The Medical Practice Playbook
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Our mission at Associates in Dermatology is to provide the highest quality, patient-centered dermatologic care within its communities while fostering a positive work environment and excellence in training future dermatologists. The key to achieving these goals is by continuing to hire the best and the brightest young physicians. We hire individuals who have a desire to serve patients and to give back to our specialty by teaching medical students, non-dermatology residents and dermatology residents. Over the past 10 years we have had an aggressive growth strategy with aims to expand our reach by opening offices in underserved areas. We have expanded from two to 14 office locations in the Kentuckiana area and increased from 11 to 36 providers including physicians, physician assistants and nurse practitioners. With locations across Kentucky and Indiana, our goal is to make expert dermatologic care available to everyone, urban and rural patients alike. Expanding access to care is a cornerstone of our mission and one of our sources of pride. Our physicians, nurse practitioners, physician assistants, nurses, medical assistants and administrative staff all share the same mission. We rely on one another’ s strengths and experiences to ensure that every patient receives high quality care.
The tools that make our practice successful include a mix of advanced tools, efficient systems and a formidable team. At Associates in Dermatology, several factors contribute to our continued growth and reputation. Technologic advances include incorporating digital imaging and dermoscopy, and an advanced electronic medical record system that allows collaboration of care among providers easier. New laser and light-based systems improve outcomes for both medical and cosmetic procedures. Our administrative team has dramatically improved our ability to manage 14 locations and all our employees.
Patient education and prevention are central to our mission. We host public skin cancer screenings, provide lectures and collaborate with multi-disciplinary teams to promote early detection, awareness and the most advanced care currently available.
Challenges in our practice seem to be growing and include declining reimbursement rates, growing administrative demands, regulation and compliance, recruitment, technology, Centers for Medicare & Medicaid Service changes with MIPS quality reporting and changes to adapt to an ever-changing health care landscape.
Declining reimbursement rates and growing administrative demands are constant pressures. Prior authorizations, coding complexities and billing audits consume significant amounts of time and resources. We have addressed this by outsourcing our revenue cycle management and integrating technology that allows our clinicians to focus on patients instead of paperwork.
Health care regulations are evolving continuously. Maintaining privacy laws, maintenance of certification, continuing medical education and billing transparency requires vigilance. Regular staff training, legal oversight and an increase in administration have become necessary in our practice management.
Attracting and retaining skilled clinicians is another challenge. The demand for dermatologists exceeds supply in many underserved regions. We work hard to create a culture that supports professional growth, mentorship, educating future dermatologists and work-life balance. Our model allows for greater autonomy, higher earning potential and personalized care with the negatives of a lower starting compensation package, higher financial risk and more administrative burden. Due to the change in current practice environment, there has been a dynamic change in our area evolving to be a tri-modal choice for new dermatologists to choose between either private practice( solo, single specialty or multispecialty), joining a large equity business owned single specialty practice or working for a hospital-based system. We feel that our growth in large part has been due to these changes of forcing young physicians to choose, and our practice being one of the most successful in our category. Associates in Dermatology have chosen to remain independent, emphasizing quality, trust and longterm relationships instead of volume-based metrics.
The rise of technology has expanded access and increased efficiency but also has introduced new challenges: ensuring accuracy in diagnosis, maintaining cybersecurity and navigating reimbursement policies.
In conclusion, choosing to work in private practice has allowed me to practice medicine the way I believe medicine should be practiced with independence, integrity and empathy. In a world where health care often feels impersonal, private practice remains a model for what patient-centered care can look like. Associates in Dermatology exemplifies that model allowing our providers to choose their own schedule and how they want to practice. While the industry evolves and challenges grow, our focus remains constant: helping each patient achieve healthier skin and a better quality of life.
Private practice is not easy and seems to be getting harder each day. It requires constant adaptation, creativity and commitment. But for those of us who value autonomy and the deep satisfaction of seeing our work improve the lives of our patients, it is the most rewarding way I have found to practice dermatology.
Dr. Brown practices with Associates in Dermatology, PLLC and is a Professor in the UofL Division of Dermatology and Director of the UofL Micrographic Surgery and Cutaneous Oncology Fellowship.
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