My patients and answering service understand my policy of no refills after hours. When I go on vacation, there is another doctor that takes my call. Going solo requires good business sense and courage (you certainly have that by considering going solo straight out of fellowship). However, if being solo suites your character/personality, you will love it.
You might consider going solo if:
1. you enjoy networking, marketing, selling yourself
2. have a history of starting companies
3. enjoy multitasking (you will not just be practicing medicine, but running a business)
I do enjoy these activities. I have had a lot of business ideas over the years, and have a few works-in-progress that had to be put on hold for residency and fellowship. I have a master's in health administration (for what it's worth), and have read books on how to start a business, but I have never gone all the way with one of my ideas. I do think I would enjoy the responsibility (and power over my destiny) that comes with having my own shop. I love taking care of patients, but I also think i may get even more satisfaction from creating a place of work that employs other people and gives them a rewarding career.
My solo venture may not end up solo in the end (nor do I want it to be). I have a colleague who will be completing fellowship a year later than me, who has some very aggressive and fleshed out plans to create a multidisciplinary practice that includes a medical spa, and possibly a small ASC. He's even got VC guys ready to give him a lot of money. We have spent a lot of time talking about putting this thing together, but I certainly couldn't do it alone while he's in fellowship, and I'm not 100% sure I could find someone else I trust to jump in with me right away. I do have a few candidates in mind, however.
What I'm trying to sort out now, in addition to my own due diligence of studying the demographics, competition, and reimbursement landscape of my prospective locations, is just how much of a critical mass I need to maximize potential for success, while minimizing investment, and risk early on. For example, how large an office, how many support staff, how much equipment, etc, beyond the bare minimums. I would like to keep my operation scalable, so I can grow when we have the money to invest. I feel that to maximize my chances of success, I need to be able to go to potential referring doctors and offer something more than just good pain diagnostics and injections. My prospective locations have other pain doctors around, but not in large number. I'm wondering if I should pursue getting on local hospital committees to increase my networking opportunities and local clout.
Regarding courage to strike out on my own right away- I feel as though working for someone else for a year or more would be valuable in some ways, ultimately it may be wasted time (since my goal is to eventually have my own practice). If starting a practice right out of fellowship is possible, I should make every effort to make it happen now, before the market becomes any more saturated.
