Sometimes you end up in a conversation where only after looking back on your notes do you realize just how much ground the interview covered. That was our conversation with Dan Kirkpatrick of Partners in Improvement.

Dan’s expertise lies in working with physician practices, particularly emergency medicine groups, to improve their operational efficiency, financial standing, and leadership. During the conversation, we discussed a range of topics including MedPAC and MIPS. Be sure to listen to the full episode to learn more.



1. The Foundation of a Successful Provider Group

Kirkpatrick has been in this space long enough that he has a good eye for physician groups that have the underlying perspective necessary to succeed – even if they need some help getting there. These are the groups he views as ideal clients.

“I look for a provider group that is firmly committed to patient care. And while that may sound either euphemistic or somewhat passe, that’s extraordinarily important to me. I like partnering with a practitioner or a group that is firmly entrenched in the best care and being part of a community and having a practice that is going to make a difference.

”I tend to look for a longer term perspective and partnerships within their community, partnerships with payers, partnerships with the various stakeholders that are involved in patient care […] historically I tend to like those that have a longer-term view and I find that there’s probably a better symbiosis for success and really understanding the patient constituent.”

That underlying attitude isn’t just a feel-good trait, although Kirkpatrick is quick to note that groups focused on the shorter term, looking to build a practice and sell it, have an entirely valid approach, too. Still, he says that long-term vision and the emphasis on patient care and partnerships are actually leading indicators of a practice that has the commitment needed to improve:

“I find that a group that embraces those values tends to be more interested in bringing me in to help in areas that maybe they don’t have the expertise in. For instance accounting, budgeting, structuring their practice, or forming partnerships with hospitals or other groups, and doing so in a way that can be both cost-effective but meaningful.” (Emphasis added)

Conversely, then, groups that he sees potentially struggling “have a very short-term focus on either financial success or they don’t reinvest in new technology or new alternatives to a stay state of the art or be able to embrace relationships that are going to allow better care.”

2. Deficits in Clinician Training

Kirkpatrick went on to discuss the challenges faced by physician practices in further detail. It comes down to planning:

“With new practices, I find a common mistake is anticipating and planning cash flow, and many times not understanding how to contract with payers or managed care alternatives […] The other piece I see is perhaps poor planning around bringing on new partners and how to structure the buy-in of a new partner joining a practice or the cash flow for that new partner. [Those are] probably the two most common. And then as with many other things, it’s the timing of these and understanding when the practice is ready for some of these changes and preparing for them.”

But why is this often a struggle? Lack of training. Without the right tools, how can anyone be successful in a given role?

“Most physicians during their training have a very heavy dose of clinical care management, clinical patient management, but a much lesser dose of how to manage a practice [and] the accounting principles for structuring a business and managing that business. Many times, at least the groups that I get involved with, they have grown without necessarily a really well-prepared plan, and have grown because they have a good reputation because they do good care, but it’s not uncommon to find that the group is kind of running by the seat of their pants as it relates to their finances.”

This is becoming a recurring theme among people we talk to, highlighting the need for clinicians of all types to have additional resources outside of their clinical training.*

The third point we discussed deals with the future of the hospital. Because that part of the conversation diverged significantly from the two points above, we have split that section into its own post. You can find that here.

*Health:Further is deeply committed to providing clinicians with the tools they need to succeed in non-clinical roles. Whether that’s joining a startup, entering an established company as a Chief Medical Officer, or becoming an investor, we want to see this gap closed. For more information on how we’re doing that, check out this recent article with Dr. Mario Ramirez, our own Chief Medical Development Officer.

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