As a child, or perhaps even as a young medical student, you might have envisioned your clinical career as a physician. Maybe you imagined becoming a private practice gynecologist, providing care to patients as the only doctor on staff. You visualized forming and fostering lifelong relationships with these patients and establishing your role as a trusted expert who could guide them from young adulthood to midlife and beyond.
Today, however, reality is a bit different. According to recent reports, the number of physicians in a solo medical business is in decline, with fewer doctors entering private practices. An American Medical Association (AMA) study revealed that the percentage of physicians practicing alone fell from 41 percent to 17 percent between 1983 and 2014. During that same time frame, the percentage of physicians in practices with 25 or more doctors quadrupled from 5 percent to 20 percent.
But does private practice have to be relegated to the past? Here's a look at some of the factors contributing to its decline — and how gynecologists interested in starting a solo medical practice can succeed.
Group Versus Private Medical Practice
There's no one reason for the waning number of solo practices. The decrease is likely due to a perfect storm of factors that drive physicians to larger medical groups. As reimbursements decrease, for example, solo practitioners tend to wait a long time for payouts, which are even lower when paid by Medicaid than by Medicare or private insurance. The Affordable Care Act compounded these problems for some physicians because it increased reporting and tracking demands in an environment of high potential liability and problematic reimbursement. As a result of these problems, combined with the costs of maintaining overhead and paying off loans, many private practice physicians are struggling to stay afloat.
In addition, the rise of accountable care organizations has made joining a larger hospital system appealing to many doctors. For gynecologists and other specialists in particular, a group practice can offer the support of other physicians as well as nurses and administrators. The latter is useful when trying to navigate areas such as electronic health record keeping and marketing needs. Group practices also provide more flexible schedules, which can be valuable for younger physicians who are starting families.
Building a Successful Private Gynecology Practice
All that being said, there's still a lot to love about running your own practice. With some smart planning, success as a private practice gynecologist can be both attainable and enjoyable. Below are a few tips for practitioners considering going solo.
- Think beyond borders. Private practice gynecologists are still booming in rural areas, where, according to the AMA report, patient populations tend to outnumber physicians. If you're willing to relocate, you may be able to enjoy the solo practice you've always wanted — and see it thrive.
- Form relationships. Provide your patients with exceptional care and access to leading-edge technology that will help improve satisfaction and establish you as a valued member of their healthcare family.
- Be financially smart. There are many costs associated with starting and maintaining a solo medical practice. Consider not just renting or leasing fees, but malpractice insurance, sales and marketing, office furniture and supplies, tax advisers and more. All told, it can take a year or more to get a new solo practice ready for patients, so factor that in to your plan as well.
- Stay informed. Keep abreast of changes to healthcare and insurance reform to understand how they can affect private practices.
- Get support. A business advisor or consultant can help guide you through the ups and downs of self-employment, while a financial advisor can help keep you on track balancing income and expenses.
- Reach out. Join national and local professional organizations — not just for continuing medical education purposes, but for networking benefits as well.
It isn't always easy to start and maintain a private practice, but with a solid plan and good support, you can succeed as a private practice gynecologist. The advice outlined here can help you get started on your way.
