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Discussion in 'Pain Medicine' started by nvrsumr, Apr 14, 2007.

  1. nvrsumr

    nvrsumr Member
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    Thinking of starting my own practice in a small town. This is a southern coastal community with tourism as the primary employer. What is the minimum population required to support a single physician pain practice? 50,000? 100,000? What about a 2 person group? Thanks and any thoughts on starting you own practice would be of interest.
     
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  3. mille125

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    if you are the only full time pain doc there, i think that 50K could easily support you. It may even work if there is a part-time doc who comes from a surrounding city. I strongly suggest that you sit down with your referral sources prior to starting. Small towns tend to have outmigration to big areas. Also you want to explain what you have to offer to the referring docs as they probably already have established referral patterns. Talk to PCP's as well as spine/orthopedic surgeons. Give a talk on "nonsurgical management of lumbar spine pain" or some other topic. This allow you to meet other docs as well as explain to them who you would like to see. You will find that most PCP's view "pain management" as a dumping ground. You need to educate them. In a small town setting you can expect to do a great deal of opioid management (it just goes with the territory). Good luck. I think that you will like working for yourself. I also set up a practice in a small to intermediate sized city and would be glad to answer any questions.
     
  4. nvrsumr

    nvrsumr Member
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    Thanks for your reply. I am about a year out from this decision but thought I should start looking into it now. I do not have a great "in" at this town but really like the area and I know there isnt a dedicated pain doc there.

    Any thoughts on how to judge the receptiveness of the local medical community to my pain management services? Should I contact the local hospital? The anesthesia group or solo PMR practioner that I know are in the area? Is it unrealistic to think of starting a practice as a "newly minted" and unknown physician in a small town?

    I would definitely be happy to modify my perfect job(ie. narcotic management, call, solo practice) for the perfect location.
     
  5. mille125

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    start by talking with the hospital...they may be able to give you an income guarantee to move to the area if there is no one providing your services. There are pros and cons.

    PRO: You dont have to borrow a ton of money. You get advertising. The hospital can but you in contact with the PCP's in the area and may sponsor a conference in your behalf.

    CON: You have to stay there for 3-5 yrs or pay the money back. The hospital may have other stipulations in their contract. Some hospital administrations can be very hard to deal with.

    Because of the cons listed some people choose to take out a loan and do it themselves. You can easily qualify for a practice loan if your credit score is higher than 600.


    I would not contact the anesthesia group unless you are also interested in providing anesthesia services. They would likely view you more of a threat than an asset especially if they do not have an exclusive contract with your hospital.


    I also strongly urge all new doctors interested in solo practice to get in contact with a practice management group so that you are set up correctly to start. I went through my state medical society. They had a practice management division that helps physicians set up practice. Even though you are a year off, if you know your location, I would start working on it now.

    Finally, I would suggest the book called "Starting a Medical Practice" which is put out by the AMA. It really really helped me out. It has a timeline of events for you to follow.


    Good luck.....I will be glad to answer further questions.
     
  6. nvrsumr

    nvrsumr Member
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    Thanks! This is a great start.
     

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