I’ve been asked many times by young ophthalmologists who are about to finish their training if they should try to start their own practice. The short answer is yes; however, there are several questions you need to ask yourself beforehand.
1. Are you good?
This seems obvious, but you really have to take a good look in the mirror. The most important attributes are having a good bedside manner and surgical skills. If you lack these qualities, you may still be successful in solo practice, but you should plan on opening in a less-crowded environment. If you have good bedside manner and surgical skills, then open wherever you like—your strongest attribute starting out is that you will not be that busy. This gives you plenty of time to talk with your patients and develop great word-of-mouth referral sources.
2. Are you willing/able to have no income for a while?
It can take months to get on plans and even longer to develop a strong patient base. On the other hand, if you join a group and start receiving a paycheck on day 1, keep in mind that you will pay a lot back when you buy in, possibly more than you would have “spent” starting your own practice, 100% of which you would own.
3. Do you have a special skillset?
Again, this is more important in ophthalmology-heavy areas, but if you treat diseases no one else will treat, or want to treat, you can quickly build a practice. If you don’t have a special skillset, you may want to consider developing one by spending time at the AAO/ASCRS meetings and visiting other MDs.
4. How much do you want it?
If you’re committed, you’ll be successful at some point, guaranteed. However, there can be large speed bumps along the way. There will be frustrating times and sad times, but if you stay focused and have that drive, you can truly accomplish anything.
Without sounding too much more like a fortune cookie, I will add that if owning your own practice is exciting but you don’t want to start from scratch, you can consider buying out an existing solo practice. I personally do not recommend this unless you can purchase that practice for a reasonable price. Keep in mind that many near-retirement practices are full of paper charts that will need expensive conversion to EMR, outdated equipment and furniture that will need to be replaced, and a patient population consisting mostly of pseudophakic blepharitis patients who will unlikely generate significant income. That said, for those who enjoy having control over the development and growth of a clinical practice, having your own is the way to go.