Charleston, S.C.-based Articularis Healthcare Group has built a model aimed at preserving the independence of community rheumatologists while providing the scale, infrastructure and resources needed to thrive in today’s complex healthcare environment.
Founding Partner Colin Edgerton, MD, joined Becker’s to discuss how Articularis strikes the balance between physician independence and the benefits of integration, and why physician leadership remains central to its approach.
Editor’s note: This interview was edited lightly for clarity and length.
Question: Could you talk a little bit more about finding the balance between independence and integration?
Colin Edgerton: First and foremost, it’s physician leadership — making sure that even when we bring in experienced senior management, they are serving physician leadership. The idea is that we, as physicians, really care about the patient. Everything is oriented toward the patient. One of our unwritten rules is ‘The patient comes first.’ If you do the right thing for the patient, everything else falls into place. We’ve found this time and time again.
Many of our physicians have come out of large facility practices — either hospital or large multispecialty— and have had the experience of an accountant telling them what to do or having a front desk that doesn’t work for them but for a company, and doesn’t move quickly enough to fill an empty slot or help a patient reschedule. When we get together as groups throughout the year, we always reinforce how we do things differently. Despite our size and multiple practices across multiple states, we all operate as if we were in a two- or three-doctor practice, putting the patient first.
Q: Why is physician leadership important, especially as hospitals and systems seem to move away from it?
CE: It is maddening, isn’t it? The highest-performing hospital systems generally have a physician CEO, and they’ve figured out how to meld a clinician approach with the approach of a really good business mind. Sometimes you see those people who make me feel inadequate — they’re MD, JD, and a bunch of other things, maybe even an astronaut — and you think, “Where did you come from?”
But it doesn’t have to be like that. You just need a governance structure that says there’s strategic clinical guidance from someone who’s been through med school, residency, fellowship, and patient care, and then there’s great leadership from people with business expertise — financial officers, HR directors, marketing gurus. There’s a way to marry it together, but you have to have good governance and value the clinical input.
When we say physician leadership, it’s not hubris to say a doctor has to always be on top. It means the focus is the clinical side of things, because that’s what patient care is, and everything else supports that. But you’d better have a really good CEO to help navigate the healthcare landscape.
It can be done. I think that’s a message we try to carry to physicians: as you’re ready to lead, you need to be taught how to work with people who have expertise in business and listen to them. It’s not like a patient visit where you have all the answers, but it can and should be done. If there’s something I wish we did better in medical school, residency, and fellowship, it’s giving physicians more exposure to leadership so they’re ready for it—instead of coming out knowing every bacterium ever discovered but not how to read a profit-and-loss statement.
