For doctors working in large hospitals and group practices, long hours, insufficient pay, and limited resources can quickly lead to burnout, with a recent study by the AMA finding that physicians are 82% more likely to experience burnout than workers in other fields.
These pressures have led many doctors to consider going out on their own and starting a private practice. Being your own boss can be an exciting prospect, as this gives you the autonomy to control your own environment and set your own schedule, while also providing the potential for higher income.
It’s then no wonder that 27% of physicians surveyed on Sermo said that they are currently a full or partial owner in their private practice, enjoying the benefits of being able to work independently. Yet, being a business owner also comes with its own set of challenges, including greater responsibility and financial uncertainty, making it important that you take the time to consider the pros and cons of each option before making such a big decision.
This article will look at the factors you should consider before deciding to open a private practice.
Pros of owning a private practice as a physician
Private practice ownership can provide various benefits over working for a hospital or group practice. Just a few of the advantages of owning a private practice as a physician include:
Clinical Autonomy
One of the most appealing aspects of owning a private practice is the autonomy it offers. Many doctors in hospital settings struggle with reduced autonomy, with one plastic surgeon on Sermo stating that “I am saddened about our state of affairs in medicine. Many docs have lost autonomy, too much busy work, and not patient-centered care unless you run the show.”
Rather than having to follow corporate or hospital guidelines and policies, owning a private practice gives you the power to make final decisions regarding patient care protocols, which medical equipment to buy, and how much time you’ll spend with each patient. With no productivity quotas forcing you to see a patient every 10 minutes, you can schedule your patients with the time you need to give each patient the attention they deserve.
Business Control
Owning a private practice also gives you complete control over your business. You get to set the workplace culture, decide what hours you want to work, and what insurance providers you work with.
You will also have complete say over HR and staffing, ensuring you have a team of healthcare professionals by your side that you work well with. When asked about their opinions on private practice, one GP on Sermo said: “In my opinion, working privately and independently is always the best option, since you are responsible for your own work, it is done to your liking and in your own way, and when you depend on a larger institution, you have to meet the demands or whims of someone else.”
Stronger Patient Bonds
Since doctors in private practice often have more time to spend with patients, this often fosters a stronger doctor-patient relationship. You can more easily develop strong relationships with everyone who comes through your door, which can lead to better patient satisfaction, outcomes, and patient retention. Without the revolving door feel of large health systems, you can focus on building strong connections that can result in you having multi-generational relationships with families.
Potential for Higher Long-Term Income
While startup costs can be high when opening a private practice, owning a private practice also often results in higher long-term income potential compared to salaried positions at a hospital or medical group.
Cons of owning a private practice as a physician
Of course, owning a private practice is not without its difficulties, and there are cons to private practice that you should consider when making this decision. Some of the potential downsides of owning a private practice as a physician include:
The “Administrative Weight”
When you open a private practice, you are no longer just a doctor; you are also a CEO, HR manager, and IT troubleshooter. You are also responsible for a variety of administrative tasks, including managing payroll, paying rent, managing cybersecurity, handling paperwork, and negotiating with insurance companies.
Unless you hire outside help to handle some of these tasks, you’ll likely find yourself spending a lot of time managing the administrative side of your practice, which can mean overtime hours or less time spent with patients.
As one family medicine doctor on Sermo put it: “The paperwork/admin is horribly burdensome. Expenses are higher, (and) income is down. Looking for supplemental income in order to support the practice. However, we love being able to really spend time with our patients, are happiest when we are seeing patients. Just wish we weren’t always worried about meeting expenses.”
This is also why one psychiatrist on Sermo prefers not to be in private practice, as they claimed that “making $10.000 less is ok as it frees you from many responsibilities of billing, payroll, filing taxes, and looking for employees if someone leaves.”
Staffing and Overhead Struggles
Finding and keeping qualified medical assistants, nurses, and front-office staff is increasingly difficult and expensive in a competitive job market. Unfortunately, if a key employee quits, the burden to replace them falls directly on you, and you may even have to pick up some of the slack until you can fill their position.
