CardioOne recently announced a partnership with Cardiovascular Specialists of New England (CSNE), an independent cardiology group made up of physicians transitioning from hospital employment. Based in New Hampshire, CSNE offers access to comprehensive, personalized heart health solutions, from prevention to advanced procedures.
We sat down with Dr. James Flynn, FACC, FSCAI, an accomplished physician leader, to hear about how he and his colleagues made the change from employment to private practice.
Can you share some highlights of your professional journey so far?
Dr. Flynn: I wanted to practice medicine as far back as I can remember. In medical school, I was drawn to cardiology, and later to interventional cardiology and structural heart interventions, because of the ability to save lives and make significant changes in outcomes.
I began my career in an established private practice, where I worked for about five years. Through that early experience, I learned how a private practice was run and saw the benefits of independence up close. Later, I had the opportunity to serve in several health system leadership roles, including as a founding member of the Nebraska Heart Hospital. Most recently, I served as the co-executive medical director of the New England Heart and Vascular Institute.
What inspired you and your colleagues to start an independent practice?
Dr. Flynn: We were all focused on providing quality care and a better patient experience. In the employed model, we weren’t able to make some of the changes we felt were necessary—like expanding access to care. We thought an independent model would allow us to have the input and control to accomplish those things.
We thought an independent model would allow us to have the input and control to accomplish those things.
Most of us had already decided to go independent. We began talking with one another and had discussions over several months. We agreed we had the ability, resources, and willingness to take the risk and do it. It’s a process of introspection and then risk assessment.
How did you choose a partner to help you build the practice?
Dr. Flynn: All of us knew that building the practice would be a big lift. We knew what we needed to do, we just needed to choose how to go about it. We considered working with partners that would give us structure and refer us to vendors that would take care of each piece.
Then, we looked at more comprehensive platforms that brought all those pieces together. That’s what appealed to us about CardioOne. We felt like we had one team behind us, rather than a number of different teams that we had to constantly interact with and manage.
For example, CardioOne helped us choose the electronic health record system we wanted to use and negotiated with that provider for us. Secondly, we had started the credentialing process and needed to move it along. CardioOne took that over, which gave us time back in our day to focus on other priorities. They gave us the framework we needed to build on.
What are some lessons you’ve learned in this process?
Dr. Flynn: One is that we would have started with a partner to have all our resources lined up early on. There’s a certain order in which things need to be done. Give yourself plenty of lead time to find a site, complete real estate build-outs, complete credentialing, line up an electronic health records vendor, and so on.
Building an independent practice is more than just starting a business. You’re layering on the practice of medicine and its complex workflows.
Building an independent practice is more than just starting a business. You’re layering on the practice of medicine and its complex workflows. Then you’re adding in the uniqueness of Medicare and government bureaucracy, going through the registration process, dealing with insurance companies. These are layers of complexity you don’t normally see in business. You need partners who have done this before.
What advice do you have for other physicians considering the transition?
Dr. Flynn: Whether you’re leaving with your colleagues or on your own, each person has to ask themselves why they want to do this. It’s important that everyone is on the same page.
Then, assess the quality of your team relative to the local environment. I worked with a high quality of talent, and we wanted to keep that experience together. We were seeing talented professionals leave, and we didn’t want the interventional and electrophysiology cardiologists to scatter.
Third, someone needs to take the leadership position and get familiar with the basics of starting a corporation. There are partners who help you with that.
You also have to think about what kind of business environment you want to develop. At our practice, we want everyone to feel that they’re an important part of the team and that they have a voice.
What do you envision the practice will look like in five years?
Dr. Flynn: I think we’re going to be a much larger group because we’ve already had so much interest in the region. Access is a huge issue for patients needing cardiac care, preoperative clearance, urgent care and more. We’re seeing that already in the appointments we’re scheduling. We’ve made a promise for good access to care, and we intend on keeping it.
What do you think the future holds for cardiologists?
Dr. Flynn: This specialty has a great opportunity for value-based care, and I think we’ll see a significant shift in that direction. Instead of focusing on treating heart attacks, for instance, we’ll focus on proper lifestyle medicine to prevent heart attacks and cardiovascular diseases. We’re going to see that being delivered in a more systematic way and tracked with outcomes data.
I also think we’ll see more groups go independent because of the changing landscape of practicing medicine over the past five to 10 years.
I also think we’ll see more groups go independent because of the changing landscape of practicing medicine over the past five to 10 years. I’ve heard from people in different practices in different hospital systems that have had the same issues, motivating them to consider a self-employed model again.
When you’re independent, it’s so much easier to make important changes that can be delayed in a big system. For most people, the tradeoff of the extra work versus the improvements in autonomy and decision-making are well worth it.
Curious about shifting to independence?
CardioOne is committed to supporting cardiologists who want to make the shift from employment to independence. Our solutions are designed to enhance clinical quality, boost financial performance, and drive growth for independent practices. If you’re considering a transition from employment to private practice, check out our guide for insights and next steps.
