Top Considerations for Physicians Beginning Their Practices

Whether you’re a dermatologist who just completed school and training, or an experienced clinician making a change to a new private practice, certain considerations for your career can make success more likely. A major factor in this success will be choosing the type of practice best suited to you. Whether it is going out solo or joining a specialty-specific, multispecialty, or private equity group, you will want to consider a few areas in making this important decision.  

Put Yourself First
Most importantly, know thyself. The practice you start or join is not only about training and skills, it is also about your personality and what type of day-to-day work you are likely to find most satisfying. When I started, I knew I did not want to be on my own. I am a social person–so starting out on my own was not going to work for me. 

Go It Alone or Join a Group?
A solo dermatology practice makes the most sense if you want to control most aspects of the practice, and importantly, you are comfortable running the business and managing operations. A specialty-specific practice could be right if you are more collaborative. There were seven dermatologists when I joined my practice, so I always had colleagues to consult when needed, which was helpful in the beginning. Multispecialty practice centers on working with colleagues across disciplines, and some dermatologists enjoy that scope of clinical care and teamwork. Private equity-backed organizations are ideal for those who wish to just focus on patient care. 

Fitting in with Colleagues and Culture
Performing due diligence on the business side can be easier than predicting the cultural fit. When it comes to colleagues, you do not have to become best friends or spend time socializing outside of work, but at a minimum, you want to form a respectful working relationship. I suggest taking the time to meet the staff before you join a practice—you will be spending many working hours with them as well. 

Technology Check 
If you are joining an established practice, ask to see their dermatology software in action. Ask questions about how well the technology works, how it streamlines scheduling, patient flow, billing, and other aspects of the practice. If you are going solo, it might be wise to start small and purchase only the practice software you need to get up and running, such as an electronic health record system, for example. Also look for a system that offers cloud storage and mobile access to information, so you will not need to invest in a server or other hardware.  

Ask About Financial Performance
For doctors joining an existing dermatology practice, negotiating the terms of the contract, including salary, can vary greatly depending on the size, breadth, and location of the business.  If you are interviewing at a group and are seriously considering the position, ask to see “the books.” If they are unwilling to share the financials, I would be very suspicious and cautious of that practice.  Even though it can be scary for a practice to be transparent about their financial bottom-line, it can also indicate that they trust you.  

Be Bold
Starting a new dermatology practice or joining an existing practice–no matter what the business model–takes courage. It can be scary but remember that many dermatologists succeed on their own or after finding the right practice and right colleagues. 

I hope the advice I’ve outlined is a good starting point and helps you make the leap successfully!

Dr Miller is senior medical director of dermatology at ModMed and a dermatologist in private practice at Northern Arizona Dermatology in Flagstaff and Sedona. 

Disclosure: Dr Miller receives financial compensation for his role with ModMed.