Starting a Solo Practice

The evolving healthcare environment has led to a decrease in the percentage of dermatologists in solo private practice, dropping from 44% in 2007 to 35% in 2014.1 However, if you decide that solo practice is the right fit for you,2 it can still be done! You matched in dermatology; therefore, you have more than enough ability to run a private practice. Six years into solo practice, the best piece of advice I can offer is to be as diligent about planning your practice as you are in patient care or in preparing for an exam.

We spend at least three years in postgraduate education to absorb the fundamentals of dermatology, but minimal time learning management skills. Just as you memorized genodermatoses in training, focus on learning about topics like profit and loss sheets before you enter private practice. The time you put in at the outset pays off tremendously. You will only become busier and have less time for these details as your practice grows. There are extensive resources available about starting and running a private practice – avail yourself of these.3

Spend time defining the structure and organization of your practice. From the beginning, implement an Electronic Medical Record. Learn how to use accounting software, and familiarize yourself with legal, human resource and regulatory requirements. While a good accountant and attorney are necessary allies, the practice is ultimately your responsibility. Think carefully about how many staff you need and create detailed job descriptions and practice policies. The most challenging aspect of running a practice is recruiting, training and retaining an excellent team.

Before entering into any contract, compare at least two to three bids. You will be astounded at times by the cost difference for comparable services or devices! One hazardous waste removal company quoted me six times what another company did for removing my sharps containers. A laser salesman once had me write a paragraph to earn a so-called “Key Opinion Leader” quote, which was still thousands more than the price advertised on a postcard I received directly from the company. Suffice to say, it is worth the extra time to get multiple bids for items you may think are “standard.” Try to avoid being locked into long-term contracts for services or utilities. Many companies realize that young physicians lack business experience and will try to take advantage of you.

Running a solo private practice requires commitment and hard work but remains very rewarding. If you make as much effort to design and run your practice as you did to become a dermatologist, you will have the opportunity to shape your signature dream practice. It is well worth it!

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1www.aad.org/dw/monthly/2015/june/move-away-from-solo-practice-continues

2A good starting point for this is www.aad.org/chooseyourownpractice

3Some of the resources I found particularly helpful were: The Medical Entrepreneur: Pearls, Pitfalls and Practical Business Advice for Doctors by Steven M. Hacker, AAD’s Starting and Marketing a Solo Practice eBook, and 31 ½ Essentials for Running Your Medical Practice by John Guiliana, Hal Ornstein and Mark Terry.

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