Why I'm going solo

September 14, 2009

I am embarking on a new adventure. Or what some are describing as a suicide mission. You see, for the last eight years, I have been an employed physician at a community hospital that is an affiliate of a major university hospital, and I am going into solo private practice. No, there was no major falling out, no catastrophe, nothing obvious that set this into motion. Why then, you may ask (everyone else has), am I leaving the security of employment for the uncertainty of a new practice?

I am embarking on a new adventure. Or what some are describing as a suicide mission. You see, for the last eight years, I have been an employed physician at a community hospital that is an affiliate of a major university hospital, and I am going into solo private practice. No, there was no major falling out, no catastrophe, nothing obvious that set this into motion. Why then, you may ask (everyone else has), am I leaving the security of employment for the uncertainty of a new practice?

Is it the need for autonomy? Is it to be five minutes from my kids’ school instead of 25? Is it because I am tired of being pulled in three directions every day? Is it temporary insanity? It is probably a combination of all of these, as well as some other annoyances I’d like to avoid and some dreams I’d like to pursue.

Being employed definitely has its advantages. For the last eight years I have enjoyed a decent salary, good benefits, paid vacation time, and conference time. I have not known nor cared to know how much it costs to keep a roof over my head, a secretary at the desk, or paper in the copier. As part of a faculty practice, I was surrounded by peers I could bounce ideas off, curbside about patients, and complain to about the administration ( uh, I’m talking about the government, I would never complain about the hospital administration). Teaching residents and students kept my mind fresh, and I had ample opportunity to receive CME credits.

So why, oh why, am I leaving? Part of it is purely personal. My new office will be closer to home and closer to my kids’ school. And part of it is because I think it’s time for me to start calling the shots. I want to be able to choose what EHR I want to use (a subject for another post), to fire a staff member I think is incompetent, inconsiderate to patients, or just downright freaky, and to have hours during lunch or after five so that patients who work can come in. And also because, while I wanted to do a little bit of everything when I started, over the years I have been asked (a little more adamantly each time) to 1) see more patients, 2) set aside more dedicated time for teaching, 3) and commit to doing research. And while multitasking is one of those talents every doc must have to some degree, there are only so many hours in a day.

It was not an easy decision. It took more than two years of research and soul-searching. I read books, blogs, and e-newsletters. I attended practice management conferences, webinars and telephone conferences. I talked to family and friends in and outside of medicine. And while I am somewhere between excited and terrified, I think I probably know more about running a practice than most docs I know.

Melissa G. Young, MD, FACE, FACP, is an endocrinologist in private practice, an assistant clinical professor at Robert Wood Johnson, and a working suburban mother of two in Freehold, N.J. She is a regular contributor to Practice Notes.