“In an independent practice, I have full control over every decision, and I can make the best decisions for my patients and my practice.”
“Of course, I’d heard this from so
many people, ‘The first year is always the hardest,’” Dr. Ramirez said. “There are a lot of headaches to deal with. But little by little, things get smoother, and I find myself getting more comfortable. At this point, we’re getting to the level of patient volume where we need to be to do well.” Ms. Odell says physicians need to
keep in mind that it will take up to six months — and often longer — to get a new solo practice up and running. “We must have the practice address,
Texas license, current medical liabil- ity insurance, and a phone and fax line to begin the credentialing process,” Ms. Odell said. “And we don’t recom- mend starting this process until the financial pro forma is completed and funding is approved. Most physicians say they’re ready to go, but once they dive in, they find it takes longer than anticipated due to timelines that are completely out of their control. We encourage physicians not to give no-
tice with their current employer any sooner than what’s stated in their em- ployment contract due to the risk of immediate termination.” With his solo practice up and run-
ning, Dr. Ramirez is enjoying the abil- ity to make business decisions without delay. He says that in his former group practice, the process to purchase a procedure chair, for example, involved various levels of administrative ap- proval. The decision could get delayed until the next budget year. “I wanted the autonomy to do
things the way I want to do them,” he said. “Dermatology is very unique from other specialties. In the multi- specialty group setting, not every de- cision made by the group is in the best interest of all specialties. Some of the decisions made that were best for the clinic as a whole were terrible for me. In an independent practice, I have full control over every decision, and I can make the best decisions for my pa- tients and my practice.”
STARTING PRACTICE TYPE BY PHYSICIAN AGE Age Practice Type
Group practice owner, co-owner, shareholder Group practice employee Hospital employee Partner Solo Teaching/research/administration Other
Source: TMA Survey of Texas Physicians 2014: Practice Settings 36 TEXAS MEDICINE July 2015 ≤40
7% 51% 16% 4% 7% 9% 7%
41–50
14% 38% 9% 6% 12% 15% 7%
51–60
12% 34% 5% 6% 24% 12% 8%
≥61
14% 19% 4% 7%
34% 13% 9%
Total
12% 34% 7% 6% 21% 12% 8%
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