26% of solo practitioners on Sermo forced to close doors

Physicians Nationwide Discuss Causes of Struggling Practices and Possible Alternatives

Sermo, the world’s largest online community for physicians, today announced its weekly hot topic. Nearly 500 physicians from 40 specialties participated in a Sermo post “It’s 3am. I can’t keep my solo practice anymore” from a Family Medicine physician. Over 26% of respondents admitted they too had been forced to close, or are considering closing, their solo practice. This new polling data confirms the seriousness of many forecasts predicting a shortage of primary care physicians and sheds light on the many reasons physicians are choosing to leave the profession.

Why all the struggles to run a successful Family practice? Physicians point to a variety of issues including low & delayed reimbursements, problems with management companies, and a lack of business/practice management education.

Lack of training in business principles

Without business fundamentals, solo physician practices suffer; high overhead, high insurance costs, and low reimbursement rates can create a failing endeavor. One Family Physician from North Carolina summed up the perspective of many physicians; “I was trained as a physician and not a businessman and not an insurance coder.” Another physician found the “cost of rent, medical supplies, malpractice [insurance], employees” to be “prohibitive” and was forced to close as well.

Declining/Delayed reimbursements

In recent years, Medicare reimbursements have been declining, coupled with delayed physicians payments. One Family physician cites delayed reimbursements as the “biggest problem” facing his practice. He continues, “When the companies are all paying promptly, I am just barely able to keep things covered.” Another physician experienced the same problem, which was a “driving force” to work with a practice management company.

Inadequate support from practice management companies

Small practices frequently turn to management companies to handle administrative requirements including negotiation of reimbursement rates with insurance companies. But often physicians claim these companies fail to deliver on their contractual obligations. One Texas Family Physician was forced to declare bankruptcy after his relationship with a practice management company soured. Another Family Physician asserted “I believe I am in practice today because I did not hire a practice management company.”


Physicians propose options, though they admit no solution is perfect. Some suggest selling the failing practice or transitioning to a cash-only model. Others advise colleagues to take a salaried position at a hospital or the military. Another common suggestion was locums work.

To view the full discussion and polling results, visit the Sermo Blog at blog.Sermo.com. The Sermo Blog highlights the most vibrant discussions happening. Discussions on Sermo are physician-initiated and cover topics ranging from medical ethics & practice management to challenging clinical cases.

About Sermo

Sermo is the largest online physician community, where over 112,000 physicians collaborate to improve patient care. Sermo provides access to its community for clients that need fast, actionable insights.

Sermo Contact:

Andrea Squitieri
P: 617-229-5188
E: asquitieri@Sermo.com