Starting own practice?

[Merely]

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I don't really see any threads on physicians starting their own practices. I was wondering if anyone had any sources about how common and feasible this was since I can't imagine that most physicians would want to be slaves to corporate hospitals. What are the thoughts on starting your own practice as a surgeon or IM doc and could one be very successful financially by doing so?

 

[TexasPhysician]

I'm currently establishing my own practice. I still think it is the best long-term option financially, but short-term the costs hurt.

 

[Smart Money MD]

The first few years obviously are the toughest. You will end up having to learn about running a business and managing many aspects of the practice is non-medical related. On top of that, if you are a specialist you will end up having to promote yourself to the community. Most people who've started their own practices or bought a retiring doc's practices will tell you it's a challenging road, but gives you the freedom to control how you run your practice.

 

[dpmd]

The first few years obviously are the toughest. You will end up having to learn about running a business and managing many aspects of the practice is non-medical related. On top of that, if you are a specialist you will end up having to promote yourself to the community. Most people who've started their own practices or bought a retiring doc's practices will tell you it's a challenging road, but gives you the freedom to control how you run your practice.

I really love my set up. I give 25% of my collections to a guy who has a contract with some local hospitals for call coverage (i am a surgeon). I tell him how much call i want (it is paid) and he provides an office with staff including billing and an office manager who handled getting on all the insurance panels and keeping up with my credentialing. Also they have the after hours answering service and any office or medical supplies i want. I doubt i could do it for less on my own especially since if i go on an extended trip and earn nothing one month i would pay nothing despite calls getting answered and stuff still getting taken care of (there are some other surgeons who have similar deals so we cover for each other when we need). Sure i have less than complete autonomy but i am the kind of person that would agonize for hours about which 4x4s to get to make sure i was getting the best deal so fewer choices is probably better.

 

[Smart Money MD]

I really love my set up. I give 25% of my collections to a guy who has a contract with some local hospitals for call coverage (i am a surgeon). I tell him how much call i want (it is paid) and he provides an office with staff including billing and an office manager who handled getting on all the insurance panels and keeping up with my credentialing. Also they have the after hours answering service and any office or medical supplies i want. I doubt i could do it for less on my own especially since if i go on an extended trip and earn nothing one month i would pay nothing despite calls getting answered and stuff still getting taken care of (there are some other surgeons who have similar deals so we cover for each other when we need). Sure i have less than complete autonomy but i am the kind of person that would agonize for hours about which 4x4s to get to make sure i was getting the best deal so fewer choices is probably better.

That's a pretty good setup. Some specialties work better than others. For instance, I am a surgical subspecialist, but overhead in my field tends to run from at least 50% up to 90% (yes, I've seen that high). Great that you've found a turnkey operation like that.

 

[dpmd]

That's a pretty good setup. Some specialties work better than others. For instance, I am a surgical subspecialist, but overhead in my field tends to run from at least 50% up to 90% (yes, I've seen that high). Great that you've found a turnkey operation like that.

Yeah, general surgery doesn't tend to have a bunch of fancy equipment we need to own. If i want to do a procedure i will usually just go to the surg center and take the lower reimbursement (in office procedures pay more right?) so i can have the ease of working on a sedated or anesthetized patient and know they are going to have all the unexpired supplies I need.

It is profitable for the guy because he has enough people doing this that he can do it cheaper plus i am sure he gets more from the call contract than we do. He is a shrewd businessman so i know he is profiting from my money (so much so that he actually changed it so that everything i collect above a certain amount monthly only gets charged 12.5%-he didn't have to do that, but he wants me to stay happy i guess since i take a third of the call each month)

 

[lantus2000]

This is a good thread. Are there any resources (books/websites/etc.) to help learning more about starting private practice. The game has changed so much in the past 10 years it seems with hospitals buying everything up.

 

[Merely]

Yeah thanks for the insight everyone, the more the merrier!