Considering private practice? Here are 6 things to think about

Despite the evident benefits of private practice—being your own boss and running a practice exactly how you want to—fewer doctors are choosing this route. Just 17 percent of physicians are now in solo practice, down from 25 percent in 2012, according to a recent survey from the Physicians Foundation.

Medical students are often reluctant to consider private practice, says Janet Burns, who works with students on clinical rotations as business owner of University Family Medicine Center in Orlando, Florida.

However, Burns has taken it upon herself to show students the joys of running a private practice, and she often succeeds in changing students’ minds.

“By the time they finish their rotation, they’re ready to start their own practice,” she says.

Often, this turnabout happens after Burns gives students a tutorial in the business side of medicine.

“In small business, you will make mistakes,” she notes. “You’ll get things wrong. But physicians are not used to making mistakes.” Burns explains to her students that private practice requires a mindset adjustment and a willingness to move beyond your comfort zone—and that the rewards of this practice style are many.

If the idea of being your own boss appeals to you, check out this list of six things to consider when thinking of pursuing the solo route:

1. Your specialty

Non-hospital related specialties like family practice or pediatrics are more suited for solo practice. “If you are a specialty with a great deal of hospital work, like ob/gyn or surgery, it may behoove you to be in a large group or employed setting,” says David Garza, DO, who has run a solo practice, Osteopathic Family Medicine, in Laredo, Texas, for 24 years.

2.   Location

Less-populated areas with growing families are often more supportive of the solo practice model. “There aren’t enough physicians in our town,” says Dr. Garza. “We’re in a manpower shortage area. We are underserved, so there is no competition.”

More densely populated areas foster more competition, and thus, more of a challenge for solo practice. “You need to be in an area where there are new families moving in, and you need to become active in the community,” says Burns. “People love to meet doctors outside of the doctor’s office. In a small town, people know who you are, whether you’re at church or volunteering or at a community event. People who meet physicians often become patients.”

3. The benefits of solo practice
   

When you work for a large group, your ability to customize the care you provide can be limited, notes Dr. Garza.

“But when you’re your own boss, you have complete control,” he says. “If you want to spend more time with a patient or customize your patient profile, or if you want to spend more time doing osteopathic manipulative treatment, there is nobody to tell you ‘no.’ ”  

4. The downsides of being on your own
   

More than 70 percent of physicians say patient relationships are the most satisfying aspect of medical practice, while nearly 60 percent say regulatory/paperwork burdens is least satisfying, according to a 2016 survey from the Physicians Foundation.

For a solo practitioner, paperwork, regulations and medical billing requirements can be especially burdensome.

“We’re spending more time in front of the computer, making sure we’re doing the right things and saying the right things, so we don’t get penalized by those who reimburse us for our services,” says Dr. Garza. “I’m married to someone who runs the business side of things, so I can focus on the practice side. But if you’ve not run a business, you have to learn those tasks, or delegate them to someone. You have to hire someone who knows how to run a business.”

Additionally, solo practitioners also assume more financial risk than their employed counterparts.

5. Shadowing opportunities

It’s a good idea to shadow both a solo physician and an employed physician in a group setting to see which setup gels best with what you’re looking for.

“I recommend talking to and visiting physicians who are in solo and group practices and taking notes and asking questions,” Dr. Garza says. By doing this, prospective solo DOs can better assess the schedule, demands, and culture of a solo setting and determine if they’re in alignment with the lifestyle they’re seeking and their career objectives.

6. Different paths to practice ownership

If you’re interested in solo practice, you can either start your own or buy an established practice from a physician looking to sell. Working with or shadowing a physician near retirement that may be looking to sell their practice soon may be a viable option. Most often, retiring doctors are looking to pass on the business to someone with a commitment to the same level of patient care that they’ve delivered, Burns says.

Further reading

Quiz: Which practice style is right for you? Find out if solo practice, group practice or locum tenens is right for you.

Quiz: What’s the ideal specialty for your personality? Are you better suited for pediatrics or emergency medicine? Or is surgery the best match for your personality? Take our quiz and find out!