How to know when the time is right to add another physician to your practice

Judgments about when and whether to add a new physician to your medical practice are among the most difficult and important business decisions that you are likely to confront.

A new physician can provide a clinic with increased revenue opportunities, a fresh perspective on clinical care and business operations, plus improved work-life balance for the practice’s existing physician(s).


Aniruddha Malpani, MD “A badly organized practice can find it hard to assimilate a new doctor—and if there aren’t enough patients to keep doctors busy, this will create a lot of unhappiness.”
-Aniruddha Malpani, MD, medical director of Malpani Infertility Clinic in Mumbai, India


Conversely, adding a new physician has the potential to saddle a practice with a slew of additional expenses, lead to conflicts with staff and other doctors, and potentially upset patients who[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] have grown comfortable seeing the same doctor for years.

Key Point: Deciding whether it’s time to add another doctor to your practice can be challenging. It’s important to ask yourself: whether it makes financial sense, how busy the practice’s existing physicians are, and whether you can find a physician who will be a strong fit with your practice’s culture and approach to patient care.

“A new doctor is likely to improve efficiency as he/she brings in new blood,” said Aniruddha Malpani, MD, medical director of Malpani Infertility Clinic in Mumbai, India, and author of a physician and patient education blog at www.drmalpani.com.

“However, a badly organized practice can find it hard to assimilate a new doctor—and if there aren’t enough patients to keep doctors busy, this will create a lot of unhappiness,” said Malpani, who is a member of mdCurrent-India’s Editorial Advisory Board.

Additionally, deciding whether to add the new physician as a partner or associate comes with its own set of challenges.

Adding up the pros and cons

To a large extent, the answers to the following 3 questions will help practice owners determine whether it’s the right time to add another doctor:

  • Does it make financial sense?
  • How busy are the practice’s existing physicians?
  • Can you find a physician who will be a strong fit with your practice’s culture and approach to patient care?

Like virtually all business decisions, finances are the most important consideration when contemplating the addition of a new doctor.


Pragnesh Vachharajani, MD“By and large, if you find yourself very busy and tired of attending to unlimited calls and emergencies from patients, that is one of the main reasons for adding another doctor.”
-Pragnesh Vachharajani, MBBS, family physician in Ahmedabad, India


First, develop an estimate of how much a new physician is likely to cost your practice in terms of salary, new support staff, new equipment, added insurance costs, attorney or accounting fees, and the like.

Then determine roughly how many patient encounters per year would be required to break even on those costs. Is it likely that your local market can provide those additional patient visits?

Your own schedule is a valuable starting point for determining whether your market is ripe for a new physician. How busy are you? If new patients have to wait longer than a week or 2 for an appointment, that’s a strong indication that there’s enough demand to support a new doctor. For another hint, check with physicians who refer patients to you. Are they sending as many patients to you as they once were, and are you able to see those patients in a timely manner?

“There is no calculation that will work for every practice, but by and large, if you find yourself very busy and tired of attending to unlimited calls and emergencies from patients, that is one of the main reasons for adding another doctor,” said Pragnesh Vachharajani, MBBS, a family physician in Ahmedabad, India, and a member of mdCurrent-India’s Editorial Advisory Board.

Partner or associate?

If you’ve determined that adding another physician makes sense for your clinic, the next question becomes whether that new physician should be brought in as a partner or associate.

That depends largely on the needs of the practice: Will the new physician bear a significant amount of responsibility for growing the practice? If you’re pushing to aggressively grow the practice and the new physician is expected to work long hours and bring in new patients, a partnership would seem the best choice.

“A part-time doctor would be best as an associate, while a partner helps in the growth of the practice by practicing in more than 1 location, and can also work as the practice’s backbone in case you’re sick or on holiday,” Vachharajani said.

Next, it’s critical that the new physician is a strong fit with the practice’s existing physician(s) in terms of culture, personality and work style. This factor becomes even more important if the new physician will assume a role in making key decisions about the practice’s future.

“Adding a new doctor can be quite disruptive, and this is especially true if he/she is not a team player and does not know how to get along with other staff members,” Malpani said.

Still, a new doctor also holds the potential to boost feelings of collegiality, especially when a practice moves from 1 physician to 2. The new physician can help improve the practice’s patient care routine and business operations, ideally adding valuable insight and experience.

“It’s great to have someone else with whom you can discuss complicated cases; 2 heads are often better than 1,” Malpani said. “Another doctor can provide emotional support when you are having a bad day, and it can be helpful to vent when you are fed up of filling in all the paperwork!”

[/s2If]

Log in or register for free to continue reading
Register Now For Free Already Registered? Log In
This entry was posted in Business of Medicine, Practice Management and tagged , , , , , , , . Volume: .

Post a Comment

You must be logged in to post a comment.