Here is my situation; I will be finishing fellowship soon and am looking at two strong possibilities.
1. Join the major private group in a medium city. It is a 60min drive to where I would ideally like to live but I could compromise. There are 5 guys doing mostly bread and butter interventional plus stim trials with both a hospital-based clinic and a community clinic. It is a stable happy group that is aging with some of the members looking to cut down hours in the next few years with retirement possibility in several more years. They have a strong referral base and a full schedule. The office work is totally supervision of midlevels with staffing of new patients and any questions on return patients. The offer is: full benefits and approx 300+K to start x 3years, then 250k buy-in with 750k-1mil partner/yr. All the partners share the net practice income and then split the income based on hours worked.
2. Start a solo practice in a neighboring county (my home county area with a population about 60k) that is devoid of a pain presence. I could reliably get nearly all the PCP referrals in the area of three small cities/towns (approx 14 doctors). There is minimal neurology presence and no spine surgeon presence. The region has a fair-good payor mix. I would be looking at mostly bread and butter interventional with SCS trials and hopefully some kypho and other ancillaries/possibly PT. I have a fantastic consultant that is helping with the details of setting up the practice for a one-time fee. I would pursue a midlevel when the time came to help maintain the office flow while continuing to build the procedural flow.
I have always been interested in having my own business and doing things my way and I am very adaptable to better ways of doing things and wish to minimize delay and institutional hindrances so the solo route seems very attractive. I am certainly not risk-averse but I want to be sure if I start my own practice, that I am not missing out by not joining the group.
From a financial perspective: In my own practice, I would anticipate making slightly less than 300k the first year performing some anesthesia on the side. I would expect that the income would grow rapidly, but the question is how much and how fast given I would aggressively pursue interventional treatments (given the appropriate indications of course). Would my solo practice likely ever equal/beat the group practice monetarily? How likely? How soon? I realized that time spent, stress, and personal equity would be greater but it is something I have always wanted to do and it would give me great pride. I do realize there may be differences in economy of scale for various portions of overhead, greater risk, etc. I know it is near impossible to predict which I should do but I am nearly evenly split with my decision. 55 solo : 45 group
1. Join the major private group in a medium city. It is a 60min drive to where I would ideally like to live but I could compromise. There are 5 guys doing mostly bread and butter interventional plus stim trials with both a hospital-based clinic and a community clinic. It is a stable happy group that is aging with some of the members looking to cut down hours in the next few years with retirement possibility in several more years. They have a strong referral base and a full schedule. The office work is totally supervision of midlevels with staffing of new patients and any questions on return patients. The offer is: full benefits and approx 300+K to start x 3years, then 250k buy-in with 750k-1mil partner/yr. All the partners share the net practice income and then split the income based on hours worked.
2. Start a solo practice in a neighboring county (my home county area with a population about 60k) that is devoid of a pain presence. I could reliably get nearly all the PCP referrals in the area of three small cities/towns (approx 14 doctors). There is minimal neurology presence and no spine surgeon presence. The region has a fair-good payor mix. I would be looking at mostly bread and butter interventional with SCS trials and hopefully some kypho and other ancillaries/possibly PT. I have a fantastic consultant that is helping with the details of setting up the practice for a one-time fee. I would pursue a midlevel when the time came to help maintain the office flow while continuing to build the procedural flow.
I have always been interested in having my own business and doing things my way and I am very adaptable to better ways of doing things and wish to minimize delay and institutional hindrances so the solo route seems very attractive. I am certainly not risk-averse but I want to be sure if I start my own practice, that I am not missing out by not joining the group.
From a financial perspective: In my own practice, I would anticipate making slightly less than 300k the first year performing some anesthesia on the side. I would expect that the income would grow rapidly, but the question is how much and how fast given I would aggressively pursue interventional treatments (given the appropriate indications of course). Would my solo practice likely ever equal/beat the group practice monetarily? How likely? How soon? I realized that time spent, stress, and personal equity would be greater but it is something I have always wanted to do and it would give me great pride. I do realize there may be differences in economy of scale for various portions of overhead, greater risk, etc. I know it is near impossible to predict which I should do but I am nearly evenly split with my decision. 55 solo : 45 group