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Dear Jon,
You should consider creating a hospital based version of your product incorporating Rover Ink and maybe an IPAD. The notes then could be directly imported into the our EMRs. I know you are focused on small practices; however, I have read many articles recently that private practice is on the way out.

With respect, I disagree with the idea of private practice being on the way out. The trend I see is when the economy is bad, doctors rush to hospitals as a safe-haven economically but are willing to deal with the horror that is hospital beuracracy. When the economy is good, those same docs strike out on their own again as soon as they can get out from under their contracts.

JamesNT

What has happened in this area over the years is that the primary care docs tend to stay in the groups and hospital based practices where they are subsidized; then the more highly paid procedure based specialists get fed up and migrate out on their own. Sometimes non-compete agreements have an impact on this, but the surgeons make enough more by going on their own that it doesn't seem to matter.

Having been in my area of Florida over 25 years, I saw the consolidation of the late 80's-early 90's, when some hospitals were buying up other hospitals and private MD practices. Then it all fell apart and hospitals dumped the docs & practices. Now the hospitals seem to be acquiring practices again, I guess hoping to come out ahead as the reform bills cut down inpatient payments, and to form ACOs.

Exactly the same thing happened here in Maryland, John. The primary care providers were all told "you better sell your practice now; if you don't take money for it ASAP, you will miss your only opportunity to cash-in, and even to survive". The obituary for the solo and small practice was written. Then it all fell apart. The hospitals realized that doctors don't always make good corporate employees. My favorite story of lament from a hospital practice administrator "When Dr. X. ran his own practice, he could tell you the grade of copy paper in his copiers and the cost per ream. Not that we run his practice he has no idea; but he knows he wants new machines". The exact same hospitals that were buying practices in the early '90's are doing it again, under the guise of forming ACO's. Hopefully the end result will be just the same and we can ride it out. Of course this time the feds seem to be pushing this model....