Article Date: 11/1/2007

Thinking About Going Solo?
practice management

Illustration by Christopher Zacharow

Thinking About Going Solo?

Here are 10 traits essential to making it in private practice, say your colleagues.

BOB LEVOY, O.D., Roslyn, NY

I've met countless practitioners who've quit employed positions to go solo. For some, it was a great decision. For others, it was their biggest regret.

Here are some of the traits (in no particular order) that, in looking back, these practitioners consider essential to "making it on your own."

You must be:

1 Comfortable with independence

A Texas doctor spent 11 years with an optical chain before going solo a few years ago. Would he do it again? "Definitely," he said. " … I love being in control of my own practice. I don't have to clear things with anyone or go through channels if I want to purchase new equipment or attend a continuing education (CE) course."

On the other hand, one O.D. confided: "It's [private-practice] more lonely and less social than I anticipated."

2 Self-confident and willing to take risks

A New-Jersey practitioner realized he was chained to a corporate-owned practice because he feared the risks involved in starting from scratch.

I call this the "golden handcuff syndrome." It has kept many O.D.s from pursuing their dreams.

3 Tenacious

Solo practitioners don't have failures. They have learning experiences. They don't spend a lot of time blaming insurance companies, corporate chains, mail-order contact-lens companies or ophthalmologists for their problems. They know there is always a choice: a different strategy, path to take, a decision to view the unexpected as a challenge, not a crisis. As one practitioner put it: "If it is to be, it is up to me."

4 Goal-oriented

Goal-setting turbo-charges your business plan. How? It forces you to make commitments and reduces unnecessary conflict about what to do, which in turn increases your chances of success.

5 An experienced manager

Experience in managing others enables you to hire the best people and retain these employees — the backbone of a high-performance practice.

6 Diligent

You must have a high energy level and a willingness to work long hours, especially at the beginning. "Cement family support by having a realistic discussion about the demands of solo practice, especially one started from scratch, before you proceed," says one O.D. "You don't want constant arguments or questions about when you will start making money."

7 Financially secure

Have a financial cushion (or a bank loan) that can carry you until you've established the practice. Numerous practitioners, with whom I've spoken, admitted this was their downfall. As one O.D. told me, "When my husband started asking whether my practice had become a hobby, I realized it was time to quit."

8 Versatile

Be willing to wear several hats (both clinical and office-related), so you can keep your overhead low until you can afford part-time and eventually, full-time staff.

9 A mover and shaker

You must network to establish relationships with primary-care physicians, ophthalmologists, neurologists, pediatricians, pharmacists, school nurses and other potential referral sources.

10 Tolerant of ambiguity

Many aspects of solo practice are unpredictable — especially in the start-up phase. This includes, numbers of new patients, patient compliance with periodic eye health and vision examinations, practice revenues, the willingness of other healthcare practitioners to send referrals, etc. Uncertainty goes with the territory.

Going solo also requires luck, from picking the right time to do it to finding the right location and staff. When it works, however, it can be very rewarding. "I'm working harder than ever," one O.D. who's been on his own for less than a year told me, "but I've never been happier." OM

Dr. Levoy's newest book, 222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices has been published by Jones&Bartlett. For details, visit:

Optometric Management, Issue: November 2007