Reality of having "your own practice"

[bla_3x]

In today's healthcare scene it seems that there is precious little room for the private practice FP doc. For me, my medical future is a wide open book...I don't know what I will end up doing. Yet, I have always been intrigued by the idea of having "my own little practice." I this something that can bee seen more in small communities/towns more often today? If so, how "successful" are FPs who do their own thing? By this I don't mean are they rich...rather, do they come out with a comfortable lifestyle after loans, taxes, etc.?

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[AviatorDoc]

It's interesting that you bring this up. This is exactly what I want to do. Are you from AZ? I actually want to open a small clinic in Northern Arizona. I plan on doing much more than just breaking even, b/c I have some ideas on how to do things a bit differently than how it works now. I plan on practicing for a number of years to get some good experiences, but then I want to move into more of a managerial role, allowing Nurse Practitioners the opportunity to handle the majority of the "routine" cases.

Anyway, that's my pipe dream. We'll see what comes of it.

 

[Wifty]

AviatorDoc -

Sounds like a wonderful dream actually.

I was just wondering what other ideas you have for setting up a practice that are a 'bit different'?

Hubby (your classmate) and I have talked about how things would have to be different then the current system in order for such a dream to work.....but that it is possible.

We were a bit disillusioned by how bad things have become in WA for independant docs.

Anyways, just wondering what other thoughts linger in your head.

I have a feeling that my idea of offering free coffee to all patients, just wouldn't cut it.

With smiles,
Wifty

 

[AviatorDoc]

Well, one of the ideas is to expand my "practice" to include another clinic in another part of the state. In fact, I'd like to have a series of clinics in very remote areas. This accomplishes several goals. One, I'll be serving some very underserved communities, including Native American reservations. But I'll be using clinics in more upscale communities (Sedona, Flagstaff, etc.) to help offset the cost of the others. As far as actually practicing, once I've got a clinic established with some rapport, Nurse practitioners or other family practice docs would be brought in as partners. This would be "their" clinic, in the sense that it would be their patients, and their local flavor of management. Meanwhile, I'd take care of their salary, malpractice insurance, and billing procedures. But I wouldn't want a "employee vs. management" sort of mentality to develop, so I'd encorporate some of the ideas made popular by tech companies to have a camradere sort of mentality. I'd still want to see patients, but it would have to be on a somewhat limited basis.

The final goal would be to get the company to buy my airplane so I could travel to these clinics.

 

[bla_3x]

I am from NV (Las Vegas), but have always loved AZ...I guess I am a desert rat My fiance and I really think that AZ is where we will eventually call home. My fiance is going into nursing with the eventual goal of being an NP. We have had some interesting thoughts about things that we could do (although we have given no consideration as to the feasibility of anything...just dreamin Little things like her having a peds practice adjacent to my office, or incorperating an integrative medicine aspect to the practice. I'll bet that with the right outreach strategy, one could do well. You are right though, it would probably be essential to get a good practice/rep/rapport going before venturing off.

 

[SawBones]

It is all about overhead. You can have a "small practice" if you plan properly. This means:

* Having one employee that does everything for you (except billing).

* Seeing only 5-6 patients in the morning and 5-6 in the afternoon.

* Having a small office with only two exam rooms, with a really, really low rent.

Internal Medicine might be more amenable to this type of practice than family medicine. As an general internist, you could advertise yourself as a "Chronic Disease Specialist" and deal primarily with diabetic patients and those with chronic heart and lung diseases. Then you advertise "by appointment only" and in so doing, you basically keep out the "riff raff" (acute conditions, like colds and runny noses and other boring junk).

So it absolutely can be done. A lot of docs say it can't, but it still can. What is difficult, however, is to have a BIG solo practice with tons of exam rooms and 10 employees. With reimbursements so low as they are, you'd have a tough time keeping your lights on.

When you are in medical school, a lot of docs will try to tell you that it is impossible. And then they will offer you a spot in their group with a starting salary of $120. Basically... they are just trying to bring you in under their roof so they can work you like a dog and make mad cash off of you. Don't fall for that. As your own boss, you can do that well AND set your hours, vacation time, etc.

I hope this encourages you.