Doctors Perspectives of Medicine

Thoughts from leaders in small, Medium, & Large Size Private practices.

As medical doctors involved in Pediatrics, we all have the responsibility of taking care of children. The constant drain on time and energy presented by not only seeing patients, but managing electronic health records, paperwork and reporting requirements can be daunting. The largest challenges to physicians- the rising cost of government reporting and changing reimbursement models. Keeping up with the latest regulations, and satisfying requirements is complicated and time consuming. These extraneous things take me away from healing my patients and my personal family. It has become ever more difficult to care of children, run a business and figure out the future of medicine. Working for a Hospital system is not the answer either. I went into private practice because I valued my autonomy and I could never be just another replaceable "Cog in the medical system wheel". This is why I opened my solo practice back in the day and continue to forge forward, but now I have like minded professionals to help me resolve any issues.
Ramon Ferrand M.D.
Managing Partner of Pediatrics of Long Island
I became a Pediatrician because I wanted build deep and lasting relationships with families,the community and most importantly see kids grow up. I am fortunate enough to even treat the next generation of children. As a medium size practice we have seen this over and over again. Lifestyle is a somewhat better with a group practice, but in order to survive we need to grow, independent practices face challenges when it comes to recruiting new patients as well as new doctors. I see trend where patients and doctors are gravitating towards large entities, such as hospital and university-based systems, crowding out independent practitioners, in some cases putting pressure on them to join different tiers of employment within the system. We are bigger than the solo practitioner, but we still have a way to go when competing with a large hospital system. In every aspect of practice we have improved resources,staffing and workflows but we still need help to continue to grow, and advance. If future doctors continue the path of employment, and refuse to take on the risk involved with setting up and running their own business then private practice can not continue to grow.
Nagpal Inderjeet MD
Managing Partner of Mariwalla Pediatrics
Many pediatricians do not realize that they have to fight to maintain their independence. They have been free to practice and they think that it will always be that way. I did not think about it either until two different events happened to me that have changed my thinking forever. My partners and I were interviewing a very nice “seasoned” pediatrician. I was surprised that we were interviewing such a good candidate and tried to find out why. She told us that she was hired by a small group who was experiencing rapid growth and everything was fine for a year but then the local big hospital decided to open a pediatric urgent care across the street from her office in Pennsylvania. Effectively she was run out of her job she never became a partner and had to leave the state. This resonated with me since my local pharmacist “Joe” was “retired” after a “CVS” opened across the street it was three times the size. I was horrified, but comforted by the fact that it was another state. I thought it would never happen to me. I was wrong. Not soon afterward a System once called our office and in plain language stated their desire to buy us or put us out of business. Their plan was to open an office close by and run us out of town. It was now happening to me. I assure you it is now happening to you whether you know it or not. Well we are still here we will not go down without a fight. If you are like us then join us. IPCLI is meant to be an organization that stands up for the little guy. It is meant to be a slingshot against the Goliaths of the world. To keep us independent and fulfilling our mission of providing the highest standard of care for our families.
James Reilly M.D.
Medical Director and Managing Partner of RBK Pediatrics & Urgent Care
For me, I became a doctor because I wanted to practice medicine the best way I know how, without the interference of an "Organizations or suits" that think they know what is "Best".
A employed physician once told me the scary story of how people in suits with [no medical background] were trying to influence her decision to not utilize expensive specialists and to not refer patients who she felt needed emergency services.
To practice medicine is different than to serve, "the bottom line". This mentality works well for Walmart, but when you are taking care of someones child, you do not want to think someone is looking over your shoulder. A worse scenario would be if you were influenced, and the child had a bad outcome. How could as a doctor sleep knowing this?
An independent physician can practice medicine the best they can, the way they want. We are not perfect, but always giving our patients the best care that we can is our "Job One", and I can sleep with that.
Neil BellovinM.D.
Managing Partner and CFO of RBK Pediatrics & Urgent Care
My main impetus for opening a Pediatric practice on Long Island was to provide high-quality healthcare to a culturally-diverse population of children. I’ve dedicated myself to fostering an environment that is, above all, warm, productive and safe for both my patients and their families. We strive to not only bring the best care and service to these infants, children and adolescents, but to grow right along with them throughout the years.

Over the past 15 years, my practice has indeed grown - from a solo practice into a medium-sized, dual-specialty office with five full-time practitioners. During this same time period, I’ve witnessed the evolution of “The Business of Medicine” model that most hospitals adhere to nowadays. For these hospital systems/conglomerates, sadly, the emphasis has gradually transitioned away from the Medicine aspect towards the “business” side, to the point where the dollar rules all.

For the few remaining independent practices left, despite the ever-increasing economic pressures, challenges and barriers we face daily, the patient is still a priority. I rue the day that I stop looking at my patients as “my kids” and only as a dollar sign or number.
David E. Sanchez M.D.
Medical Director, Managing Partner & Founder, Suffolk Pediatric, PC