Solo Practice Doctor

How to Succeed in Solo Practice in 2019


The right technology and support can keep you competitive and combat burnout

The solo practice doctor is on the verge of extinction, many industry experts have long predicted. Yet other sources say independent practices are making a comeback. “For every solo practice that chooses to close its doors, there are many more that continue to stand their ground, pretty much as they have for the last 50 years,” reported The Independent Pediatrician.

While the freedom of solo practice is a huge perk for many doctors, there are challenges associated with going it alone—burnout being a big one. Solo doctors need to be innovative and consider ways to provide high-quality patient care while not sacrificing their own wellbeing. Whether that means investing in time- and money-saving technology, hiring non-physician providers, or other solutions, here’s what successful solo practitioners are doing.

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Solo practitioners by the numbers

It’s true that the number of solo practices has been dropping for years. Only 31 percent of doctors identified as independent practice owners or partners in 2018, down from 33 percent in 2016 and more than 48 percent in 2012, according to the most recent “Survey of America’s Physicians” by the nonprofit Physicians Foundation.

Ophthalmologists are one of the specialists most likely to own a solo practice; small practices can thrive depending on location, say experts.

Certain specialists are more inclined to go solo. In a survey of over 1,500 physicians, Jackson Healthcare found that dermatologists (55 percent) and ophthalmologists (43 percent) were the top specialists most likely to own a solo practice.

Health care consultant Derek Preece, MBA, notes that “solo practice” can refer to a few different models. “There are a couple of definitions of solo practice,” he told the Review of Ophthalmology. “One is where you’ve got one doctor. Another is where you have one ophthalmologist who may have one or two optometrists working for him or her. The third definition of a solo practice is something I call solo ownership: This is where one doctor owns the practice, but might employ four or five ophthalmologists and several optometrists.”

Regarding small, independent practices of all types, Preece is “cautiously optimistic” that they can survive and thrive, depending on location. “I think small practices are viable, certainly in the smaller towns, and potentially even in larger markets if they’re able to keep access to their patients and keep up on technology.”

The benefits of the right tech

Several affordable technology solutions are available that can benefit small practices. Patients increasingly want and expect online appointment scheduling, a feature that some EHRs offer through a patient portal. There are also services such as Zocdoc that, for a monthly fee, allow practices to offer online appointments on their own websites as well as on the company’s site. Business software site Capterra offers reviews of dozens of other medical scheduling tools. Online scheduling can help attract new patients, increase patient satisfaction, fill unexpectedly empty appointment slots that can cost you revenue, and cut down on manual tasks and phone calls, according to Physicians Practice.

Technology such as online appointment scheduling tools and digital patient education can maximize solo doctors’ time and revenues.

Digital patient education tools like Rendia are another way solo practice doctors can save time explaining routine procedures and treatment options. By emailing illustrated videos to patients before their appointment or having support staff use iPads to visually educate patients about conditions and treatments, doctors’ time is freed up to focus on clinical work.

Use Exam Mode to fly through the eye.

Rendia also allows doctors to market their practice on their website and social media pages by showing prospective patients that they embrace the latest technology. “At some point, the larger groups make a pitch to their patients about having the latest and greatest equipment that not everyone else has, and it’s not just clinical machines,” said Preece. “It’s IT; it’s EMR technology; it’s technology for patient portals.”

Ophthalmologist Anjit Nemi, M.D., MBA, told the Review of Ophthalmology, “As a solo practitioner, if you incorporate the right technology, you can even outperform peers in larger practices.”

Getting support from staff and colleagues

Of course, while technology may eliminate phone calls and streamline your patient education, it cannot take the place of the skilled provider. So what happens when you, a solo practitioner, get sick or want to take time off? The flip side of the freedom associated with being a solo practice doctor is the responsibility to your patients and to maintain your revenue. That can cause solo practitioners to avoid taking time away from the office, which can lead to burnout,” stated Physicians Practice.

Hiring non-physician providers and sharing coverage with other solo doctors in your area can allow for time off and reduce burnout.

Some solo doctors hire non-physician providers (NPPs) like nurse practitioners and physician assistants who can continue to see patients when the doctor takes time off. “Most of my patients are used to seeing the NP or PA, so it’s not a big deal for them, and it works out really well for me,” David Hicks, D.O. told Physicians Practice. “If I want to go on vacation, they have full licensure and the ability to write all the scripts, so I don’t have to worry about that.”

Another strategy for being able to take time off is to partner with other independent doctors nearby who offer the same services. “In markets where there are other doctors who can cover, what we typically see is an on-call/emergency reciprocal setup,” health care consultant Matthew Bates said in Physicians Practice. “They’ll refer their patients to another doctor in town who they’ve built a relationship with while they’re gone. Many solo practitioners share call schedules. Then they might agree to use that same structure of sharing patients to help support time off.” EHRs make it possible for covering doctors to access patient charts.

‘It is possible to be productive and profitable’

Being a solo practitioner is not easy, but for doctors who choose this route, the rewards are many. By harnessing technology and embracing strategies that streamline their practices, they may even find themselves outperforming larger group practices. Said Dr. Nemi, “I think that by not succumbing to peer pressure, working hard, taking good care of patients and being mindful of expenses and overhead, it is possible to be productive and profitable as a solo practitioner.”

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