Looking for some additional guidance as July feels to be approaching faster than ever. Over the past few years, I've been very inspired by the two solo practice startup blogs, and I've gone back and forth debating the merits of each practice type (solo vs group). I was wondering if people on here could speak to some of the advantages and disadvantages of each, particularly with respect to retina and where it differs from comp or other subspecialities.
First, my wife and I are from a rural area, and after our experience with "homeschooling" during COVID, we came to realize that it is not something that would be out of the question for us to pursue were we to return to an area without great schools. So, though it would not necessarily be our first choice, we are open to moving to an undersaturated part of the country and starting a solo practice (I'm aware that it would be a lot of work, but there appears to be a lot of support in place, particularly with that of @schistosomiasis's solo practice startup venture).
There are many pros to joining a group practice, such as a starting salary, a pre-existing framework to plug into, shared call and vacation coverage, economies of scale/shared equipment overhead, etc. The big con that hangs over my head is the worry about being churned / practice being sold to PE before I make partner. Were the latter not an issue, I would probably be entirely focused on group practices.
There are also numerous pros to solo practice, the foremost being complete independence to run the practice as I see fit / no potential conflicts when it comes to decisions that affect the practice. One challenge in my mind is the call situation.
My big question is regarding the financial implications between the two. Moving to an undersaturated part of the country, I would probably pick a place where I was the only retina surgeon around, or close to it. Therefore, it wouldn't make sense to build and own a practice ASC, if I was only operating once per week. So, it would seem like this income stream would most likely be closed to me. Is this a big issue? Also, there is the fact that I would be buying all of the expensive equipment for my use only (to what extent do busy group practices see savings/profit generation via equipment sharing?).
Roughly speaking, assuming an equal level of productivity, is there a significant difference in terms of compensation (at the average and above average level) between the two practice models? Put another way, what kinds of financial opportunities might a solo practice miss out on / what kinds of financial penalties might they face? And, to what extent does the number of partners affect compensation: is a two-person retina practice, for example, significantly more profitable than a solo retina practice? Is there a point at which (say, at 2, 3, 4, 5, or 6 partners) profitability increases sharply, or, faces diminishing returns due to inefficiencies stemming from institutional complexity?
Finally, there are multi-specialty practices. This potentially deserves its own thread, but any thoughts about multi-specialty practices with respect to all of the points above are welcome as well.
First, my wife and I are from a rural area, and after our experience with "homeschooling" during COVID, we came to realize that it is not something that would be out of the question for us to pursue were we to return to an area without great schools. So, though it would not necessarily be our first choice, we are open to moving to an undersaturated part of the country and starting a solo practice (I'm aware that it would be a lot of work, but there appears to be a lot of support in place, particularly with that of @schistosomiasis's solo practice startup venture).
There are many pros to joining a group practice, such as a starting salary, a pre-existing framework to plug into, shared call and vacation coverage, economies of scale/shared equipment overhead, etc. The big con that hangs over my head is the worry about being churned / practice being sold to PE before I make partner. Were the latter not an issue, I would probably be entirely focused on group practices.
There are also numerous pros to solo practice, the foremost being complete independence to run the practice as I see fit / no potential conflicts when it comes to decisions that affect the practice. One challenge in my mind is the call situation.
My big question is regarding the financial implications between the two. Moving to an undersaturated part of the country, I would probably pick a place where I was the only retina surgeon around, or close to it. Therefore, it wouldn't make sense to build and own a practice ASC, if I was only operating once per week. So, it would seem like this income stream would most likely be closed to me. Is this a big issue? Also, there is the fact that I would be buying all of the expensive equipment for my use only (to what extent do busy group practices see savings/profit generation via equipment sharing?).
Roughly speaking, assuming an equal level of productivity, is there a significant difference in terms of compensation (at the average and above average level) between the two practice models? Put another way, what kinds of financial opportunities might a solo practice miss out on / what kinds of financial penalties might they face? And, to what extent does the number of partners affect compensation: is a two-person retina practice, for example, significantly more profitable than a solo retina practice? Is there a point at which (say, at 2, 3, 4, 5, or 6 partners) profitability increases sharply, or, faces diminishing returns due to inefficiencies stemming from institutional complexity?
Finally, there are multi-specialty practices. This potentially deserves its own thread, but any thoughts about multi-specialty practices with respect to all of the points above are welcome as well.
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