilities so they share authoritative duties equally. Then, make sure partners are compensated for the hard work, extra hours and positive outcomes they contribute.

Expect challenges

If a practice stagnates, it will die. One key to staying alive is establishing a practice vision — its purpose, expectations, concerns and goals. Whether starting a new venture, adding new partners or implementing strategic changes, your partners must mutually maintain this vision.

Of course there will be challenges, such as adding new services or procedures. Moreover, the practice will likely encounter certain issues if it opens up a new office or hires additional staff physicians. Such operational changes can alter your practice’s vision and create significant problems.

Because weathering these changes isn’t easy, don’t expect partners to always agree. Instead, allow each the opportunity to express his or her viewpoint. After all, rational, professional debate is healthy as long as it doesn’t deteriorate into heated arguments.

Avoid preferential treatment

Physician partners’ age differences can also cause problems. Doctors from different generations (and cultures) often disagree about how to practice, what constitutes work hours and whether senior physicians deserve preferential treatment.

For example, older partners may feel they have the right to make special requests of younger partners, such as to take on an older doctor’s night and emergency calls. Their reasoning is often because they themselves had to comply with such demands early in their careers.

But younger partners may disagree with these requests and feel they unjustly create more work for them. And they’re usually right. In a true partnership, partners’ accountability lies in direct proportion to their ownership percentage — both financially and operationally. Therefore, partnerships typically shouldn’t provide unequal perks based on seniority.

Create a compensation model

When reimbursements don’t keep pace with operating-cost increases, partners’ stress levels may rise. A need to decrease partner bonuses can add even more fuel to the fire. And if you’re trying to unify your partners, or add new ones, the financial turmoil only intensifies.

For instance, ill will can occur when one partner isn’t as involved in financial decisions as the others. Similarly, many practices struggle with partners who fail to produce results commensurate with their salaries.

To mitigate these issues, implement a clear, amenable compensation model for physician partners. At minimum, each partner must generate enough revenue, less expenses, to cover his or her salary. Also, annually set partners’ goals and review their performances and compensation.

Keep the peace

It can be traumatic when partners in a medical practice lock horns. If your practice is experiencing this scenario, you need a committee to help you work out the issues. Ask your CPA and health care advisor to step in. He or she can help you work out any issues, without pointing fingers, and return your practice to a peaceful state.