MD office to owning a practice

  1. Looking for some insight into the salary of starting up my own practice. DNP-FNP here.

    There is an FNP I talked to who told me the amount of hassle involved with owning your own clinic isn't worth the increase in salary that comes with it. I understand the fact that you are running a business on top of clinic practice.

    Don't get me wrong, I'm happy at 95k in podunk idaho for a 4 day work week a little over a year out of school. But like anyone else, I would like to maximize my income potential at some point. I refused to sign a no-compete so I'd essentially be breaking off the practice with an already 25 patient/day population established.

    I know there are a ton of factors that go into how much I am going to make, but I'm asking what your salary did once you got things up and running.

    So for those of you who have done this, how did your salary change? I'd like to hear the timeline involved with it if you wouldn't mind.
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  2. 3 Comments

  3. by   Roasted.Peanuts
    I am not an NP, but I have interned for an opthalmologist who did his MD/MBA dual degree and owns his own clinic which has been open for about 3 years. He said he makes a lot less than he would just working for someone because he has to pay staff (2 medical assistants and 1 front clerk), rent, medical supplies including the upfront cost of medical equipment, and invest money into the business (marketing, decor, upgrades) before he takes the rest as income. His revenue also depends a lot on the type of cases as most of his patients come from medicare which pays less than a patient who has private insurance. Revenue is also impacted by no-shows and the variability of the amount of patients he sees as it depends on things out of his control (marketing, scheduling, time efficiency). He also does his own billing with his wife who is an ER physician which is a lot of time commitment. He works 8am-7pm 6 days a week and is the sole provider in the clinic.

    Although this is different from your situation, I just wanted to highlight some of the challenges I've seen for a practitioner to own their own business.
  4. by   Bluebolt
    Quote from Roasted.Peanuts
    I am not an NP, but I have interned for an opthalmologist who did his MD/MBA dual degree and owns his own clinic which has been open for about 3 years. He said he makes a lot less than he would just working for someone because he has to pay staff (2 medical assistants and 1 front clerk), rent, medical supplies including the upfront cost of medical equipment, and invest money into the business (marketing, decor, upgrades) before he takes the rest as income. His revenue also depends a lot on the type of cases as most of his patients come from medicare which pays less than a patient who has private insurance. Revenue is also impacted by no-shows and the variability of the amount of patients he sees as it depends on things out of his control (marketing, scheduling, time efficiency). He also does his own billing with his wife who is an ER physician which is a lot of time commitment. He works 8am-7pm 6 days a week and is the sole provider in the clinic.

    Although this is different from your situation, I just wanted to highlight some of the challenges I've seen for a practitioner to own their own business.
    All of This.

    Plus here in the last few years you've probably noted many doctors offices being bought out by larger hospital entities. This helps control overhead costs but the main reason is the federal mandate that requires electronic medical records to be maintained for reimbursement. I was informed recently from an informatics nurse that the cost is millions of dollars for these EHR system, so by joining with larger entities they can get access to that hospitals EHR system. This saves the clinic millions of dollars but then you deal with the entanglements of being connected to a larger entity.

    I haven't done any official research on it, just something to consider or look into before making the leap.
  5. by   JessiJam
    Quote from hik9258
    I'm happy at 95k in podunk idaho for a 4 day work week a little over a year out of school. But like anyone else, I would like to maximize my income potential at some point
    What I wouldn't give to be in your shoes at that stage in your career.

    If you're happy and financially comfy, come up with a 3-5 year plan. A startup will likely involve front-heavy overhead and, unfortunately, on the back end, a lack of reciprocating owner income.

    Stack your chips, study how the game is played and when you are in a position to transition in somewhat of a parallel fashion (as far as stress and financial stability), only THEN do you make your move.

    That will lead to greater success for your own endeavors.

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