I’m in solo practice (yes, one of those doctors). We’re a dying breed, which is sad because I genuinely like it. It’s certainly not for everyone, but it suits me perfectly.
It’s not easy. In my first 6 months of doing this, I pretty much picked up an MBA just by experience. I’d never had to deal with payroll, withholding taxes, forms, licensing, and a million other things, and had to learn them on the fly.
But looking back, I’m glad I did it. Like many other doctors, I joined a large group right out of residency. They seemed to offer security, and it was easier than trying to hang up my own shingle. But after a few years of office politics, dealing with business people, and being forced to review graphs labeled "physician revenue per square foot of office space," I couldn’t take it anymore.
So here I am. This will be my 12th year flying solo, and I regret none of it. Nobody argues with me about my choice of computer systems, what I wear, vacation scheduling, taking call, or whether we need to hire different staff or open satellite offices (I still don’t understand why some doctors do the latter).
I could probably make more money by joining a group, but money isn’t the biggest thing to me. My life is a lot simpler here. I can control how many patients I see, how many hours I work, and what cases I take; this gives me time to see my kids.
Unfortunately, the pressures of repaying loans ASAP drive most people to join whatever group offers them the most money. As a result, most of today’s solo doctors are on their second (or third or ...) practice incarnation. They’ve gained enough experience to realize that big groups aren’t always what they’re made out to be. In solo practice, you’re at least working with someone you’ve lived with for your entire life, and you have a good idea of their strengths and weaknesses.
I have no more idea of what the future holds than you do. Every few years, there’s a prediction that solo doctors are on our way out. And maybe some day they’ll be right, and I’ll be forced to join a group again.
That will be too bad because medicine started out as a solo job, going back to the tribal medicine man, or healer. And, after all these years, I wouldn’t have it any other way.
Dr. Block has a solo neurology private practice in Scottsdale, Ariz. He has been a practicing neurologist since 1998 and in private practice since 2000.