Some lucky Providers are still satisfied with their patient volume as their waiting rooms continue to be overflowing with patients. However the reality is that what used to be a predominant Medicare and private insurance market is becoming an uninsured and Medicaid market. The result is more work but not enough resources to cover the expenses. Add to that the technological and compliance challenges coming down the pipe and you will see that some Physicians are going to have to subsidize their Practices with other sources of income in order to survive. “I know of many heavily booked practices but most of the patients are on Medicaid,” says Jeffrey J. Denning with Practice Performance Group in La Jolla, California. “The doctors are barely earning a living. They need to market their practices to attract better-paying patients.” I personally know of physicians working ER and doing other part time work to subsidize their Practices. I also know of Government initiatives that eventually will cut the flow of patients to the primary care physician. By the way, let’s not forget the minute clinic and their influence in the market. Let’s face it; the world we used to live in is no more. I personally used to be a Practice Consultant with emphasis on compliance. Now I see myself engaging in contracts as a business development specialist. The difference, in addition to knowing the rules of compliance, now I have to look at the market, potential opportunities and forecasts and try to establish a plan to capture the right kind of “customers” for the Practice. We still want to do what is best for the patients but now the challenge is; where is the money? This simple attitude seems to be one shared by many Government agencies as well as they are trying to save and capture additional funds in the ways of fines, reduction of services and changing the rules of the game. At the end of the day some people will spend their time complaining and struggling to survive. Others will learn, look for advice, adapt and grow. Which one are you?