September 16, 2015
Q. I’m an internist in a small primary-care group that was acquired by a hospital in 1997. The acquisition seemed like a good idea at the time, but now I want out. I’d like to start a solo practice. Am I nuts to even consider this?
A. You’re not nuts. Hospitals have shown themselves to be unsuited to managing physician practices. Not only is the practice buying spree of the past few years at an end, but many hospitals are trying to stem their flow of red ink by cutting loose the groups they had been so eager to purchase for top dollar.
What most of those “disaggregated” doctors are doing, however, is “reaggregating” into primary-care groups rather than going solo. That doesn’t mean you shouldn’t hang out your shingle. But keep in mind that soloists may have trouble finding call partners. And many soloists put in longer days than doctors employed by groups, who are more likely to work set hours.
There are also economic factors to consider. As a soloist, you may have trouble winning managed-care contracts in a highly penetrated market. And if you succeed, your reimbursement rates may not be as lucrative as those you’d get as part of a group. Your overhead will be higher, too, because you’ll bear the full cost of information systems and personnel needed to deal with health plan requirements. In a group, the cost is spread over a number of doctors.
So if you’re willing to accept the financial and lifestyle hits, there’s no reason why you can’t be your own boss. But give some thought to joining an IPA, which you can do as a soloist. You’ll have an easier time contracting with health plans, and you’ll enjoy higher reimbursement rates. You may even get a break on your call duties.
This article was published by Cejka Search and originally appeared in Medical Economics Magazine. Copyright by Medical Economics Company Inc. at Montvale, NJ 07645. All rights reserved.