Twenty-five years ago, when I was looking to enter private practice, small practices dominated the landscape. There was always at least one larger group in any given community, but the majority of ophthalmologists practiced in groups of one or two physicians. It was more likely that a young ophthalmologist would join a solo physician than a larger group in those days. Over the years, things have changed significantly. In my community, most solo practices have either joined other groups, added partners, or closed their doors. A young physician today entering private practice is much more likely to join a larger group than in years past.
VIABILITY OF SOLO PRACTICE
So, is solo practice still a viable option for a new ophthalmologist entering private practice? There is no doubt that it is a significant challenge to make a go of private practice alone, but it can still be a very rewarding way to practice ophthalmology. I had a chance to talk with several of my peers who have practiced alone for their entire careers. They all described the benefits of being in a solo practice—namely the abilities to have a flexible schedule, determine the direction of the practice, and make decisions about the purchase of equipment quickly. The pride in creating something of great value on your own is also a significant plus.
They also described some of the difficulties in running a practice single-handedly. Losing access to patients if insurance panels limit choice is a significant concern. Not having another colleague to easily discuss challenging cases with can also be a disadvantage. The most significant issue, however, was the difficulty in planning a transition strategy when it is time to slow down or retire.
As the medical landscape continues to evolve, solo practice will likely continue to decline, particularly in the larger metropolitan areas. For independent-minded ophthalmologists willing to live in more rural or underserved areas or who focus mainly on private-pay segments of practice like refractive surgery and plastics, solo practice can still be a very viable and rewarding career choice.