The Pros and Cons of Solo vs. Group Practice
Group medical practices seem to have become the standard for today’s healthcare delivery model, with financial considerations as the main driver for this trend. Predictable, higher salaries are one primary benefit of group practice, but there are drawbacks as well. Healthcare providers, or HCPs, may wonder if a solo practice is still viable in today’s healthcare landscape. Solo practice presents a unique set of challenges along with some surprising advantages for providers willing to take the plunge.
Careful evaluation of the pros and cons of both group and solo practice settings will help HCPs choose a practice setting that will suit career and lifestyle goals.
Group practice
There is currently no standard definition of what makes up a healthcare group practice. Practices may contain anywhere from two to hundreds of providers. In a 2021 qualitative descriptive analysis of 98 papers, patients of group practices were more satisfied with their quality of care. This effect was determined to result from increased access to care and decreased waiting times.
Instant Rx savings for insured and uninsured patients
GoodRx for HCPs has savings that can beat insurance copays and reduce your need to complete prior authorizations.
The group pros
Financial benefits: When joining a group practice, HCPs will find there are little or no startup expenses; the groundwork for establishing the practice is already done. This benefit extends to purchasing power that allows practices to obtain improved medical technology at a lower cost. HCPs employed in a group practice also tend to earn higher salaries than those in solo practices.
Built-in referral base: Group practices provide a source of referrals from other HCPs in the group.
Co-worker support: Group practitioners have the ability to consult with colleagues on complex cases. Coverage is readily available to share call duties and cover vacations or time off. There are also opportunities to learn from colleagues, improving competency levels and reducing professional isolation.
Daily routines: There is typically less work in a group practice. Routines are set, and there is additional support staff to complete tasks. Administrative, human resource duties, and billing are taken care of, leaving the HCP free to focus only on the clinical work aspects.
The group cons
Lack of control: Group practitioners have less input in decision-making processes such as in hiring and firing, and even in key details like the choice of EMR software. Administration may also dictate caseload and schedules. Productivity demands can impact compensation.
Patient attrition: Patients may transfer care to another colleague within the practice.
Shared staff: The office staff is split between providers.
Patient satisfaction: Patients may experience longer wait times in a group practice setting.
Providers seeking to benefit from the structure of a group practice but still desire more autonomy will be better suited to a smaller group practice. In this setting, there are still support staff to help with operations and a few colleagues to share coverage and call, but with a smaller organization, the provider will have more individual input on decision-making within the practice. When negotiating terms of employment, consider scheduling issues that can be addressed in contracts up front and satisfy both the employer and HCP.
Solo practice
Smaller practices have been demonstrated to see lower costs, as well as incur fewer preventable hospital readmissions and lower readmission rates overall. Additionally, studies have determined that providers working in small or solo practices experience less burnout.
The solo pros
Autonomy: In solo practice, you have the responsibility to determine all aspects and make all decisions. These choices extend from equipment procurement and hiring and firing to hours of operation and scheduling decisions.
Dedicated staff and resources: Your staff does not need to devote time or share focus with multiple providers.
Financial benefits: In a group practice, there may be services or luxuries that you don’t require. A solo provider can cut costs by streamlining these expenses, resulting in reduced overhead and better returns.
Variety: While group practices offer more support staff, some HCPs may get bored with the repetitiveness. The diverse and impromptu elements of solo practice are welcome to those that like to mix up their daily work routine.
The solo cons
Total responsibility: In solo practice, the HCP carries the burden for all the issues that arise — from setup, staffing, management, and overhead to the provider functions. This can be an overwhelming amount of work at times.
Financial: This refers to the increased financial burden for funding the practice, making ends meet, and minding the ongoing overhead.
Lack of coverage: Without peer support, solo providers must ensure 24/7 coverage and contingencies for illness, vacations, and so on.
Solo HCPs may be able to outsource some administrative tasks, such as contracting with a billing provider. This can reduce the burden of needing to do it all. However, the trade-off will be the additional expenditure for these types of services. Group purchasing arrangements are available to assist smaller clinics in obtaining better pricing on equipment and supplies.
In addition, solo HCPs are often able to work out deals with another area provider for vacation coverage exchange. Most of the challenges can be addressed with some creative thinking by providers who feel the independence and control are worth it.
Finding the right fit
How do you determine which style of practice will be best for you? There are a few things to consider that can help you in the decision-making process.
First, consider your personality type. Extroverts and those that like a lot of social interaction are better suited for a group practice. New graduates and those that don’t like to be in charge of big decisions will also appreciate the support of a larger practice. By contrast, individuals that prefer to be in control will enjoy solo practice.
Next, your financial situation will impact the ability to consider a solo practice. Individuals already carrying a large amount of student loan debt may find the costs associated with opening and running a solo practice overwhelming.
Where do you want to live? Individuals drawn to smaller communities and less populated areas are better suited to solo practice. These settings provide a more supportive solo practice setting. Densely populated urban areas are generally saturated, and hence more challenging to get a new practice up and running.
Consider your practice style and your specialty. Nonhospital specialties such as family practice and pediatrics are better suited to solo practice.
If you decide solo practice is the best choice, ensuring you have a practice plan will put you on the right track. Prepare your affairs and work closely with a financial planner and accountant to estimate short- and long-term expenses, along with your strategy for meeting these targets.
Other items to address in your solo practice plan include the following:
Practice location: Consider rural vs. metro locales, as well as high-visibility sites.
Scheduled hours of service: Would you prefer to work Saturdays? Or would you like Mondays off?
Types of services to be offered: Narrowing your focus and providing niche services is an excellent strategy for solo practices.
Staffing requirements: You’ll have to figure out how many staffers you need. Don’t forget clinical coverage.
Payer mixes: This involves which payers to credential with and process.
Flexibility and a willingness to work hard are requirements for solo practice. You’ll need to stay on top of everything and be willing to put in as much time as your business needs. Capitalize on a small practice’s ability to provide personalized attention and services to set yourself apart from the competition.
Making your choice
As we’ve seen, both group and solo practice have their pros and cons. Most challenges can be addressed in either setting. Knowing your personality and practice style will help you decide which setting will best suit your needs.
The two main factors separating practice types are increased autonomy and control for private practice, and a higher income associated with group practice. Having clarity on your needs and wants will allow you to decide if the trade-off in one of these areas is worth the benefits.
Why trust our experts?
