Five Qs: Dr. Joseph Berenholz on the Fading of Private Practice


Dr. Joseph Berenholz, an OB/GYN with a practice in Farmington Hills, spoke with DBusiness Daily News about staying competitive with new technology and the likely end to private medical practices.

1. DDN: Tell us about the new technology that’s available at your office.

JB: Vanquish (is a non-invasive fat removal procedure) that is ideal for the patient that has never been able to get rid of those 2 to 3 inches of fat around the abdomen and around the sides and the love handles. They’re the ones who are eating fairly healthy, exercising periodically, and are pretty much stable in terms of weight, but they can’t get rid of that area of fat no matter what they do. And Protégé is a way of getting a face-lift without surgical intervention or ultrasound therapy. A lot of the modalities that are out there hurt to the point where some patients request anesthesia.

2. DDN: Why did you decide to offer cosmetic procedures in your gynecology practice?

JB:  Ten years ago, I introduced cosmetic gynecology to the Detroit area. I was trained in Beverly Hills (Calif.) with Dr. David Matlock, and had wanted to come up with a way to sculpt and rejuvenate that part of the female anatomy, especially for women who have already had children and women who were born with enlarged vulvar structures that can cause pain, discomfort, and embarrassment. So that was my first entrance into “cosmetics.”

As time went on, we introduced Botox, Juvederm, Latisse — all of the standard fillers and facial treatments for cosmesis — but we wanted to add something else other than that. So we looked at all of the various devices that were available, cellulite treatments and all of the ultrasound therapies. And literally, it took us a year to vet all of the technology. And we always found something either painful or something incomplete or something not satisfactory to all of these therapies. Finally, we came up with (Protégé and Vanquish). I looked at the background and the animal studies that went on, and (the results) were very dramatic. And at that point, we decided to add it to our menu of services.

3. DDN: What other changes are you seeing?

JB: I think medical practices will survive in spite of all of the changes brought on by the Affordable Health Care Act, but I think you will see the end of those private practitioners. In other words, most of us will have to be in some type of system, whether it’s a hospital system or a management-type care system, because of the complexity of federal regulations and keeping up with all of the requirements.

But that aside, I think there’s going to be tremendous need for health care in this area of the country. We have so many retired workers from the automotive industry who are going to put heavy demands on the health care system, and I think we’ll still be a very viable industry here in Michigan.

4. DDN: When will we see doctors transitioning out of private practice?

JB: It’s already happening. About 10 years ago, about 70 percent of those in (the medical field) were in private practice. Today, the figure is more like 30 percent. So the transition has been ongoing, and I would suspect in the next five years, it will be complete. Those that deal with primary care — which is family practice, internal medicine, obstetrics, and gynecology — will still continue to do well. The people who will be hurt the most will be specialists because the emphasis will be on prevention versus high-tech solutions to complicated health problems.

5. DDN: How do you stay competitive?

JB: The way to be competitive is to contain costs. The other methodology, of course, is electronic medical records, which help streamline the ability to communicate and keep track of patients’ files. It requires a great deal of communication with patients and staying in constant contact with patients regarding the latest and greatest advancements in medicine so that they know what’s available to them when they come to the office.

So to be competitive, it’s about whole cost value, improved communication (through) electronic medical records, and keeping your patients in the loop on the various developments in the field of obstetrics and gynecology. These are the types of things, like any business, you have to do.

But as I said before, most of these practices won’t be competitive anymore because they will all be part of a health care system. So the competition you’re going to see is perhaps between the Henry Ford system versus the Beaumont system versus the St. John Providence system versus the Mercy system. Those are the people (or organizations) that will ultimately have to be competitive and cut costs. The doctors will really be integrated into the systems by that time.