It’s difficult enough to start an otolaryngology practice in a group; launching one as a solo practitioner can be even more daunting. Proper planning can ensure that this will work just as well as the most popular group practices.
Explore this issue:May 2014
“In spite of everything going on in medicine today, you can survive on your own and in a private practice, provided you have a following and you have a reputation,” said Michael Setzen, MD, who opened a solo practice in Long Island, N.Y., in 2008, after 26 years in a group setting.
Opening any otolaryngology practice requires planning and preparation, said practice management consultant Cheyenne Brinson, MBA, CPA, of KarenZupko & Associates (KZA) in Chicago. In a solo setting, the practitioner should decide up front whether the geographic market is suited to a solo practice, she said.
“It really depends on where you are,” she added. “When there are only two ENTs in town, it’s actually very easy to run a solo practice. The competition is so low, people have to go somewhere.”
In addition, being a solo practitioner brings logistical issues into play that group practices don’t deal with. Buying malpractice insurance, dealing with credentialing issues, joining an accountable care organization, fighting through reimbursement or billing issues—all of these are more difficult when operating alone, Brinson said.
“In a solo practice, you have little to no negotiating power,” she added. “When you’re in a larger group, you typically have some negotiating power. And, of course, there are economies of scale with staffing and billing, etc. At the end of the day, it really comes down to the physician’s preference.”
Albert Merati, MD, FACS, chief of laryngology within University of Washington School of Medicine’s department of otolaryngology–head and neck surgery, said a doctor’s preference to be a solo practitioner also means working a little bit harder to differentiate himself or herself.
“It’s different for a guy in Manhattan who has 14 otolaryngologists in a block versus a guy in a rural area, but for most of our academy membership, there are other otolaryngologists around who do what they do. It’s really a matter of connecting with a community.”