The Practice Manager and PDA

From a business and economic perspective, the delivery of medicine is changing.  Accountable Care Organizations (ACOs), ObamaCare, and the delivery of entitlement healthcare are powerful forces running in the background of your career and the practice’s future.  The office manager can either tune out or seize the opportunities imbedded in change. The PDA belief is that the physicians’ memberships open new vistas of opportunity related to you.  PDA is re-positioning a new title, the “Physician Practice Manager”, i.e. PPM. This is the first in a series of messages from PDA management and physician leaders that address a suggested identity and empowerment change.  The goal is to identify and contribute to the development of the professional that manages the physicians’ practice.  Doctors generally practice in an exam room, surgical suite on the hospital wards, etc.  Everything else related to operations is highly dependent on the PPM.  Thus, it is pragmatic to invest in the over-arching goal of recognizing, enhancing and empowering the Physician Practice Manager. The outcome will be to produce big dividends for the practitioner, for the PPM, and for PDA.


  • With leadership of the PDA Chairman and the Medical Director, organize a Physician Practice Manager  Leadership Counsel:
  1. Selected from the seventeen county market place of Flagship Physicians Network of Texas and PDA.
  2. Equally representative of primary care, specialists, nurse practitioners, and other clinicians.
  3. Elected every two years with staggered terms of service
  4. Equal access to ancillary and facility investments presented to physicians.
  5. Leads pursuit of grants, career path related scholarships and community service
  • Establish a community-based program of college certification. The program would begin as a certification and mature into four year degree with access to a graduate degree.

Courses will be internet, experience credit, class hours and internship.

  • Establish Human Resource website for collegial communication, career path counseling, compensation surveys, continuing education and open position listings




We want to either get your attention or figure out who is not interested.

From PDA–the IPA for Independent Practitioners

A Message for the Office Manager and Staff

From PDA–the IPA for Independent Practitioners.

Our promise is that we will be here for you when you have a problem. We have your back.  And, we have the door open for you to stop by and get to know us. Or, give us a call, and we will come see you.  PDA is focused on the office manager.

PDA has a Medical Director, Chief Medical Officer, Primary Care Practice Leader and a professional operations person, Chris Cash.  Also, the past manager for Harris Methodist’s physician network in Dallas and East Texas is wearing PDA colors.  Our leader, Buddy Miers, built the Presbyterian JVE and operated the SPA PCP network.  And, we are working to establish a college curriculum for physician office administration.  All together, we bring a seasoned, motivated team to support you. 

We frequently communicate about managed care contract changes, getting a new doctor on the plans, reimbursement issues, etc.  The grind and pressure of the physician office is inescapable.  We just want you to know that your issues are paramount to us. Also, we do so appreciate your needs and good spirit.   Our announcements, blogs, and other communications are intended for both you (office manager and staff) as well as the physician.  Your knowledge and experience are critical for dealing with “ObamaCare”, and we welcome and request your feedback. 

Also, we appreciate that you are the linkage from PDA to the Doctor.  You can assist us by being sure that faxes and other communications reach the physician’s desk.  This coordination will allow us to interact efficiently with both you and the physician.  We need that coordination so when we see them face-to-face, they know what we are talking about.  This is huge!

 PDA, you, and your team, are making a stand for the independent physician office. Together, we are definitely going to be successful both as stakeholders in PDA and for our patients’ well-being.

ACOs and the 501A

The conjecture of pundits and consultants is at a high pitch. The fact is that Medicare/Medicaid (CMS) has not issued rules yet. There are expectations for rules and regulations covering how physicians can group together, avoid inappropriate self-enrichment, and work within outcome-based structures. We will soon learn more.

It looks like an Accountable Care Organization (ACO) will be able to directly receive funding and patients while a physician component linked to a hospital system provides the actual care. In simplest terms, this is a way to link the hospital systems, Medicare/Medicaid patients, reimbursement, and the worker bees, (physicians).  We do believe that ACOs, as mandated by ObamaCare, are the intended forerunners for a future single payor system.  Unless there is an independent physician option, independent physicians will find it difficult to participate other than as workers.

Baylor has its linked physicians, HealthTexas. THR has its linked physicians, Texas Health Physicians Group. Methodist has its linked physicians, Dallas Methodist Physician Network. The Flagship Physician Network is the option which can link independent practitioners to hospital facility colleagues.

The Flagship Physicians Network (that’s us) is organizing independent physicians (the majority of physicians) so that we too have access to the ACO system and/or build our own.  Eventually, members of other Metroplex IPA’s will join us if they find they don’t have a seat at the ACO table.  Our role is to be the advocate and defender for the independent physician in the world of ObamaCare. Life is about to become very interesting.

Adding Value to PDA

It is crucial for our office managers and physicians to understand exactly how our MSO/IPA structure works. The Miers Group with its brand, the Flagship Physician Network of Texas*, is retained contractually to perform work for PDA and to interact with the members and the PDA physician board.  The Flagship business unit is continuously building infrastructure and new programs. Today, the Flagship directly serves 180 PDA practitioners and has contract relationships with another 600 non-PDA independent physicians in a seventeen county North Texas area. We are marshalling a powerful force of independent physicians. We are professionally arming for the coming ObamaCare Accountable Care Organization (ACO).  We, the independent practitioners, are going to successfully compete against Baylor’s “HealthTexas” and THR’s “Texas Health Physicians Group” to manage delivery systems and dollars.  Baylor and THR have more financial resources than we do, but size is not always conducive to speed.  The Flagship is fast and maneuverable.  Our goal is to rapidly and effectively build an option for the independent practitioner.  Such a system must work effectively, produce cost-efficient care, and provide $ material rewards for the independent physician.

As an entrepreneurial brand with a commitment to putting cost and investment squarely where it should, the MSO directly funds its human resource investment with its own money, not with PDA dollars.  Our physicians need to understand the Flagship product. First and most important, The Flagship Network of Texas is not beholding to any IPA or hospital entity.  The message is that we are building a robust, hard-hitting for-profit enterprise for the service of selected independent physicians, nurse practitioners, physician assistants, podiatrists, chiropractors and other clinicians. All new care-giving members are vetted and passed through a credentialing committee. Any cost to physicians will always be scrutinized and approved by your physician representatives and by operations management.  There is no bureaucracy and there are no unnecessary personnel at the MSO.

 Our goal is in sight, and only success is acceptable.  You are invited to join forces with us in this adventure. This is a game of musical chairs.  The music will stop suddenly, and those who remain passive will not find a seat.