Starting own practice vs. PE

[Huggy]

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I know this is premature, but I'm a fourth year medical student applying for dermatology residency this upcoming cycle. I've been trying to learn as much about the business side of medicine now that I have a lot more free time.

I understand that PE is consuming the field of dermatology and buying out many well-established private practices. Given the rise in PE, what new challenges will there be in five/ten years if I wish to practice general dermatology and avoid PE? Would starting a practice from scratch be the most rewarding approach? Would joining a group and putting in time/money to become a partner be wiser? Will neither of these options be available in 5-10 years, and will I be forced to work as an employee for PE?

 

[asmallchild]

I know this is premature, but I'm a fourth year medical student applying for dermatology residency this upcoming cycle. I've been trying to learn as much about the business side of medicine now that I have a lot more free time.

I understand that PE is consuming the field of dermatology and buying out many well-established private practices. Given the rise in PE, what new challenges will there be in five/ten years if I wish to practice general dermatology and avoid PE? Would starting a practice from scratch be the most rewarding approach? Would joining a group and putting in time/money to become a partner be wiser? Will neither of these options be available in 5-10 years, and will I be forced to work as an employee for PE?

I think you will have all 3 options available.

I've heard from numerous physicians that starting their own practice and managing a business (learning a new skillset) was the most rewarding thing they've done professionally.

Similarly, I have plenty of happy colleagues who are partners in a group setting. This can help to offload some of the administrative headaches (and introduce the headaches of balancing a group dynamic). I don't think one pathway is wiser than the other. It depends on how much control you wish to have and how many headaches you are willing to put up with to be the sole person in control.

I cannot foresee a scenario where PE-backed groups are the only way to practice in 5/10/15/XX years. Not all PE groups are the same, some actually have semi-reasonable work terms. But in general, the big financial benefit is in selling your practice (you can also argue, your soul and your specialty) to the PE group, not becoming an employee for one.

 

[Sushirolls]

Wander into the Psychiatry area, I have a thread going about my practice start up. Also look into the FM area, where you'll find a link to Investing Doc, who also started up a private practice.

Dermatology is akin to Psychiatry with a very low overhead, and you could start out in a small office, literally just by yourself.

Sign up for the EMR eMedicalPractice or ChARM EHR.

I won't ever go back to working with a Big Box Shop. Private practice is part of our Professional legacy, the gift each and every physician should not neglect to open.