How to create your specialized niche in a private practice
Economic considerations for subspecialties
Compensation for subspecializing is often a major factor. Understanding the economics of your specialty are important, as providers can become disappointed and disenchanted when they realize that their desire for income, especially when compared to other colleagues, differs from what their subspecialty can provide.
For instance, in GI, a physician pursuing a procedurally focused subspecialty like advanced endoscopy is likely to be compensated more highly than one who focuses on a more office-based, evaluation and management (E/M) billing-driven specialty, like motility, geriatric gastroenterology, or even hepatology. These office-based specialties are no less important, but the reality is that they create less revenue for a private practice.
Negotiating a fair contract at the beginning is critical, as you may need your income to be supplemented by your higher revenue-producing colleagues and partners for long-term success. Academic centers are often able to provide the supplement through endowments, grants, or better payer reimbursement for E/M codes, compared with a private practice.
Remember, everyone’s in sales
From my vantage point as a partner at Atlanta Gastroenterology Associates, there are several ways new GI physicians can set about a path toward specialization.
One of the first things that you should ask yourself during training is whether you want to spend another year beyond the typical 3 years. Best-case scenario would be figuring out a way to get the necessary training during the 3 years, possibly spending the third year dedicated to the specialty. Another possibility is to simply get on-the-job training during your first few years in practice without the extra year.
Whichever path you choose, building up a specialized niche within a private practice won’t come overnight. You have to create a plan and navigate a course. Here are a few ways to do that:
