ABSTRACT
The physician practice that is in transition is being impacted by any number of market and financial forces. It is characteristically understaffed, undercapitalized, and operating without a strategic vision or any kind of long-term plan. This comment is not meant to disparage any of the doctors that are working day to day to both operate a business and care for their patients. Understaffing and sparse capitalization are another way of saying that the practice is efficient from an operational perspective, and that the management is acutely aware of the risks of long-term capital commitment in a marketplace that is dominated by a few major purchasers in a form that might be considered oligopsony.* The purchasers all branch their pricing off the main fee reference source-Medicare. Information about fee schedules is relatively easy to obtain. This puts the doctor at a disadvantage from a purely economic perspective.
