“Physicians don’t like all these new quality metrics, and the hospitals and government agencies that hire the physicians aren’t good at it, either, so they end up losing a lot of money on employed physicians,” he says. “I decided to create my own practice and participate proactively to get my quality measures to where they needed to be,” he says.
It can be risky. Walking away from a guaranteed or RVU-based salary takes some guts, so being at least a little risk tolerant is essential, experts say. At the time she launched her direct-pay practice two years ago, Gunther still had about $170,000 in medical school loans left to pay. Today, that’s down to about $100,000. On top of loans, there is the common need to borrow funds to start a practice. Gunther was able to secure a Small Business Administration loan to buy her office building, which she’s partially renting out to other professionals while she builds out her practice. To mitigate risk if funds are extremely tight, she says, consider starting out small by renting space in a medical complex and moonlighting to supplement income for a while.