Flowing downstream with the current combined with serendipitous timing were two ingredients that have helped Steven P. Dingfelder, Ph.D., a St. Augustine, FL psychologist, create a sound future.
In private practice for nearly 15 years, he had built his solo practice into a small group, and had incorporated. Along the way, he developed a relationship with several managed care companies, and he helped develop several EAPs and other products.
But by the early 1990s, he believed that he had now reached a crossroad, and wasn’t moving forward as quickly as he wanted. Several colleagues he spoke with in the Jacksonville area were experiencing similar discontent. John Moreland, Ph.D. and Eileen Krimsky, Ph.D. of Jacksonville, were partners in a small practice; separately, Gary Buffone, Ph.D. also owned a small group practice. A third group joined the dialogue but later decided not to sell their practice.
They began their discussions about the future in 1993, considered and helped develop a “clinic without walls.” They soon determined the concept would not likely be feasible because it would was all about sharing control, although the potential benefits of marketing their practice cooperatively was appealing.
Meanwhile at the national scene, the sale of group practices was becoming a booming business 1993 and 1995. Exhibit halls of some national conventions became veritable feeding frenzies for sales and acquisitions of practices. Dingfelder and his colleagues were mindful of the national trend, a window of opportunity, which they promptly began to explore.
After negotiating with three national groups, they sold their respective practices to Apogee, Inc. of King of Prussia, Pa., becoming part of Apogee’s network of 93 practices east of the Mississippi. Each of the principals received a share of the sale — the amount was not disclosed by Dingfelder. The principals of the individual practices would become Apogee’s payroll employees, and continue to practice in the same venues as before.
Apogee has since been reconstituted as Integra. In the profit-motivated, ever-changing world of managed care, Apogee sold all 93 clinics to Psych Partners of Birmingham, AL. The changes were a blessing for Dingfelder. He has received the reward of building a practice and selling it at a profit, yet retaining a continuing interest in practices he formerly owned without assuming the risks, the billing woes and all the attendant complications of ownership as he assumed “employee” status which was his goal from the outset. But there were now new bosses to contend with.
The other psychologists who sold their practices have ventured into new milieus. Moreland and Krimsky opened a bookstore, playground requirement and consulting operation; Buffone became part of another small group doing more industrial/organizational work.
By the time the final transaction involving Psych Partners was consummated, the new company’s goals had become fairly clear: to make it grow financially. The computer operation affecting the combined practices were unified and expanded; billing was streamlined to enable better market penetration. Dingfelder was assigned additional responsibilities in covering several PsychPartners clinics in north Florida. He became their clinical director.
Recalling the events leading to the sale. Dingfelder noted that “our goals were simple. “We were looking for a company to promote quality treatment in a least restrictive way, without interfering too much with our therapy techniques.” As it turned out, it was win-win for everybody, the sale being consummated about the time the window of opportunity on mergers and acquisitions was closing. By the end of 1995, the booming business of small practice sales had tapered off.
Dingfelder, who is 54, is pleased with the results. Had he resisted selling the practice, he figures he would still be operating his private practice with one additional staff person. Instead, his opportunities have expanded. The large Psych Partners network has enabled him to broach opportunities that a large company with 93 clinics makes possible. He includes among such potential growth areas the creation of a Exclusive Provider Organization (EPOs), a method of working with managed care and retaining more control, expanded EAPs and other special products.
In his new role, he is also more involved in “coaching” business and industry leaders. (See related article about Kathryn Williams, Ph.D., an executive trainer, elsewhere in this issue.) Despite current problems affecting psychologists, Dingfelder believes a satisfying future lies ahead although practice arrangements have to change. He speculates that the marketplace will resolve the plethora of graduates now causing a severe employment crunch. Dingfelder envisions among future possibilities for psychologists EAP work, operating counseling centers for colleges, specialized arrangements to allow for supervision in different settings, working more closely with primary care physicians and becoming more involved in geriatric services.
He wants state licensing boards to become both more provider and consumer friendly without sacrificing consumer protection. To enable psychologists to pursue “books of business” that help them build stronger practices, he maintains that no graduate program should graduate future practitioners without an adequate business background. This would enable them to approach leaders of business and industry whom they will inevitably have to deal with as well as giving them the skills to manage their own practices.