How to ensure independent medical practices thrive in Colorado | OPINION
Jeffrey Ferguson
Running an independent physician practice, once the norm for doctors, has become increasingly difficult.The problem isn’t medical. It’s the growing operational and financial burden independent practices face.
Many physicians, myself included, want to remain independent — to resist joining the large hospitals and health systems coming to dominate the health care market and limiting patient choice in the process. To do so, we’re teaming up with entities called management services organizations, which handle much of the business associated with running a practice.
Critics of this model claim that it corporatizes medicine — that it puts dollars before patients. Some are pushing to ban or severely restrict these types of partnerships.
That would be a mistake. Partnering with an MSO has enabled my urology practice to provide better-quality care at a lower cost than we could on our own. And our patients are reaping the benefits.
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Before bringing on a management services partner, my colleagues and I had reached the ceiling of what we could do as managers of our urology practice. We didn’t have the bandwidth to both serve our existing patients and grow to meet the burgeoning needs of our community.
Our MSO has helped us meet those dual aims. For example, in the past two years, our MSO has recruited four new urologists to our practice. Previously, we would have had to take time away from patient care and devote considerable resources to add to our ranks.
This additional manpower has had a direct benefit for our patients, especially those with cancer. Wait times for an appointment have fallen from as many as eight weeks to just two weeks or less. In some cases, we’re seeing patients the same day.
With more doctors, we’ve been able to open clinics in Pueblo, Alamosa and soon Limon — three communities that have historically been underserved or lacked state-of-the-art urology care altogether.
Patients would rather receive care close to home, from doctors they know and trust. That’s what we’re able to provide — and at a fraction of the cost of a major urban or academic hospital.
In addition, our MSO has given us the financial support to purchase and install cutting-edge polymerase chain reaction (PCR) testing technology across our clinics in a fraction of the time it would have taken for us to do it on our own. Back when I worked in a large hospital or university setting, such a purchase would’ve taken months or even years to secure approval, funding and implementation.
This molecular diagnostic technology can allow us to determine what’s causing a urinary tract infection within a few hours — and whether the pathogen doing so is resistant to certain medications. That knowledge can allow for precise, prompt treatment. And that can save patients and the health care system money.
Previously, we had to wait days for a urine culture to suggest a diagnosis. We might identify the strain of bacteria but not know it was resistant to front-line antibiotics. That led to weeks of pointless, sometimes costly treatment.
In some cases, a so-called “fastidious organism” would not present on the culture at all — and an infection would go undiagnosed. People would suffer for months, thinking their symptoms were a function of stress or diet.
Now, we’re successfully treating problems that used to appear chronic. For some patients, the results have been life-changing.
We’ve also been able to learn from the other independent urology practices affiliated with our MSO. For example, one of our peers suggested we review patients we’d diagnosed with chronic inflammation of the prostate or bladder to see if a PCR test showed a previously undetected infection.
Sure enough, we found many more infections — and were able to treat many more patients whose suffering had been a mystery.
Given the benefits an MSO partnership can afford physicians and patients, I’m puzzled by the movement in some states — and even in Washington, D.C. — to regulate the model out of existence.
Criticism of MSOs typically zeroes in on their financial backers, which are often private equity firms. But that critique lacks substance. Our practice is physician-owned and physician-led. We have complete control over clinical decisions. Our MSO enables us to focus on what we do best — providing great care for our patients in a high-quality, convenient setting: their own doctor’s medical practice.
Independent practices are crucial components of our health care system. Indeed, research shows patients prefer them. We must ensure patients continue to have access to them. As I’ve experienced firsthand, partnering with an MSO makes that possible.
Dr. Jeffrey Ferguson is a practicing urologist with Colorado Springs Urological Associates.

