Easiest specialties to open a practice in

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medstyle

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Basically, what specialties are easiest to open a practice in? What I mean is which ones have an easier time getting patients and a less prohibitive cost to opening.

Like, neurosurgery vs. ortho? Or neurology, derm, rads, GI, urology, ob/gyn....

I dunno, my concern is that I would like to open a practice where I live after school is done, and I dont want to have to join someone else's group. Ultimately, people with their own practices will make more too, which is another benefit, aside from the independance and location aspects.
 

beanbean

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It is difficult in this day and age to maintain a solo practice in many specialties. From a financial and workload standpoint is is often better to work in a group in many areas. Most people join a group practice and then buy into the partnership after 2-3 years. The timing of this option usually part of the offer to join the group and is part of the contract.
 

medstyle

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but there are plenty of solo practices out there. There are plenty of groups too, but the majority of doctors I know opened their own practices. If they expanded, it was by hiring more doctors, but they remain the boss or whatever.

I am not into the idea of joining a group, because i would be making less money and giving up autonomy for the benefit of having no start up costs/effort.

My understanding is like cards is difficult to get started in because the costs of the machines are so high. But I am certain many fields have much lower start up costs and risks, like derm or internal. I just want to identify which ones are like that. Also, some fields have an easier time getting referrals, like ortho.
 

kenmc3

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Looking purely at the cost to start a practice I think that most surgeons would have the lowest overhead. For example, there aren’t too many procedures a neurosurgeon can perform in their office. Whereas dermatologists perform the bulk of their procedures in-office and usually have a surgical suite. Ophthalmologists probably have some of the highest overhead with the expensive optical equipment and slit lamps which must be purchased. Orthopedic surgeons must pay for casting supplies and would probably have their own x-ray machine. So I think the most invasive surgical specialties like neruo and CT are probably going to be the cheapest. Everything else probably averages out to be the same. However ophthalmology is expensive and so is plastics (they usually have entire operating rooms with anesthesia machines).
 

medstyle

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kenmc3 said:
Looking purely at the cost to start a practice I think that most surgeons would have the lowest overhead. For example, there aren’t too many procedures a neurosurgeon can perform in their office. Whereas dermatologists perform the bulk of their procedures in-office and usually have a surgical suite. Ophthalmologists probably have some of the highest overhead with the expensive optical equipment and slit lamps which must be purchased. Orthopedic surgeons must pay for casting supplies and would probably have their own x-ray machine. So I think the most invasive surgical specialties like neruo and CT are probably going to be the cheapest. Everything else probably averages out to be the same. However ophthalmology is expensive and so is plastics (they usually have entire operating rooms with anesthesia machines).

so surgeons have procedures done where generally? Hospital? clinic? Do they have to pay by procedure for use of the facility/staff?

Sorry i am asking so many questions, but I haven't anyone to ask and the internet was no help.
 

AJM

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Physicians tend not to start their own practices anymore. What is being more commonly done these days instead is for physicians fresh out of residency to "inherit" a practice of a retiring physician in their specialty. By taking over someone else's practice, you get an already-established patient base as well as the needed facilities and staff. Usually the way it works is that the retiring physician will advertise (or just ask around) for someone to take over their practice. The new physician will then work with the retiring physician for a year or two to make sure they understand the ropes, and then the retiring physician will retire. Usually the retiring physician will be paid a certain amount of money by the person taking over their practice for the "service" of providing an already developed practice.

From people I've talked with, this sounds like it is probably the safest way to start a solo practice.
 

doc05

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medstyle said:
I am not into the idea of joining a group, because i would be making less money and giving up autonomy for the benefit of having no start up costs/effort.

You need to be realistic. Setting up a solo practice fresh out of residency is not always the best idea. Practice and referral patterns are often in place; depending upon where you end up practicing, it will be difficult to impossible to establish an adequate patient base. Beyond that are obvious group practice benefits like shared call schedules, shared overhead, etc.
 

YouDontKnowJack

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probably most primary care practices are easy to open in underserved areas. there might be tax benefits too. i dunno.
 

kenmc3

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medstyle said:
so surgeons have procedures done where generally? Hospital? clinic? Do they have to pay by procedure for use of the facility/staff?

Sorry i am asking so many questions, but I haven't anyone to ask and the internet was no help.

Surgeons typically use their office for pre-op/post-op visits and the hospital for most of their procedures. The hospital bills the patient for the supplies, OR, and staff – so the physician doesn’t have to pay the hospital. Ophthalmologists and plastic surgeons have a wide range of procedures which can be done in office. This leads to higher overhead costs and higher operating costs. It is then the responsibility of the individual practice to bill the patient for the supplies and staffing. Most surgeons (general etc) have a procedure room in their office for minimally invasive procedure (mole removal – maybe colonoscopy etc). While this increases costs, it benefits the doctor by not having to travel to the hospital. Plastic surgeons are another story altogether. Many have a full operating room at their practice which they may share with partners or other practitioners in their building. These surgeons typically perform all their procedures at their office and never go to the hospital.
 

PineappleGirl

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A friend my family is in private practice as a psychiatrist. He has the tiniest little office in a medical arts building which he shares with two colleagues, boths PsyDs. He takes patients during the day and they use the office space in the evenings and on weekends. He does all his own paperwork and billing. I think the only things he has in his office are chairs and a microwave (for his coffee and his lunch). Very low overhead. :)
 

medstyle

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thanks for the help guys. at least i have an idea that if i want to be independant, i can be. I use to think i wanted this huge multimilliondollar practice, but i am starting to see that since i am pretty lazy, i might not be able to handle the neurosurgery lifestyle, no matter what the pay.
 

Llenroc

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If you like solo practice, go into primary care.
 

kenmc3

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One of the biggest advantages to a larger practice is being able to share call with your partners. For example, if you are with 3 other people you would only be on call 1 week/month. If you were with 6 other people you could be on call once a week.
 

Mutt

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medstyle,

Your PM box is full, can't reply to the PM you sent me last week...
 

YouDontKnowJack

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so you're in it for the money eh...

RIGHT ON BROTHA! YEAH!
 

medstyle

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YouDontKnowJack said:
so you're in it for the money eh...

RIGHT ON BROTHA! YEAH!

uh, haha, but honestly I just dont want to be taken advantage of and i like the freedom of having your own business. Besides, who wants to get paid less to do the exact the same thing?
 

Winged Scapula

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medstyle said:
uh, haha, but honestly I just dont want to be taken advantage of and i like the freedom of having your own business. Besides, who wants to get paid less to do the exact the same thing?

You aren't necessarily paid less in a group practice - more partners means more volume, a higher community profile (which can translate into more referrals, more patients, more cases, bigger fees, etc.), paid vacation (which you won't get in a solo practice), cheaper malpractice insurance (ie, "bulk rate" for the group), etc.
 
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