Can the solo practice premium surgeon survive in today’s health care environment?

Twenty-four years ago, I was completing my third year of ophthalmology residency and already had plans to open a private practice solo in a somewhat rural location at that time outside of Chicago. Even as far back as 1993, it was rare to go solo, knowing the financial risks involved at that time. Most of my colleagues either went directly into a fellowship program or joined a group or corporate practice.In 2017, with the changing landscape of health care, with the need for electronic medical records (EMR), data reporting in terms of meaningful use (MU), Physician Quality Reporting System (PQRS) and soon Merit-based Incentive Payment System (MIPS) and Medicare Access and CHIP Reauthorization Act (MACRA), and the financial penalties for not following such, it seems nearly impossible to consider embarking on a solo practice career. For those brave premium surgeons who have established themselves as or are about to become solo practice warriors, here are a few survival guide tips that have helped me as I approach my 25th year in practice.