It's 3am. I can't keep my solo practice open anymore.


From Daniel Palestrant, Founder & CEO of Sermo
Nearly 500 physicians on Sermo responded to one's Family Physician's tale regarding his struggle to keep his business afloat. In the end, he was forced to leave his solo practice due to financial hardship. Click below to scroll through the physician comments.

Originally Posted to the Sermo Community
By: doctorfurl, Family Medicine

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It's 3am. I can't keep my solo practice open anymore.

It has finally happened.  I have been keeping my income just high enough to pay personal expenses because I have a second job (moonlighting in an ER).  The income from my almost 5-year old solo family practice is not enough to make it.  I am making about 1/2 of what I should.  Between ER and FP, I am working about as much as I did as a resident.  I soon won't have the ER gig anymore.  They are trying to get rid of part-timers so as to fill their schedules more readily.  I can't commit to full time with them, as they have full-timers already.  Ah, the politics of shift work...

Part of the problem is a horrible management company that I joined 2 years ago.  (My mistake, but there are 300 other docs in this God-forsaken company)  The amount they charge (aprox 25%) for what little they do amounts to financial sodomy.  Suffice it to say, the contract I signed indicated to me and my lawyer that they would do a lot more.  They know I don't have any money for court costs, so they just do as little as they want.  I am powerless to change it, for if I walk away the debt on the office is mine (at least 100k) and if I stay, I can't make the overhead and get a reasonable salary.  I will post more about the management company later, so that no one else deals with them.  I can't mention them specifically until the contract issues are resolved.  They have an army of lawyers.

I'm exhausted.  I'm 39 years old.  I looked at myself in the mirror, and I look like the after picture of a US President.  You know, the before compared with the after, the after shot always looks like they aged 20 years compared to the before.  I sleep about 3 hours a day, sneaking 4-6 on weekends.  My wife doesn't know this...I have nearly wrecked my car coming home from overnight ER work on at least 6 occasions.  I take too much Provigil.  I am addicted to "Energy Drinks."  I know they are bullshit, but I'm hoping for a placebo effect.  Liquid Hope, I call it.

But I don't want to whine or ramble.  I just want to make sure no one else ends up like this. 

I vow to you, my fellow Sermoans, to describe my upcoming closing of a solo family practice.  A lot of posts have talked about it in generalities.   There is much more press about opening a solo practice.  The thought of opening another solo practice makes me want to vomit.

My practice currently has over 5,000 patients in a growing suburban metropolitan area.  Most have insurance.  The main lesson I have learned: I can't be the product of the business AND the manager of the business.  I reached out to a company to help, and now they are my pimp.  This ho just can't ho no mo'.  Not on 3 hours sleep a night.

My next question: Anyone else going through this?  Contemplating this?  Have anything to offer?

Stay tuned, as I will add to this post as events change.  I am expecting a flood of calls from recruiters after my many emails about jobs...

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