Employment vs Starting Private Practice

[bbkl123]

Hi all,

Family resident here doing my final year. I've been thinking of what I want to do upon graduation. I'm on the fence of starting a private practice and just being an employee.
I think private practice is only an option if the income is significantly more in the long run compared to the employed model. I have an entrepreneurial spirit and understand that I'll have to put in the extra hard work especially in the beginning.

What do you all think? Is private practice dead or is this just a saying by older attendings who had a taste of the glory days?

What do you think of private practice startup consulting firms? Are they worth it? Any recommendations of any reputable firms?

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[deleted87716]

Consulting firms just take your money (which you likely borrowed from the bank to begin with). Avoid.

There's a happy medium between being in solo practice and being a cog in the wheel of a big health system. It's called the physician-owned private multispecialty group. Look for one near you. Or move.

 

[Sushirolls]

I spent a lot of time in med school reading about private practice primary care. I wished I liked primary care more than psych. But I liked psych more.

Look at the range of options and their labels: Direct Primary Care / Micropractice / Concierge / Retainer / Cash only, etc.

Micropractice start out with you just you, an office, a waiting room, and a bath room ensuite. Have a pull curtain in the middle of the office to seperate the nice desk from the exam table. Call the people in from the waiting room yourself. Do your own vitals, turn over of the exam table, etc. By not having the usual 4-5 office staff and smaller volume of patients, your per hour earnings can match or exceed the usual mad rush of primary care. Get a quality website. Emphasize on website you want people to come in for the same day urgent issues (so you don't lose money to urgent care or the patients). Don't hire a mid-level. There's 1, maybe 2 docs in my area that are doing retainer/DPC style practices, but they both have mid-levels. I don't want to pay cash to be seen by an ARNP.

Spice things up and look at the retainer side of things too. Charge $100/month for unlimited access. $100 x 400pts x 12 months =$480k to then subtract overhead and taxes from. Better than seeing the usual 2000-4000k patients primary care doctors see in the Big Box shops.

Chances are, you dream, you can do it. Don't let the docs around you cut down your dreams. Go get 'em tiger. Own you career, own your freedom, own your future.