How Independent Practices Can Still Thrive: Adaptability



How Independent Practices Can Still Thrive: Adaptability

The key to realizing one’s goals amidst a turbulent, often changing professional landscape is embracing the many pathways to getting there. Let’s assume you’ve attained the necessary certifications, have found the ideal practice location, and are a wiz with advertising. What if you simply cannot afford to open and staff an office, in the traditional sense? Do you pack it in, and head for the security of the nearest hospital? Do you delay your career until the market “stabilizes”? Rigid adherence to a traditional business models and unrealistic timeframes can leave even the most capable and driven physicians stalled, bankrupt, and dejected.

The way your primary physician built his/her practice may not be the best way for you to build yours. Theirs was a great trail to blaze, but it certainly isn’t the only way to go about it. As we discussed in the previous post, you will have to take on certain marketing and networking responsibilities to ensure that your practice thrives. Your predecessors may have found Facebook frivolous, or the idea of constant self-promotion garish, and beneath them. The fact is that they aren’t beneath anyone, nor are the variety of different business plans and methods available to you as you embark on your career in independent practice.

Location, location…location?

What makes a good doctor? Is it the newly-built office, the square footage, the number of faithful staff working under them? Or is it the persistent commitment to quality, personalized medical treatment, regardless of backdrop? The answer may be obvious, but your viewpoint here may ultimately decide whether or not you are able to do what you love for a living, as close to your terms as possible.

Once upon a time, operating out of shared real-estate, or commercial space was considered the mark of a lesser, or even sketchy practice. Put simply, this viewpoint is outdated, and destructive. There are plenty of time-share offices available, and retail space, no longer an indicator of a poor practice, presents more pros than cons: plentiful parking, good foot traffic, and great visibility. You will have much business space to choose from, as turnover tends to be very high in certain communities. The holistic health food stores and vapor lounges represent waxing and waning fads. Quality healthcare from a capable and trustworthy physician never goes out of fashion.

Operating out of a time-share office provides financial breathing room while you are first getting yourself established. If you are willing to do this, you may be able to obtain a retiring physician’s practice. Many older physicians need help managing their caseload in the latter stage of their careers.

Another great option to consider is opening a “micropractice”. This will allow you to effectively work without nurses and receptionists, further limiting your overhead. Does your spouse work in the medical field as well, or have business experience? Your partner in life can very easily become your partner in business, and this approach lends itself well to the micropractice model. Moonlighting physician jobs are another valid, and effective way to augment income while your practice stabilizes.

Combining forces

If long-term finances are a chief concern, there are options available that will allow you to join together with other small practices. Large, “clinically integrated” physician networks promote cost-efficiency through shared negotiated contract rates, and allow physicians to retain their independence and autonomy while decreasing operating costs. Some benefits include: lower malpractice insurance rates, lower payroll costs, cheaper healthcare benefits, and better prices from medical suppliers.


As we’ve discussed in previous posts, dealing with the ever-increasing number of private party insurers can lead to issues with billing, most notably getting paid on time. However, filing insurance is not the only way anymore. There are a number of direct-pay options that allow your practice to rely less on insurance payments. While making a move to the direct-pay format is a big step and should be considered thoroughly, it brings with it some big benefits, including: decreased practice overhead, fewer medical errors, less exposure to risk, improved practice collections rates, more time with patients, and reduced patient volume.

Wherever you see yourself in the next five or ten years, keep an open mind, especially in these all important early stages. None of the options mentioned above are the sign of a desperate, or second-rate physician, but rather one who is proactive, flexible, and productive. Happiness, to quote the poet Mary Oliver, is good work ongoing. Securing a lifetime of good work depends on your ability and willingness to adapt. Remember, you will ultimately be remembered for the work you did, not the well-appointed office you did it in.


Brian Torchin

| HCRC Staffing | |

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