Fewer physicians than ever before own private practices. But new local start-up MedCoShare is hoping to reverse that trend and capitalize on it.
MedCoShare, which officially opened on July 1, brands itself as a coworking space for outpatient medical offices. And like other coworking businesses, it’s based on the idea of shared space and resources.
Physicians and medical providers can book time for patient appointments at the Fishtown location as needed, and have access to such common equipment as EKG machines, blood pressure cuffs, and exam tables. The booking fee also includes cleaning services and disposal for syringes and biohazards. Membership plans, which vary from levels of part-time to full-time booking, range from $390 to $2,500 a month.
MedCoShare’s backers say it is the first start-up of its kind to launch in Philadelphia. Other cities such as New York have seen similar businesses in medical office coworking such as Clinicube. But because providers are often licensed in only one or two states, these businesses aren’t a real concern for competition against MedCoShare.
The start-up’s first-floor site at 2418 E. York St. holds eight exam rooms and two offices, and could serve 10 doctors if each signed up for full-time membership, though the owners expect most clients to choose part-time options. Two doctors are already confirmed as tenants while a third is signing papers, the principals said. The company says that, if this site is successful, it hopes to expand to other locations and become the first medical coworking company to go national.
The start-up grew out of a collaboration at Temple University’s Fox School of Business between Ronak Vyas and Greg Goldmacher, who were partners for their capstone project there.
Vyas, along with fellow MedCoShare co-owner Amit Mundae, brings real estate expertise to the business, while Goldmacher, a physician now working in the pharmaceutical industry, provides insight on the medical side. The fourth co-owner, Anthony Khan, has worked as a project manager in the health-care and pharmaceutical industry and cofounded investment holding company ARA Group LLC with Vyas.
With these backgrounds and local knowledge of real estate and medicine, Goldmacher hopes that MedCoShare will allow more providers to consider private ownership options. Because medical workers pay only for the time they need, instead of signing a long-term office lease, Goldmacher says, MedCoShare makes private practice more flexible.
“We can alleviate one of the major risks, which is going to sign up for a seven-year lease and pay huge upfront costs,” he said.
The most recent survey from the American Medical Association published in 2019 found that private practice ownership was at a historical low among physicians in 2018. Only 45.9% reported owning an independent practice, while 47.4% were employed by a hospital or other organization, marking the first year on record that there were fewer physician owners than employees.
Jaan Sidorov, an internal medicine physician and CEO of the Care Centered Collaborative at the Pennsylvania Medical Society, said that “private practice isn’t as attractive as it used to be.” He noted that although there are benefits to being a business owner, there’s also the downside of having to deal with administrative regulations and overhead costs. The income, too, is less predictable, as it relies on keeping a consistent group of patients.
But these challenges don’t obscure what Sidorov sees as the biggest advantage of independent practices: improved quality of patient care. “They’ve got a lot of patient loyalty, and they focus on their patients,” he said. He noted that often, the benefits of this individualized focus are reflected in high-quality scores on patient satisfaction and physician availability.
Sidorov argued that COVID-19 might be eroding the stability of hospital employment for providers. Although the Philadelphia area is home to dozens of hospitals, he pointed out that many have faced economic losses and layoffs, leading to lower income or fewer support staff for doctors.
“If I were a physician in Philadelphia right now, and I was thinking about trying private practice, what better way to do this than to put your toe in the water with this start-up?” Sidorov said. The flexibility of the space-booking process, he argued, might be appealing to providers who want a taste of independence on a part-time basis.
Anjana Patel, a health-care lawyer with Epstein Becker Green, thinks the pandemic could accelerate the exodus of doctors from private practice. With widespread economic turmoil, independent physicians might feel more pressure to sell their practice to a hospital, she argued. “I’m seeing a lot of inquiries from physicians right now, saying, ‘Hey, I think we’d like to explore a strategic partnership because I don’t think we can survive the next level of this,‘” she said.
Despite those pressures, Patel thinks there still might be demand from patients for a service such as MedCoShare. “A lot of people want to avoid the hospital at all costs,” she noted, and gaps in telemedicine could require in-person appointments.
Goldmacher sees this as one potential business model for MedCoShare. One example, he said, would be an endocrinologist, who can review lab results with patients over telemedicine, but would need a place to perform a thyroid biopsy. “All you would need is a little portable ultrasound machine and some needles,” which he said MedCoShare could provide.
Goldmacher and Vyas also think their business could attract new graduates from the area’s many medical schools. “This is a really great offering for them because they may not have a patient base that justifies a long-term commitment and all the upfront costs of a full-time office,” Vyas said.
He also hopes that MedCoShare will provide a space for “people who want to try a new market before committing to that market.” That’s the case for Marybell Rodriguez, a cardiovascular nurse practitioner who recently launched her company, Blissful Aesthetics, with its first location at MedCoShare.
While medical aesthetics and skin care have long been Rodriguez’s “side passion,” she worried about establishing a steady client base for her business, especially during the pandemic. “Knowing that I don’t have a full lease through my membership [with MedCoShare] gives me confidence and reassurance that if I don’t have a huge clientele in the next couple of months, I’m not bound to anything,” said Rodriguez.
Blissful Aesthetics started offering in-person consultations at MedCoShare once businesses were allowed to reopen in Philadelphia in early July. Rodriguez’s clients check in through an iPad when they arrive. Both she and her patients are required to wear masks at all times because of the pandemic, and all rooms are fully sanitized by a cleaning service between appointments, said Vyas.
She brings her own laptop for appointments to keep track of client medical records and maintain their privacy. MedCoShare has HIPAA-compliant storage for any paper medical records as well.
MedCoShare launched during one of the worst economic crises of the century and targets a decreasing population of independent providers as its clientele. But Vyas and his fellow co-owners remain confident. “Even though we didn’t plan to open during the pandemic, we’re being optimistic, and going full speed ahead.”