If you’re like most physicians, you have probably given some recent thought to selling your practice or merging with one or more other groups. If you are part of a group practice, it’s quite possible that all members of the group might not agree on a single course of action. Keep in mind that even if your corporate agreements say that "majority rules", dissenting shareholders may have certain rights under state law, including the right to fair value for their shares in the practice. For an idea of what can happen if these dissenter’s rights are ignored, have a look at this recent article on Indystar.com.
Do you have a succession plan for your medical practice? In my experience, too many physicians wait until close to retirement age to begin developing a plan to transition out of practice. Given the volatility of the healthcare market, you should certainly not assume that there will be a ready and willing buyer for your practice if and when you decide to slow down or retire.
If your local hospital, or another practice or physician in your community is not interested in purchasing your practice, you could be out of luck. Without someone to take over the practice, your only option is to close your doors and liquidate your assets. If you’re lucky, you may find a local physician who will take custody of your medical records, but if not, you will need to pay to store these to the extent required by law.
There’s an interesting piece in the Miami Herald today regarding hospitals once again acquiring physician practices. The article raises some good questions regarding the motivations underlying this growing (recurring) trend and suggests that it might be more about control than preparing for a "reformed" health care system. The article also questions whether hospitals will be any more successful this go-round in managing the acquired practices than they were in previous attempts.
I frequently represent both hospitals and physicians in practice acquisition transactions. In my experience, only a handful of hospitals and health systems have a true plan for how they will integrate the practices they are acquiring in a manner that will improve the delivery of healthcare. To be sure, how best to integrate providers to improve care is not an easy question to answer. I find, however, that the "smart" hospitals and health systems are willing to acknowledge that physicians should be involved in the development process and that they (the hospitals) do not necessarily have all the answers for how best to accomplish that goal.
If you are considering selling your practice to a hospital, or you are a hospital looking to integrate the physicians in a thoughtful way, consider whether it makes sense to begin the process with a dialogue about where each party envisions the relationship to be several years in the future. If you can reach consensus on where you want to end up, you can then structure a transaction which is specifically designed to get you there.