Grow your own: case study of a capital alternative.

The physician-administrator team can take all that is good from the physician practice management company (PPMC) model and apply a variation of self-financing called a "tithe" in order to facilitate their group's growth. Essentially, a group can create its own PPMC for local consolidation purposes, contracting with payers, spreading risk contracts over a larger base of providers, getting access to ancillary services, centralized business office services, bulk purchasing and many other of the advantages extolled by PPMCs. Organization has value, especially in times of specific industry consolidation. Although most everyone agrees that the medical industry is undergoing tremendous consolidation, consolidation will not likely occur "top-down." Rather, it will occur more slowly--one group at a time, one locale at a time. If a group positions itself as a local consolidation leader and amalgamates other groups onto its "token ring," then all participants--especially those who initiate this consolidation--will reap the benefits.