Running Your Own Medical Practice: An Interview with
Dr. Inna Pildysh, DO
Running your own medical practice is not easy. However, Dr. Inna Pildysh, DO., an internal medicine provider in New York State, makes it work. She has been running her practice successfully for about 12 years now, but it is not without her own set of challenges.
We recently sat down with Dr. Pildysh to get her insights on running a medical practice. We touched on important questions about medical practice operations and the main challenges in handling a business that deals with healthcare.
Main Challenges in Building a Medical Practice
Telling the story of starting a private medical office, Dr. Pildysh says that there were many difficulties associated with the new practice establishment.
“There were many challenges, but the first that came into my mind is the credentialing.” According to Inna, “You have to go through a long and complicated enrollment process. Upon credentialing, you have to capture contract nuances, payer’s regulations, requirements, and maintain the enrollment by timely re-credentialing, revalidations, and demographic updates.”
Also, Dr. Pildysh points out how important it is to build a good team from the very beginning. “You have to cooperate and know people you work with. I would even say we do not work together, but build a practice together and make it better every day. Without a good team, you will not be able to grow.”
The Secret to Having a Successful Medical Practice
Dr. Pildysh shared the secret to her practice’s success. “The success of your medical practice is defined by your healthy and satisfied patients. We do not use any advertisements except for the positive feedback from our patients who recommend us to their family members and friends.”
According to Inna, “There are no doubts that the most important in running your medical practice is to provide exceptional medical care to your patients, spend enough time with patients, and pay close attention to their problems and needs.”
She continues this sentiment throughout the interview, saying that “Patients trust you as a doctor, and it is very important to justify this trust. And overall, it is very important to love what you do and to be honest.”
Also, Dr. Pildysh mentions how automation and electronic/online tools have become vital in the everyday routine. “Online pre-approval requests, electronic referrals, and e-prescribing, of course, save us a lot of time.”
Restrictions to Coverage—The Biggest Challenge in Healthcare Provision
When we asked Dr. Pildysh about the biggest challenge in providing healthcare nowadays, she highlighted one particular issue that she keeps on facing every day— restrictions to coverage. According to her, payers are putting more and more restrictions on coverage, which negatively affect the care. It is not only tighter requirements for documentation and frequent audits, but the fact providers have to justify their professional opinion and argue with payers when it comes to diagnostic tests and prescriptions.
“You have to deal with payers every day to justify that the prescribed medicine and diagnostic tests, for which you requested authorization, are medically necessary,” says Inna.
These days, MRI and CT scans are necessary diagnostic tools needed to diagnose and prevent the worsening of certain conditions. However, providers still have to argue the necessity of these services with payers in writing or via phone calls. The time that they could have spent treating their patients is then used to justify why that diagnostic tool is necessary for the treatment. This becomes incredibly frustrating, especially since the patients are waiting, and this time may be critical for their treatment.
“Sometimes, during the day, I receive calls from pharmacies, literally every 30 minutes telling me that prescribed medicine is non-covered,” tells Inna. And providers have to deal with that knowing that their patients need that prescription.
Inna continues, “From one side, we have payers that monitor the providers and from the other side patients that need proper and timely diagnostics and treatment.”
Finding a Solution to Healthcare’s Biggest Challenges
When we asked about the changes Dr. Pildysh wants to see in healthcare, her answer was pretty simple. “I want to see trust given to the providers in treating the patients and less paperwork to spend more time with patients. Patient’s care must be the first priority,” concluded Dr. Pildysh.
It is a great pleasure to get to know the medical providers we are working with. We hope that by sharing the experiences of others, we would be able to help other providers running similar medical practices know how to deal with the challenges they face.
From our side, we want to thank Dr. Inna Pildysh for the great interview. We wish that her practice will continue to grow and be even more successful in the years to come!