Buy a practice or start your own?

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How do you plan on beginning your career?

  • Starting your own private practice

    Votes: 6 15.8%
  • Buying somebody's private practice

    Votes: 4 10.5%
  • Joining a group

    Votes: 19 50.0%
  • Working in a University setting

    Votes: 6 15.8%
  • Other

    Votes: 3 7.9%

  • Total voters
    38

crocshagreen

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The main reason I am starting this poll is because I am curious as to how much it would cost to buy somebody's practice (in a medium sized city, full practice in terms of patients)? You would also be buying equipment for the 5 exam rooms the office has. After thinking about that question, I started wondering how some of you folks were planning on starting your careers.

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The main reason I am starting this poll is because I am curious as to how much it would cost to buy somebody's practice (in a medium sized city, full practice in terms of patients)? You would also be buying equipment for the 5 exam rooms the office has. After thinking about that question, I started wondering how some of you folks were planning on starting your careers.

I'm surprised at the results. I think many new doctors of all types grossly underestimate the potential and the viability of starting a practice cold.
 
Fascinating results. I hear this from many new docs out there. That being said, I would love to see a poll of OD's and Oph's who are 3-5 years into their career. Work experience and perspective can make it easier to envision being successful in a startup practice or buying a practice.
 
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I'm surprised at the results. I think many new doctors of all types grossly underestimate the potential and the viability of starting a practice cold.

Most residencies are poor-quality training environments for learning how to start and run a private practice. Most academic doctors don't have much experience with this themselves and most academic departments are not good models for a successful private practice: they survive on cheap resident labor paid from the government and massive throughput, they are nonprofits that don't pay taxes, and most don't exercise the level of scrutiny to payer performance that you would have to have to survive in a private practice. Residents learn nothing of hiring and firing nor of any of the other non-clinical requirements of practice. Usually that comes from personal study once working, usually in a practice someone else set up.

The other problem is that most residents are broke. They have just finished a long train of years of poorly paid training that followed years of unpaid study and accumulation of school debts. A cold start is a tough choice, and often impossible if you don't have something in the way of equity to leverage startup lending.

The good old days of the friendly local banker giving you generous terms for both a house and a practice on a glimpse of your diploma and a handshake are long gone. You are subject to the same scrutiny as any other small business.

I personally think a startup is a good way to go if you can meet the requirements, and is the way most likely to lead to personal and professional satisfaction, but the general climate in medicine and the economy makes it more difficult than it was for earlier generations of doctors.
 
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I finished residency this past July, and I'm in the middle of trying to start my own practice. Like orbitsurgmd said, it definitely is a challenging, yet very educational experience. It certainly is not for everyone. Obtaining funding will probably be the most difficult hurdle, but is not impossible. It would definitely have been much easier had I had one or two years of private practice experience behind my belt. As for me, I have been fortunate to have family members willing to give me a generous loan.

I have no prior business experience, but my residency was sort of a hybrid private practice/academic institution, so I did get some, albeit little, exposure. Regardless, if you have the motivation to learn and have the right expectations, I think it is definitely a feasible venture. It's amazing how much you can learn from google. I, for one, am absolutely happy with my decision, and cannot see myself doing anything else...so far.

I actually have started blogging about my experience. Feel free to follow along.

http://iballdoc.blogspot.com
 
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Most residencies are poor-quality training environments for learning how to start and run a private practice. Most academic doctors don't have much experience with this themselves and most academic departments are not good models for a successful private practice: they survive on cheap resident labor paid from the government and massive throughput, they are nonprofits that don't pay taxes, and most don't exercise the level of scrutiny to payer performance that you would have to have to survive in a private practice. Residents learn nothing of hiring and firing nor of any of the other non-clinical requirements of practice. Usually that comes from personal study once working, usually in a practice someone else set up.

That's true but that's not unique to ophthalmology. That's pretty much accross the board in all fields of medicine. The fact is, that if private practice or being a business owner is what you want, it's prudent to try to educate yourself while you're in residency as much as you possibly can. I get that residency is intense and learning to run a business is not the primary reason that you are there but even participating in discussions at society meetings with other doctors, or discussing with faculty members who have private practices on the outside about it will go a long way to help you get off the ground because then you at least have a frame of reference for a lot of things.

The other problem is that most residents are broke. They have just finished a long train of years of poorly paid training that followed years of unpaid study and accumulation of school debts. A cold start is a tough choice, and often impossible if you don't have something in the way of equity to leverage startup lending.

There are many specialty lenders out there who will lend based on potential cash flow, not your personal assets. Yes, you might pay a higher interest rate than a tradtional bank or SBA loan, but interest rates are quite low right now. If this is your goal, there are ways of making it happen. Don't take the defeatest attitude.

The good old days of the friendly local banker giving you generous terms for both a house and a practice on a glimpse of your diploma and a handshake are long gone. You are subject to the same scrutiny as any other small business.

From the traditional bank. Seek out alternative sources of funding for a start up.

I personally think a startup is a good way to go if you can meet the requirements, and is the way most likely to lead to personal and professional satisfaction, but the general climate in medicine and the economy makes it more difficult than it was for earlier generations of doctors.

Of that there is no doubt. The point is, it's not impossible. You just have to be willing to make it happen.

And let me say also that a cold start up straight out of residency is even more beastly than a cold start up after you've been in practice for a few years. I'm not suggesting that people should do it. It definately takes a particular kind of person. I'm just saying that for that particular kind of person, it can be done. I'm surprised that out of the number of responses, no person said that that was what they planned on.
 
I finished residency this past July, and I'm in the middle of trying to start my own practice. Like orbitsurgmd said, it definitely is a challenging, yet very educational experience. It certainly is not for everyone. Obtaining funding will probably be the most difficult hurdle, but is not impossible. It would definitely have been much easier had I had one or two years of private practice experience behind my belt. As for me, I have been fortunate to have family members willing to give me a generous loan.

I have no prior business experience, but my residency was sort of a hybrid private practice/academic institution, so I did get some, albeit little, exposure. Regardless, if you have the motivation to learn and have the right expectations, I think it is definitely a feasible venture. It's amazing how much you can learn from google. I, for one, am absolutely happy with my decision, and cannot see myself doing anything else...so far.

I actually have started blogging about my experience. Feel free to follow along.

http://iballdoc.blogspot.com

cool, i read your blog about family business. good decision to have the loan made to your practice....this would be crucial if you ever needed to refinance practice debt or do a consolidation down the road.
 
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