They came with money. They came with stock. They came with promises of new patients and great service. Yet, in the wake of physician practice management companies, we were left with no assets. We were left with invoices for management fees. We were left with overvalued stock. We were left with the same number of patients. We were left with an element of service, but far short of what was promised and what we needed.

Why? There was a lack of strong management, a greedy need to grow the PPMCs, not our practices, and the ultimate Wall Street perception that the PPMC effort was no more than a "stock play." Shareholder dollars went toward the growth of the companies, not new and improved services.

LET'S NOT MAKE THE SAME MISTAKES WITH IPAs

Despite all that, we still believed that a mechanism existed to help make our business lives better. Many of us took it upon ourselves to consolidate. We invested some money, hired an administrator and agreed on a monthly stipend to be paid for services. But we learned that we, as a group, were only as good as our administrators. Some of us found out the hard way that some physician peers were benefiting from the fiscal upside of our monthly dues. Was that our intent?

Why should we invest in an IPA or an organized physician group only to find that our services are limited and that our peers are pocketing a healthy portion of the proceeds? You already know the answer to that question. At a conference about the pros and cons of joining an IPA, I heard a managed care executive prophetically say to a group of doctors: "Never spend money unless you're certain you are getting something in return, and if you're getting something, make a clear evaluation of its worth."

We've resigned ourselves to the fact that we can't run our practices like we did 10 years ago. We can't afford to. We don't have the time to search for business solutions. And our administrators spend most of their time completing insurance and credentialing forms. So, we must seek a partner who is "provider friendly" and who's willing to provide services for reasonable fees.

A few firms exist that consolidate necessary physician services and offer them to providers at low cost. I'm happy to do the research. In the meantime, I'm going to assess every IPA and physician group I belong to and evaluate the need to continue with them. I can only encourage you to do the same.