Congratulations Dr. Sonido on Being Chosen as the Filipino Chamber’s Entrepreneur of the Year Awardee
If you haven’t already noticed, private medical practices are quickly disappearing or being gobbled up by hospitals, large clinics or large physicians groups. The American Medical Association says less than one-third of American physicians will remain in private practice in the near future.
Where are doctors going?
The American Hospital Association reports a 32 percent increase in the number of physicians employed by hospitals, and growing each year.
Or, doctors stay exactly where they are in what appears as a small private practice, but are completely or partially owned by a large company that happens to own not just that small private practice but several throughout the city or state.
Why the trend toward “employed” doctors? Some report overregulation, reimbursements are too complex needing larger specialized administrative staff; some say fixed cost of procedures makes it impossible to run a profitable practice (because they are too small and see too few patients); some say the financial risks are too high.
For younger doctors with huge student debt, they don’t have the capital to start a private practice and have no choice but to turn to hospitals or integrated health networks as employers. Or some older doctors, accustomed to older models of practice, less business-oriented, just want to practice medicine and live a less stressful life.
Experts say what’s happening is the institutionalization of medicine where business entities or business savvy doctors with huge capital flow have taken over.
It’s Darwinian, certainly.
The long-term affect to patients could result in what we see in giant companies – the patient-consumer could enjoy better prices and deals than what it used to be when smaller businesses offered the same products or services. Or because medicine is so regulated, that might not even happen.
Patient care could be compromised, depending on how many patients a doctor must see per day. The higher the number, clearly, means less quality. So what matters is how much the company is willing to spend on hiring employee-physicians to have a reasonable physician-to-patient ratio. Arguably, seeing beyond 20 a day you start to see a diminishing of quality; 10 or less doesn’t make for a healthy business model.
Cost to patients and quality of patient care in this new trend is still evolving and uncertain.
Primary Care Clinic of Hawaii (PCCH)
Dr. Charlie Sonido, who was recently chosen as the Filipino Chamber of Commerce of Hawaii’s Entrepreneur of the Year, anticipated the trend of mergers and acquisitions in private medical practice (which precedence hit other industries well before the medical industry) and made the move to go big (expand) or face the alternatives as mentioned above, become an employee-physician (at a hospital or in his own office).
Sonido said he saw expansion as the only way to survive. “Status quo was not an option. The old business truism is true: economy of scale works.”
So what started out as a solo practice in 1983 grew over the years to what his practice is today. His company PCCH now has 75 employees that includes 9 physicians, 2 advanced nurse practitioners, 2 nurses, 7 managers, 3 physical therapists and 2 massage therapists.
PCCH has 5 locations in Waipahu, Kalihi, Liliha on Oahu; a clinic in Lihue, Kauai. And most recently he opened up yet another clinic in Hilo, Hawaii.
Expansion, however, has not compromised quality of patient care in his practice. He maintains a healthy ratio of physician-to-patient. Each physician seeing about 20 per day. He utilizes the most modern trends, including telehealth services and electronic health record keeping. He helps his physician-employees from experiencing physician “burnout” – lessening their administration tasks by hiring medical scribes.
PCCH receives glowing reviews from its patients. A typical feedback, Arlene Peralta of Royal Kunia, said, “I am a Registered Nurse and have been going to the clinic because of the trust I have in the doctors and staff. I trust in the quality of patient care they provide not only for myself but for my family.”
Staff are also pleased with the environment that can only translate to better quality in healthcare. PCCH’s Dr. Dennis Scheppers said, “I have worked for many employers and companies since coming to Hawaii in 1992. They were all nice, some more than others. It wasn’t until I came to work for PCCH Kauai did I realize the utmost organization one could work for. You can describe this organization in one word – caring. Caring for patients and their needs. But also caring for the people who work here. I see people grow in their positions because they are allowed to grow.”
Dr. Sonido said, “If you have the patient’s best interest first and foremost, you cannot go wrong. The business part becomes secondary.”
This is certainly true. But it’s also a humble answer. Many private practicing physicians have been providing excellent care for their patients, but haven’t adopted smart business plans, implemented cost-savings practices, or taken risks to invest and expand as Sonido has done successfully.
This is not to say that employed physicians are or have taken a lesser path, definitely not by any means. Their medical work are invaluable, noble, and perhaps the same as if the company they work for were their own.
It’s just that they are not as entrepreneurial or business-driven.
The Filipino Chamber should be applauded for choosing Dr. Sonido (who has also done a lifetime’s work of community service through the PMAH, BCWW, and Ohana Medical Mission, to name only a few) as its Entrepreneur of the Year awardee.
Congratulations Dr. Sonido on your remarkable achievements; and a well-deserved kudos also to your professional team at PCCH. Mabuhay and much continued success.