plastic surgery, ENT, ortho, derm, pain med, internal med subspecialties, neuro
Keep in mind, there are a lot of specialties where you CAN start your own gig. But the hurdles are immense
You need to get funding for the office, the equipment, the staff, etc since it will take months before any payments start coming in from insurers. If you’re a procedural specialty, that can be hundreds of K for equipment. You need to operate lean, since most private insurers will offer you **** for rates (think 75% of Medicare) since you have no leverage as a solo shop unless they are desperate for your specialty in your area. This will make it hard to earn anywhere close to what you could have made in a PP or employed gig where local hospital system gets paid 2x Medicare from insurance for everything you do.
Add to that the need to advertise/get your name out, the need to have coverage for your patients if you ever want a day off ever, and the list goes on and on. It’s not undoable. But it’s an awful lot. And insurance reimbursement often keeps the reward at the end of the line low, which you can try to increase through more revenue streams like the surgery center, Cosmetics, etc.
That’s why psych is pretty uniquely situated for this. Plenty of cash pay patients or insurers who are desperate to add to their network. Pent up demand in a lot of areas. Very low startup costs.
Primary care is probably next, both due to demand, limited equipment costs and the option of a low overhead lean DPC practice.