Invest in technology to progress in a stalled economy

With patients already facing out-of-pocket healthcare expenses ranging from $20 copays with traditional insurance to $3,000 deductibles with some consumer-directed plans—assuming they're insured at all—a fragile economy will make it even more difficult to get patients in the door.

As a result, "we will see many boutique practices and medi-spas folding or redesigning their business models," predicts Judy Capko, a California-based consultant and president of Capko & Company in Thousand Oaks, CA.

However, this does not mean the disappearance of the small medical group is imminent or even likely, experts say. Survival "is about being systemized, about giving care, and about using technology. A small group can be systemized using an electronic medical record just as well as a big practice," says Bruce Bagley, MD, the American Academy of Family Physicians' medical director for quality improvement.

"Technology will be the holy grail for financial survival of medical practices nationwide," Capko says. Although the tandem messages to invest in technology and control expenses may seem contradictory, they go hand in hand.

"EMRs are going to become the standard in order to practice good medicine—period," Bagley says. "It serves as the foundation for doing some of the information management that allows us to give better care."

So as patients and payers are increasingly seeking proof of quality healthcare, the technology required to capture quality and performance data will be a must.

In a similar vein, practices, particularly primary care, "are going to need to get on the office redesign bandwagon" to promote the primary care office as the medical home, Bagley says. To make the medical home concept work, enhance efficiency, and decrease repetition, specialty offices will also have to consider revamping their practices to support the team approach to care, better electronic access for patients, and better support for patient self-management, he says.