Physician Finds Optimism Amid New Realities of Practice

The co-founder of a large primary care practice and long-term leader at the American College of Physicians says medical homes and new payment models improved his practice satisfaction "tremendously."

"At the heart, we're a private practice," Yul Ejnes, MD, MACP, an internal medicine physician and chair-emeritus of the American College of Physicians' board of regents, says of Costal Medical, the practice he co-founded with one partner more than 20 years ago.

Today, Coastal claims to be the largest primary care group practice in Rhode Island, with 19 locations and more than 100 clinicians. The group is a successfulMedicare Shared Savings Program ACO, with all of its offices recognized by the National Committee for Quality Assurance as level-3 patient-centered medical homes.

Throughout this growth, Ejnes has remained a shareholder of the independent group.

"There are ways of staying in practice, seeing patients, and living in new realities," he says. "But [physicians] have to wake up and start paying attention and doing what they have to do."

Some of these tasks include learning about the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA) and understanding new payment and practice models in general. I spoke with Ejnes recently; the transcript below has been lightly edited.