Entrepreneurship opportunities within PM&R

[Wabi-sabi]

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For those of you who have your own practice or ancillary business, do you see PP (in or outpatient) being viable in the future for PM&R and are there opportunities for entrepreneurship as a PM&R physician? I’m looking mainly at services that relate to physiatry/medicine in some way, not things like real estate or stocks.

I would prefer not to be on strictly an employed/salaried model with little upward mobility in terms of income and I really enjoy the content of PM&R, so if I could satisfy my entreprenuerial itch and do so in PM&R that would be great. In particular, I like sports/spine and pain.

I know some others have mentioned being a SNF director, home health services, and a med spa type of business, but are there other avenues that would fit well for a PM&R doc? I currently have a personal training business that I run on the side fwiw

Also, do MGMA percentiles still line up with total income including ancillary services? For example, is ~95% of MGMA the max you could realistically expect even having ancillary services?

Thank you and any help is much appreciated!

 

[runfastnow]

If by entreprenuerial in the medical field you mean able to generate passive income through medicine (and not real estate or trading securities) then you are looking at owning a practice or inventing a medical device.

I can't answer your MGMA question, but if you are a skilled business person and open your own spine practice, buy into an ASC, and own a PT/personal training facility then you can collect massive passive income if you can contain margins, play your real estate correctly, etc. If you are a successful medical business owner your income could be into the $1 mil+ range.

 

[PMR2008]

I have been in outpatient PP and consulting work for the last 8 years. The future is hard to predict but it is exceedingly difficult to manage. I run a gym/performance center and weight loss center. It was going well until COVID. We open the doors again in a few weeks with a number of restrictions. Additionally I am on the advisory board for 2 tech startups.
I will list some ideas below.
- Own urgent care centers
- Medical spa/aesthetic medicine
- Own and manage Physical therapy practices
- Own and manage imaging center
- Sports performance center/ anti aging medicine/Functional medicine
- Working for insurance companies/Pharmaceutical industry as an advisor
- Develop an app or device. Patent it and sell it.

That just a few minutes of thinking. I started my first business in med school and sold it by the time I started my PGY2 year. Figure out what you are good at and work harder than everyone else.

 

[PMR2008]

If by entreprenuerial in the medical field you mean able to generate passive income through medicine (and not real estate or trading securities) then you are looking at owning a practice or inventing a medical device.

I can't answer your MGMA question, but if you are a skilled business person and open your own spine practice, buy into an ASC, and own a PT/personal training facility then you can collect massive passive income if you can contain margins, play your real estate correctly, etc. If you are a successful medical business owner your income could be into the $1 mil+ range.

Agree.

 

[Wabi-sabi]

@runfastnow @PMR2008 thank you both for the answers, that is exactly what I was looking for.

Do you feel being a PM&R doc specifically gives you an advantage in certain business like the PT/gym stuff? Are stark laws an issue at all for you in those type of business that use referrals?

Also, how difficult is it to get involved in start ups or in an advisor type of role?

 

[PMR2008]

It definitely gives us an advantage. Physiatrist are experts at managing therapy and performance. The current version of the Stark law includes an exception that allows physicians to self-refer for so-called "in-office ancillary services" .

https://coa.org/docs/LibraryofWebinars/AMAStarkLawRulesoftheRoad.pdf

Startups are all about being at the right place at the right time. Get as close as you can to where the action is. Silicon Valley, LA, NYC, Cambridge/Boston, Seattle. Get involved in incubators. If you are only a medical student you have no credibility. You can get involved once you have a MD/DO after your name.

 

[90dayMD]

I have been in outpatient PP and consulting work for the last 8 years. The future is hard to predict but it is exceedingly difficult to manage. I run a gym/performance center and weight loss center. It was going well until COVID. We open the doors again in a few weeks with a number of restrictions. Additionally I am on the advisory board for 2 tech startups.
I will list some ideas below.
- Own urgent care centers
- Medical spa/aesthetic medicine
- Own and manage Physical therapy practices
- Own and manage imaging center
- Sports performance center/ anti aging medicine/Functional medicine
- Working for insurance companies/Pharmaceutical industry as an advisor
- Develop an app or device. Patent it and sell it.

That just a few minutes of thinking. I started my first business in med school and sold it by the time I started my PGY2 year. Figure out what you are good at and work harder than everyone else.

Could you elaborate on how you were able to get on the advisory board for the 2 tech startups that you are in? Thank you.

 

[PMR2008]

Having skills above and beyond just medicine. I was approached by a group and for the other opportunity I emailed a group and made some connections. there is no magic formula.

 

[Chelsea FC]

Having skills above and beyond just medicine. I was approached by a group and for the other opportunity I emailed a group and made some connections. there is no magic formula.

Does it feel like another job or more like passive income?? Do you do it because you want to mix things up or more money than working as a doc.

 

[PMR2008]

Most advisory roles do not require much time. Maybe 4-6 hours a month. I only get involved if I get some ownership/stocks. It can be a full time job as well but that is not what I am looking for at this time. Definitely more money to be made on the tech/startup side but it is risky since many of them fail.

 

[Chelsea FC]

- Medical spa/aesthetic medicine

Mind to share your thoughts on Medispa and aesthetic medicine? Seem to be a lot of hate directed towards them. Saying its selling out/not fact-based or providing poor care to people. Do you find this to be true ?

 

[PMR2008]

I just don’t like the particular patient population it attracts. It can be lucrative though.

 

[KeratinPearls]

I just don’t like the particular patient population it attracts. It can be lucrative though.

Yeah the hormone injections for old dudes who want to look buff or feel young again.

Not scientifically proven to be more effective than traditional hormone injection from what Ive read.