The PACN Podcast - Dr. Nader Rahmanian and Cheryl Rahmanian (Part 1) cover art

The PACN Podcast - Dr. Nader Rahmanian and Cheryl Rahmanian (Part 1)

The PACN Podcast - Dr. Nader Rahmanian and Cheryl Rahmanian (Part 1)

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 In this episode, Dr. John Pagan sits down with Dr. Nader Rahmanian and his wife and practice manager, Cheryl Rahmanian, of their internal medicine and geriatrics practice in Wyomissing, Pennsylvania. A longtime PACN member with consistently high performance levels, Dr. Rahmanian brings nearly 36 years of independent practice experience — including a brief but instructive stint in employed medicine — and a candid perspective on what it takes to build and sustain an independent practice. Cheryl offers a ground-level view of what patient loyalty and trust actually look like day to day.Key HighlightsA Career Built on Independence Dr. Rahmanian completed his internal medicine residency in Philadelphia and earned board certifications in both internal medicine and geriatrics. Rather than pursue additional fellowship training at the time, he transitioned into private practice and has remained independent — with one notable exception — ever since. He took over an established practice near Community General Hospital, moved to Wyomissing after the hospital closed in 1997, and built a practice serving patients 18 and older, with roughly 75% of his panel being geriatric patients. He previously served as medical director of several nursing homes and managed complex ventilator-dependent patients — responsibilities he has since stepped back from to focus on his outpatient practice.A Brief but Telling Experience in Employment At the request of the hospital CEO, Dr. Rahmanian helped establish the Reading Hospital Medical Group in the early 2000s and joined it as a board member from January 2007 through November 2009. He left when it became clear that even board membership wasn't enough to hold the institution to its commitments. He returned to private practice and hasn't looked back. More recently, in April 2020, when Reading Hospital made clear that remaining independent hospitalists were unwelcome, Dr. Rahmanian and a colleague chose to stop doing inpatient work rather than sell their practice to the system. He occasionally works a few days per year as a hospitalist to maintain his skills, but his practice remains firmly independent and outpatient-focused.The Case for Independence — And the Fear That Holds Physicians Back Dr. Rahmanian offered a frank assessment of why physicians choose employment despite the costs to their autonomy. On one hand, medicine attracts independent-minded people — yet medical training provides virtually no preparation for the business side of running a practice. The result is a pervasive fear of billing, ledger sheets, staffing, and financial management that drives many physicians into employment simply because it feels safer. His counterargument: running a practice is not fundamentally different from managing a household budget. Once you learn the basics, it's manageable — and the alternative, having a hospital administrator with entirely different incentives dictating your patient volume, your time, and even your referral patterns, is far worse.A Vision for the Future of Independent Practice Dr. Rahmanian articulated what he hopes the future holds: organizations that handle all the administrative and operational complexity of running a practice — billing, staffing, compliance — in exchange for a percentage, while staying entirely out of clinical decision-making. He sees this model as the key to unlocking independence for a new generation of physicians who want autonomy but don't know where to start. He also called for medical schools to add a basic practice finance and business management course to their curricula — a gap he sees as one of the most consequential oversights in physician training.The Partner Behind the Practice Cheryl Rahmanian has been with the practice nearly from the beginning, and Dr. Rahmanian credits her as the smarter half keeping everything on track. Her perspective on what makes the practice special comes directly from patients: new patients frequently remark that they finally feel like they're in a real practice, seeing an actual doctor who spends real time with them. Many arrive having left larger systems frustrated by constant provider turnover and rushed appointments. That gratitude, Cheryl noted, is what makes the work rewarding.Key TakeawaysNearly 36 years of independent practice — with eyes wide open about what employment looks like from the inside — gives Dr. Rahmanian a uniquely credible perspective on why independence is worth protecting.The biggest barrier to independent practice for most physicians isn't operational complexity — it's fear born from a lack of business education in medical training.Institutions that claim not to interfere with clinical autonomy routinely do so through patient volume requirements, EMR mandates, and referral pressures — often with real consequences for physicians who don't comply.The patient experience in a well-run independent practice — continuity, time, personal attention — is something ...
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