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13 Articles in Volume 18, Issue #7
A Commentary on Medical Cannabis
Are Abuse-Deterrent Opioids Appropriate for Your Pain Patient?
Behind the AHRQ Report
Challenges Facing Abuse-Deterrent Formulations
Demystifying Opioid Abuse-Deterrent Technologies
Editorial: Our Clinical Pain Neighborhood
Independent Pain Practice: A Case Example
Inside Performing Arts Medicine
Letters to the Editor: ACT Therapy; Compounded Topicals
Nerve Growth Factor and Targeting Chronic Pain
Pain Control for Athletes: What Works?
Quality Training: One Center’s Experience with Pain Assessment
The Importance of Developing Professional Relationships in Pain Practice

Independent Pain Practice: A Case Example

Practitioners share their experience of partnering with a financial and operational investor and lessons learned along the way.
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Over the past five years, macro market dynamics have changed the interventional pain management industry. Greater education and awareness of the opioid crisis, combined with a more enlightened, aging population seeking non-surgical solutions and a higher quality of life, have led to a fierce search for alternative solutions. However, these changes do not mean that independent pain management practices cannot be in control of their own destinies. As the authors have learned, there are still options for accelerated growth. Pain management continues to evolve at a rapid pace, with emerging treatment options and technologies steadily improving patient outcomes. For practice owners, this evolution offers an opportunity to make pain management a fresh and robust industry, while growing reach and quality of care for patients.

Crossroads sign.How to choose the right path for accelerated growth for your pain practice (Source: 123RF).

The Birth of Clearway

We founded the Gulf Coast Pain Institute in 2013 and quickly grew into one of the leading interventional pain management practices in Florida. But we soon found ourselves facing diverging paths common among private practices of our size and scale: either work with an outside partner or continue growing by ourselves. We took the former path and partnered with NexPhase Capital, a New York-based private equity firm that shared our vision for creating a leading pain management platform that would leverage what we created. We finalized the partnership in February 2018 and formed Clearway Pain Solutions Institute.

We view interventional pain management as an underutilized and emerging healthcare segment and, with our combined clinical and financial resources, are now able to grow Clearway into a regional and national pain management platform. Specifically, our partnership with NexPhase has allowed us to be more strategic and proactive with our services. For example, as the aging population creates more demand for sustainable pain care, and as government agencies become more involved in solving the opioid epidemic, board-certified interventional pain management providers are beginning to be seen as more viable, safe, and valuable alternatives to the traditional medication-focused pain practice. Comprehensive pain management is creating a more cost-effective environment, and patients and payors are benefitting as alternative treatments such as radiofrequency ablation, endoscopic rhizotomy, neurostimulation, pain pumps, and regenerative medicine become more widely accepted as alternatives to surgical approaches. What some individuals once tolerated, they can now receive treatment for, and what once required surgery, in many cases, can now be treated with minimally invasive procedures. The use of regenerative medicine techniques is also demonstrating high success rates with more potential uses and outcomes expected in the future.

How to Choose an Investor

Investors exist to provide capital, but they can also help to grow operational expertise for practice owners and help them thrive. Letting an experienced partner assist with business operations has allowed our doctors to be doctors. In our case, NexPhase brought a strong operational structure to the table on Day 1. Their team helped us form a strategic vision and growth objectives to execute on, while allowing our doctors to focus on the services that matter: providing high-quality care to patients, significantly reducing process and information inefficiencies, and continually monitoring the patient experience. This move enhanced physician-patient relationships across our practice. Furthermore, we have formed several significant strategic partnerships with local groups, redesigned our operations to increase output, and grown monthly new patient referrals by 30% without adding providers or facility space.

Practice owners should seek the right fit when vetting potential investors. In our case, we sought a team with a track record of success and knowledge of the shifting trends and emerging opportunities specific to our industry. For example, NexPhase had a strong vision for our business and commitment to grow our platform. The firm’s previous investment success with a leading national outsourced anesthesia provider also influenced our decision; NexPhase was able to help that provider more than triple in size and execute multiple acquisitions during their five-year partnership.

What Practices Can Offer Potential Investors

Clinical quality is paramount. In our experience, investors desire to partner with physicians that offer excellent care. However, investors also generally seek ongoing partnerships with practice owners who have a sense of entrepreneurial spirit and a commitment to growth. In our case, NexPhase was encouraged by our leadership team’s overall vision, which played a key role in the genesis of our partnership. While the frequency and amount of patient cases our practice held were notable factors to the investor, they also conducted a thorough review for any compliance, financial, or legal risk factors.

Investors also tend to seek practices that utilize protocols to ensure consistent, compliant care. For example, our medication management risk-stratification protocols were of crucial importance in the evaluation of our practice. Practices with a strong growth trajectory obviously rise to the top of any investor’s list, but, in our experience, providers and groups with a passion for quality clinical care, a team approach, and a vision to define the future of the industry are also respected.

How to Shape a Better Practice

For practice owners seeking optimum growth, creating or consolidating into a larger platform is a common approach. A larger platform of pooled resources may provide a practice with increased access to research, advanced technology, treatment algorithms, best practice synergy, as well as process and information efficiencies. At Clearway, we are now able to provide joining practices with the strategic leadership, operating infrastructure, and financial resources that allow providers to increase their clinical time and survive the business of medicine. In short, we put operational efficiencies in place to ensure that patients receive the best management of their pain.

In the coming years, we plan to grow Clearway into a one-stop, comprehensive, integrated system of advanced pain solution treatments. We intend to serve as the end-to-end coordinator of interventional treatments, medication management, chiropractic services, physical therapy, massage therapy, and regenerative medicine. We also hope to make Clearway the “first stop” on a patient’s cure to pain. To accomplish this, we are working to grow the reach of our practice in three distinct ways: contiguous geographic growth within a 150-mile radius of our main offices by bringing local providers into the Clearway group or by opening new offices; identifying key strategic markets throughout the southeast that are in short supply of interventional pain physicians; and identifying a strategic partner and/or successful groups across the country that share our commitment to quality and vision of the future.

Last updated on: October 3, 2018
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The Importance of Developing Professional Relationships in Pain Practice
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