MD office to owning a practice

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.

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.

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.