Doctor’s Diary August 28, 2017: Private Practice

(Snippets from the frontline)

Private Practice

I’ve been practicing medicine for 36 years.  One of my patients fought in the 1898 Spanish-American War; a handful lived in three centuries…born in the 19th and living into the 21st; while several had parents who grew up during the Civil War.  These connections to history boggle my mind, but also unfortunately remind me of my age.

For 30 years, I have had a solo private practice which from the get-go, is a business.  Initially with consultant assistance I rented office space, hired staff, signed contracts, got privileges to practice at hospitals, purchased malpractice insurance, hired a CPA, and paid my taxes.

But most importantly, because it was MY business, I had to provide professional medical services elevating care and establishing a reputation to keep customers happy.  That meant good communication skills, waking up at night, having few days off, and nowadays being an advocate for my patients.

Newly graduating doctors still want responsibility of being a physician, but not being a business owner.  So rarely do they go into private practice.

Employed doctors don’t carry the same pride of ownership as private practice physicians. 

Without this motivating factor, the depth of your healthcare may be affected.

Gene Uzawa Dorio, M.D.


  • “The Defense Never Rests” is about the law; it’s the same in other fields, of course.

    The only choice I see is always to have a choice of hospitals, whether doctor or patient, because hospitals change. This probably means not being employed by a hospital.

  • Use the Internet to show
    your patients that they have a choice of hospitals, and that patients and doctors together can easily discuss choice of hospitals. See the work of Senator Charles Grassley: Google his blowing the whistle on a nonprofit-hospital in Missouri for suing indigent patients. Write or call the doctor on the staff of his Washington office at 212-224-3744: Dr. Karen Summar.

  • Sevan Stepanian, MD says:

    As a physician who has worked in both settings, not surprisingly, I’ve seen advantages and disadvantages in both. The privilege of caring for others, and the pride you have in your craft remains regardless of the practice setting. The depth of healthcare can suffer in any setting for a variety of reasons. Who a patient sees is much more important than where they are seen.

  • Nola Aronson says:

    That’s a good comment from Dr. Butler With all your experience you could write a book explaining what it takes to be a doctor even working in the business I have the same problem in my audiology practice everybody goes home at 5:30 no matter what The business owner has to put the patient in front of the other audiologists and then at the end of the day that’s it Unfortunately I find even though an audiologist has to go for their doctorate in this day and age they are not taught anything about business or sales or communication they just learn diagnostics and theory And as we know the insurance companies don’t value diagnostics and pay very little reimbursement for our expertise so we have to find other avenues to be able to support ourselves in our case hearing aids as the solution to help people hear better

  • Use the Internet to teach interns, residents, and fellows about to choose a practice what you have learned about:

    1. Incentive;
    2. Choice of hospitals;
    3. Other key decisions.

Leave a Comment