Private practice with research

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Palaver87

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I am third year MD/PhD resident who loves research and clinical work. I want to leave academia after residency (tired of the circumstantial rat race) and set up a private practice but still do *a lot* of research.

My ideal set up would be a private practice with clinical research built in, so I can constantly do both. I know Freud did this, and many psychologists currently do this, but I am trying to create a modern medical setup with e.g. randomization, standardization, automated data collection.

I imagine this would at least involve a private IRB and setting up a private research institute to access protected datasets. Looking for advice on steps to actually make this happen.

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Also interested in this. I've heard you can have a clinical association with an institution and perhaps use their IRB.
 
I very briefly looked into this. The general trend is first having a high volume insurance practice. Typically a mix of 7+ clinicians that may include psychiatrists, midlevels, counselors, psychologists, etc. Recruiting specific patients from outside of your practice is expensive. You want to already have the patient population to attract funding from pharma. Your other clinicians can help identify the current patients that would be good candidates, and they increase the total active patient load to pull from.

I’ve seen one psychiatrist do it with a smaller practice, but he did a high volume inpatient mix and most of the research I saw was neuroleptics, specifically LAI.
 
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I second Tex input, that you'll likely need to be established already with a full complement. Ideally, already have a large insurance based pt panel. IRB isn't much of an issue, most local hospitals will already have that basic infrastructure.

I remember there was a doc/clinic somewhere in Kansas where the guy basically did just this - can't recall his name or if that clinic is still functioning.

My understanding is the large pharma companies will reach out to these types of clinics to get multiple sites for their trials ranging from academic centers to these community research clinics. There will typically be contracts ahead of undertaking the study, outlining some sort of fee structure for volume of patients enrolled to defray the costs of all the extra data collection follow ups.

You'll need to be well versed in analyzing these contracts, and running a practice and how these all intersect overall to cover the overhead of all your staff and lastly pay you for your time.

Aim high for this, and worst case scenario the research side turns into a flop and you drop it. You're then left with a functioning viable clinic. Good luck.

And a nod to the forensic people before they chime in ... do a forensic fellowship first, and you'll be able to market yourself also as the real deal community clinic researcher expert, well published, in XYZ.
 
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