Derm solo/small group practices still viable?

[luxaeterna]

I'm sure this question gets asked every few months, and while I understand that derm is generally immune to hospital buy-out, what do the attendings and senior residents here think about going solo or starting up a practice with one or two other dermatologists? I read this article:

http://dermatologytimes.modernmedic...-practices-dwindling-b?id=&pageID=1&sk=&date=

(2011) that kinda scared me away from all the hassles of solo ownership and put forth how convenient group practice is. Anyone trying to stay urban/suburban and doing small group or solo practice? Still feasible/worth-it or is large group the way to go? All opinions are really appreciated!

---

Members don't see this ad.

 

[asmallchild]

I'm sure this question gets asked every few months, and while I understand that derm is generally immune to hospital buy-out, what do the attendings and senior residents here think about going solo or starting up a practice with one or two other dermatologists? I read this article:

http://dermatologytimes.modernmedic...-practices-dwindling-b?id=&pageID=1&sk=&date=

(2011) that kinda scared me away from all the hassles of solo ownership and put forth how convenient group practice is. Anyone trying to stay urban/suburban and doing small group or solo practice? Still feasible/worth-it or is large group the way to go? All opinions are really appreciated!

It's definitely doable. It's definitely getting more difficult. I had a couple of offers upon graduation to take over an existing practice and that's probably the route I would recommend if you are looking to go solo. (The departing physician will often stay on for a period of time and can assist you with the transition. I've seen examples where multiple residents may choose to take over resulting in a small group practice from what was once a solo operation)

In the end, I opted for a large group because I prefer to focus on the medical side of things and let others handle the administrative portion. That being said, we are fortunate to be in a field where we do have a choice in selection (for now at least)

 

[MOHS_01]

Doable? Yes. Intelligent? Maybe not. People need to make an effort to better understand the larger political game we are involved in and operating under. It is not just the administrative burden, increasingly complicated regulatory burden, and declining reimbursements; it is that these are not equal burdens borne by all - and the winners and losers are chosen by design and for cause. Google "vertical integration Ezekiel Emanuel Annals of Internal Medicine" - small practices, physician autonomy, and the cottage industry characterizing physician practice is actively being exterminated "for the greater good".

Yay progress!

 

[DermatoFIGHT]

Each year new regulations come out that burden small businesses and solo practices. Larger corporations lobby for added regulations because they know that the smaller guys will struggle financially to meet the changing standards. The big boys know this and gladly pay the extra money out knowing that the new regulation may cost them some money upfront but will help eliminate competition and ultimately lead to increased capital on their end longterm. It is a way they undercut utilizing political methods. It is the war on small business owners that continues today.

If you can be a solo guy, it will be more rewarding/gratifying in that your work is done the way you like. However, most graduating residents are lazy and "don't want the burden" of administrative tasks of owning a practice, so they sell themselves out and their profession for an easy paycheck earlier on. Personally, I would rather earn less than be an employee of someone else.

 

[asmallchild]

Each year new regulations come out that burden small businesses and solo practices. Larger corporations lobby for added regulations because they know that the smaller guys will struggle financially to meet the changing standards. The big boys know this and gladly pay the extra money out knowing that the new regulation may cost them some money upfront but will help eliminate competition and ultimately lead to increased capital on their end longterm. It is a way they undercut utilizing political methods. It is the war on small business owners that continues today.

If you can be a solo guy, it will be more rewarding/gratifying in that your work is done the way you like. However, most graduating residents are lazy and "don't want the burden" of administrative tasks of owning a practice, so they sell themselves out and their profession for an easy paycheck earlier on. Personally, I would rather earn less than be an employee of someone else.

I wouldn't go so far as to say that joining a group practice or even a corporate practice means selling your profession out. I agree it would be nice to see more of an entrepreneurial spirit in dermatology and medicine in general. I'm glad you are willing to earn less than to be an employee. I think you'll find those words are much easier to say than to actually live by.