William Fox, MD, has had an independent practice in Charlottesville, Virginia, for 23 years, where he rented medical space with two other physicians.
At their first location, the group was responsible for building out the entire space, taking out a “fairly extensive line of credit” to do so, Fox, a partner in Fox & Brantley Internal Medicine and chair emeritus of the American College of Physicians, told MedPage Today.
The space was designed according to their exact specifications. Each of the physicians had their own private workspace for administrative and related work, connected by doors. “We mostly kept them open for ease of communication,” Fox explained, “but we could also close them off if we felt we needed more privacy.”
When Fox and his colleagues were told that the property that housed them was being redeveloped, the group was forced to move to another medical space.
“We had to find a space that was already built out as a medical office, so we had to find something that would work for us in totality, and that may have meant that not every aspect of the office was perfectly to our pre-desired specifications,” Fox said. “In this particular case, we moved into an office where there was a very big workspace for doctors, and the three of us took over that work office, and so we all are working in the same shared large office.”
The shared space is an “example of one of the compromises that we had to make when we moved into this new location,” he noted.
Both shared and private spaces have their benefits and drawbacks, he said.
“It’s great to have the camaraderie. It’s great to have your colleagues right there, you can run things by them, or you can just chit-chat about social things,” he pointed out. “I mean, all of that makes your day more enjoyable. And then on the downside, sometimes you feel like you need more privacy for conversations, or you need more quiet because you’re dictating, for instance.”
In a recent Reddit thread dedicated to the topic, several commenters pointed out that the majority of physicians are now employed and this has likely contributed to the increase in shared spaces, with most organizations keen to cut costs through tighter working conditions.
Fred Horton, MHA, president of AMGA Consulting, the professional advisory firm of the American Medical Group Association, told MedPage Today that there are likely a bevy of reasons for why physicians work in shared versus private spaces.
There are a “number of organizations that have gone to more of a bullpen concept for administrative services,” he said, calling it a “cultural aspect.” However, “it takes a certain organization to make sure that it helps make the culture better,” he noted.
There are also certain specialties and environments that are a better fit for shared space, such as primary care, and urgent care centers, and emergency departments, Horton said, adding that he believes a revolt might ensue if a group of emergency medicine physicians were told their central, shared workspace was being swapped for private offices.
“Number one, it wouldn’t work operationally,” he explained. “But number two, they’re so used to being together that I really view [it] being a team sport that spans across physicians and advanced practice clinicians alike.”
At the same time, specialties like oncology or surgery may be better suited for private space, Horton pointed out, because services are “more consultative in nature,” and “it really is important that a physician have a room where they can sit down and talk to a patient.”
Overall, “I think there is an opportunity to save a little bit on size of the clinics, but I’d make sure that that’s not the primary driver if it doesn’t fit with where the organization is at, the engagement focus, and the service type,” he said.
Ultimately, it’s critical to involve physicians in decisions being made about how they work, Horton noted. “I’d say this would be a key area where you’d want to make sure you had physician engagement in, however you’re creating the office environment, and that should be occurring between the physicians and the administration, talking and having dialogue, and planning jointly.”
For physicians already working in shared spaces, Fox pointed to another consideration.
“I think there should be a culture where, in the office, you try to respect others being able to do their work, so that you’re not interrupted too much or people aren’t too loud in the background,” he said. “Those are things that I think can definitely help when you’re working in a shared office.”