Financial Vulnerability
While there is the potential for higher income when you own a private practice, you are also taking on some risk as your income depends on your patient volume and reimbursement rates. Unlike hospital employees with a guaranteed paycheck, your income can fluctuate in private practice and may be reduced by unexpected expenses like a broken MRI machine or a change in billing regulations. Furthermore, the unfortunate reality for private practice physicians is that finding patients can be difficult, particularly for specialists. An orthopedic surgeon on Sermo claimed that “My biggest challenge is getting patients that don’t know of me, since I don’t do ER call, and 95% of the PCPs are now employed by big hospital systems and ONLY refer to their specialists. My patients are friends & family of my loyal patients; [people] who know my positive reputation and/or from Google search.”
The “On-Call” Burden
In a small private practice, it can be harder to disconnect from work. Since you will likely have fewer colleagues to share the call burden with, this can make it difficult to truly take days off or go on vacation without sourcing external temporary coverage.
Navigating the 2026 staffing and overhead crisis in healthcare
While owning a private practice can be rewarding and give you greater autonomy, but it’s important to understand that doing so also comes with its fair share of challenges, particularly regarding staffing and overhead costs.
While many physicians dream of working shorter hours and making more money in private practice, the reality is that there is currently a severe staffing shortage in the healthcare industry. 2026 is seeing leaders in healthcare being confronted with the harsh truth that staffing shortages, high labor costs, and inflation are squeezing operating budgets, making it difficult for some small private practices to hire the staff they need, or even make ends meet.
Unfortunately, this can make opening a private practice difficult, as there are not enough experienced professionals to fill vacant positions, and with competition high, support staff may require higher salaries than you anticipated paying. In fact, 52% of physicians surveyed by Sermo claimed that they struggle to hire and maintain the number of staff that they need. When coupled with the rising cost of medical supplies and EHR maintenance, physicians in new private practices may find themselves working long hours and struggling to make ends meet, with one family medicine doctor on Sermo stating:
“I ran an emergency medicine corporation and coincidentally two urgent care practices and eventually one urgent care/family practice, and with the exception of only a handful of years, I moonlighted in emergency rooms every chance I got and did medicolegal work whenever it came to me, for extra income. In family practice, we had huge overhead and made our money in nickels and dimes instead of in hundreds and thousands like some surgeons with low overhead.”
The digital world as a means to grow your private practice
While staffing shortages, competition with other practices, and rising costs can make it difficult to succeed in private practice, the digital world provides unique resources that can help you grow your practice.
It’s important that private practice owners do not underestimate the importance of digital marketing, as maintaining a strong digital presence is essential for doctors in this day and age. This is because more patients than ever are using Google and social media to find new doctors and make critical healthcare decisions. New private practices should develop a strong website that leverages SEO and takes advantage of cross-posting content from your website on social media, as this can help you stand out on search engines and attract business to your practice.
Furthermore, with the CDC finding that 58% of adults use the internet to look for medical information and find new doctors, but less than half of doctors surveyed on Sermo using their website to acquire new patients, maintaining a strong digital presence can be the difference between success and failure in private practice in a digital world. As you begin building your private practice, you may also find it helpful to invest in paid digital marketing on Google, Facebook, and other popular social media platforms to boost traffic to your website.
Supplementing practice income when it comes short
While many physicians see taking on “side gigs” as something residents do to pay down their student loans, the truth is that side gigs can also be a critical resource for doctors in private practice that can help them supplement their income and pay for rising overhead costs. The majority of physicians surveyed on Sermo claimed that supplemental income was essential in helping them pay for personal expenses and prepare for unexpected business expenses.
The good news is that there are more ways than ever for doctors to earn supplemental income while still being able to maintain their private practices. For instance, telemedicine, medical writing, and paid medical surveys allow you to make extra money from the comfort of your own office. If you are looking for a little extra income, participating in Sermo surveys can provide a financial buffer when times are tough for your private practice.
The bottom line of owning a private practice as a physician
While owning a private practice can come with certain challenges, it can also be a premium clinical model if you approach it with a sophisticated business mindset. When properly managed, private practices can provide greater income potential and a better mental health outlook, as you will have the autonomy to do things as you see fit without having to worry about adhering to corporate policies and mandated productivity quotas. While the administrative burdens of private practice are real, the clinical and financial price of “safety” in a hospital system can be even higher. If you are a physician who values the joy of the office and the sacredness of the patient relationship, the independence of private practice remains a challenging but deeply rewarding path. If you’re considering opening your own private practice but aren’t sure where to start to ensure success, consider joining the Sermo community. Sermo provides physicians with a platform to connect with one another, which can give you access to valuable, real-world insights on what it takes to successfully run a small business and keep your practice’s “open” sign hanging.
