Yes, You Can and Should Start a Solo Medical Practice in 2013!

You might think I’m crazy, but this is a really good time to start a solo practice, especially for primary care providers.

Many physicians want to control how they deliver care and as independent thinkers, do not care to be told how to practice medicine. Whether you are disenchanted with your current practice, tired of being an employee, or fresh out of residency, this is a great time to venture out on your own.

Here are the reasons why:

  1. There are not enough physicians/providers to meet the current demand and many new insured people will be looking for care in 2014.
  2. Filing insurance is not the only way anymore. Today you can choose from a number of direct-pay options that allow the practice to rely less (or not at all) on insurance payments.
  3. Fractional Practice Administrators are available to assist new practices get started right and stay on the right track. Once you get started, an FPA may only be needed one hour a week.
  4. Software is available at a low cost and sometimes even no cost. The cost of an EMR/EHR is no longer a barrier to the private physician, Physician Assistant (PA) or Nurse Practitioner (NP.)
  5. Hiring remote employees means you can have your pick of qualified staff and often they are willing to work for less for the perk (and savings) of working at home.
  6. Time-share offices are available and retail space, no longer the sign of a low-class practice, could fit you perfectly – good parking, good foot traffic, good signage. There is lots of business space to choose from almost in most communities.
  7. Attaining a retiring physician’s practice does not need to be the costly proposition it used to be. Many retiring physicians are looking for someone to take responsibility for their charts and the phone calls.
  8. Moonlighting physician jobs are plentiful and a good way to bolster income while the practice stabilizes.
  9. Many large physician networks accept affiliated practices that can share in the negotiated contract rates for a fee.
  10. Micropractices are a type of “popup” business. Physicians can choose to work without nurses and receptionists, further limiting their overhead by leasing space from another doctor or timeshare office.
  11. Social media takes time, but little to no money. With a little guidance, you can do it yourself.

 

Tips for starting a practice:

  1. Some of the most successful new practices are spouse teams. Forget those old jokes about the doctor’s wife in the practice – these new teams have a spouse that is business-savvy and looking out for the welfare of the business in a way that less-invested employees may not.
  2. Be prepared to have a marketing plan – in all but the most underserved areas you will still have to establish a digital presence to grow your practice quickly.
  3. Establish your practice with a credit card on file program. This is not greedy, this is efficient, and will make the difference for you in keeping the money flowing in so you can survive your start-up phase.
  4. Shadow providers whose practices seems to run well, and watch them using an EMR in their practice. The workflow using an EMR is one of the most critical points in the practice where you will either lose time or stay on track.
  5. Is a business plan and a pro forma really necessary? Yes, yes, and yes! The business plan will help you think through the process and will be required if you plan to borrow any money The pro forma will awaken you to the realities of how long it might take you until the practice can support you.
  6. Know your market. Don’t go blindly into solo practice without understanding the political, economic and business environment where you want to practice. Understand the population density needed to support the number of practices in the area plus you.
  7. Be prepared to work hard and defer extended time off (a week) until the practice has found its legs.
  8. Do you like people? This is a serious question. Your practice will grow if you enjoy and plan to speak to groups and market yourself. If you aren’t, but your spouse is, this can work as well.
  9. Either take call in a group or opt out of hospital work. Develop a call group with other small practices.
  10. The most energy and time-dependent demographics are the families of the youngest and the oldest members of your practice. Make sure you have a plan if you will serve either or both of these generations, whether it’s a nurse triage service, or a pay for extra benefits model where you are available for care coordination calls from family members.
  11. Give yourself enough time! Most experts say a reasonable time frame for starting a new practice is 9 months after choosing the location.

Manage My Practice is the small-practice specialist. Let us know if we can help you start a new practice. Contact Mary Pat here.

Posted in: Day-to-Day Operations, General, Headlines, Innovation, Leadership, Practice Marketing

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10 Comments

  1. Kerry Willis MD November 29, 2012

    Great to see a realist among all the self interested folks who foresee gloom and doom for Solo Primary Care. A very good review of why solo is a viable option.

    For many of the employed physicians of the last few years an option that they will flock to at contract renewal as they find the federal restrictions on Employed Physicians will not support their current salary and the new offer will be very much lower or they will personally face fraud and abuse penalties if an offer falls out of the legal parameters.

    For anyone considering such a practice exploring alternative financial models along the lines of hybrids concierge and direct contracted primary care practices might be an option as well they should seriously consider to provide for more financial stability than current rat race models offer.

    The Physician’s Practice Survival Conference Dec 7&8 in Raleigh NC will offer an opportunity for Docs looking for a different answer to explore and discuss with National experts the models that will be sustainable and improve the quality of care in the future.

  2. Ken Hertz November 29, 2012

    Great post as always. This is such sage advice, and it comes at a time when the ‘spin’ says no way! Wonderful recommendations!

  3. Mary Pat Whaley November 29, 2012

    Thanks, Ken!

    I anticipate another cycle just like the 90′s, when hospitals released physicians practices back into the wild almost as fast as they bought them, but this time we will see some significant differences. I’d be interested to hear what you are seeing in your consulting practice and what your predictions are!

    Best wishes,

    Mary Pat

  4. Mary Pat Whaley November 29, 2012

    Hi Kerry,

    Thanks for commenting, and I am glad you mentioned the Raleigh Conference. Do you have a link for interested readers in the area?

    Best wishes,

    Mary Pat

  5. dr devinder bawa November 30, 2012

    thanks for greatly informative piece please.
    Regards

  6. Devora Walker, CMM December 1, 2012

    Love this advice. Thanks for the positive,upbeat and encouraging information

  7. Mary Pat Whaley December 1, 2012

    Hi Devora,

    I think there’s too much gloom and doom in healthcare!

    Best wishes,

    Mary Pat

  8. Mary Pat Whaley December 4, 2012

    My pleasure, Dr. Bawa!

    Best wishes,

    Mary Pat

  9. Shalini March 11, 2014

    Was useful info ..
    Takes 9 months to start from the day you picked the location put me at ease !

  10. Mary Pat Whaley March 13, 2014

    Hi Shalini,

    Not every provider has that much time, but 9 months is ideal!

    Best wishes,

    Mary Pat

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