Owning your own practice

[Radguru1]

How many radiologists own their own practice? Do any of you own your own practice? Do you want to? Is it realistic anymore?

Also is working for a hospital/group and reading studies on the side possible?

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[Gadofosveset]

Radiology is so massively capital intensive that it would take balls (or ovaries) of steel to take debt on to lease all the machines and space you need without a certain payoff. People were more able to do this in the past (so I've been told) because the contracts between hospital and group were not as fluid. Also because there were fewer groups and transmission of images to be read at another site was not feasible.

Technical fees are really where it's at, so owning the equipment, or understanding where the income flowing from the machines is going, is important. There are many different arrangements for groups to avoid the fixed cost and hassle of maintaining the machines, but at a cost of income and stability.

You could still maybe start your own practice if you offer some kind of niche imaging, but starting a general practice from the ground up would be pretty hard. Not that I really want to discourage you -- it's great for the field when people start their own practice -- but it's not some thing that is an easy or simple task.

 

[Gadofosveset]

As far as your second question... It depends on your contract with your main group.

 

[colbgw02]

It's hard to do. You don't have to own any equipment, but then your business is only as sound as your hospital contract. The new practices that I'm familiar with generally consisted of a handful of radiologists who were willing to provide on-site services to small, rural hospitals. Even then, there was always talk of consolidation, as is the trend in radiology.

I don't think I would want to own my own practice, because then I'd be more of a business person than a radiologist. I can also see problems with hiring quality people without giving them a stake. Or, put more clearly, I wouldn't want to work for an individual practice owner as an employee indefinitely. However, I could envision being in a small partnership, where the business side of things is shared but it's small enough that each individual really has a voice.

ETA: Outpatient imaging centers are also an option, but, as already mentioned, then there are issues of upfront capital. Nowadays, the profit margin on non-hospital-owned imaging centers is pretty thin, as I understand it.

 

[scootad.]

I used to work for an outpatient PP owned and started from scratch by one other radiologist. It's a huge risk. As mentioned, equipment is expensive to buy/lease, not to mention costs of renting a building. And then the issue of making inroads into already established patterns of referral within the local community. You have to convince people to stop sending their patients to your competitors and send it to you instead. You have to spend your time not only reading cases, but worrying about all the business related tasks, which will suck up all your time.

Since I was just an employee, I didn't have to worry about those issues. But I ultimately left because the practice wasn't very successful - trouble building volume (getting the word out that the new practice even existed) and lack of opportunity for a partnership...as colbgw02 alluded to, the person who took all the risk in starting the practice often doesn't want to give up the money or control to someone else.

Much better to join a well established group.

 

[Mammoguide]

The best way to "own your own practice" is to join a small, private practice group. These are still quite prevalent, particularly if you are willing to live slightly outside of a major metropolitan area or if you are in a more specialized niche (i.e. breast imaging). Being part of a small group of (3 - 6 members) partners provides many of the benefits of owning a practice yet is much, much easier than starting from scratch.