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It is not an uncommon situation for a physician in a group practice to make a decision to leave the group practice and become a solo practitioner. The decision is usually related to a desire for autonomy, greater control of the practice, and often times because of financial issues. Making that transition from the group to solo practice can be an arduous process and requires finesse and attention to details. One doctor who has made that move successfully is Dr. Sharon Meyer (, a dermatologist in New Orleans, who made that transition after nine years in a small group practice. She provides her insight and advice to others who might make such a move. After reading this article, those physicians who are interested in making such a move will have the information that will make the process much easier and with less tension and anxiety.

According to Dr. Meyer, the goal or objective is leave with the integrity of both parties preserved. You want to leave in a fashion that is amicable and avoid having negative comments said by either party out "on the street." In order to accomplish this goal, Dr. Meyer suggests getting into the shoes or the mind set of the other party(s) and make an effort to see your actions or lack of action from their point of view. If you take a scorched earth approach, you will find that the feathers you ruffle will impact your new practice and will make it difficult for your patients to get access to you in your new practice and may even involve costly law suits if there is a contract dispute regarding patients, account receivables, equipment, staff issues, and that very important malpractice tail.

Dr. Meyer suggests that as soon as you have made the decision to leave, you contact your previous partners and tell them, preferably face to face, of your decision. Nothing can be worse for your relationship with your old partner(s) than for himher to hear on the streets that you are leaving. Dr. Meyer believes this was one of the most important steps in severing her relationship with the old practice. She also suggests taking the high road and never saying anything negative about your previous employerpartners even if they fire the first shot and you hear a negative remark from them. Her advice is that the street is not the place to hang out your dirty laundry.

After you have informed your old partners, she recommends that you be up front with the group and avoid doing anything offensive or underhanded. For example, don't handout new business cards while you are still working for the group. Don't go to the office on weekends or late at night and copy charts and names of your patients. Remember, your patients have a legal right to their records and can have them transferred to you after they sign a request for transfer of records.

Dr. Meyer recommends following and honoring your commitment to your contract. If the contract says that you have to give three months notice before leaving, then you must not plan to leave or sign a new lease until you have met your commitment. Often times, your previous employer will agree to let you go earlier than the contract stipulates because there can be a drain on morale in the office when one partner is planning to leave. However, the previous employer may need to look for a new partner to replace you, heshe may need to make adjustments in the overhead, they will need to remove your name from the stationary and the front door of the office, etc and this can seldom be done in a few weeks.

Dr. Meyer had the assistance of her accountant, her attorney, and several other colleagues who went into solo practice in the recent past. She contacted their office managers and they provided her with advice, checklists, and vendors to contact for various services and equipment. They gave her advice on obtaining a new tax I.D. number, pension plan, medical software, office equipment, accounting software, phone systems, managed care contracts, credit with suppliers, announcements, and phone book listings. If these office managers meet with you after hours, you might consider compensating them for their time.

Obviously, one of the most important tasks is to obtain the names of your existing patients. Dr. Meyer feels that this information is probably more important than the records. She advises that the time to clarify this issue is in the initial contract negotiations. She suggests writing a letter to your existing patients of your intentions to move your practice. Most practice management systems will cull out each doctor's patients and can place the addresses, insurance information, and phone numbers on a CD-ROM, which you can give to a printer and easily create a personalized letter to each patient. You may have several dozen patients that you may want to include a handwritten note and this can easily be done with this system. Dr. Meyer suggests that you don't ask all of your patients to request a copy of their records. This can overwhelm the staff of your previous employer and creates bad will between the two of you. For most patients you can continue providing care without the entire records. You may ask for only a lab or a path report and that is much easier to obtain than asking for a copy of the complete record.

Dr. Meyer has made an effort to continue her relationship with her previous employer. Maintaining a close relationship with your former associates, allows for valuable exchange of ideas concerning patient care. Remember, the practice of medicine is a continuous learning experience, and the former associate is probably a mature and experienced physician with a wealth of knowledge.

Her final advice: "Life is too short to harbor any resentment to what could have been. Get over it and move on as it may impact more than your practice; it may affect your health. If both parties feel this way, you may have the best possible outcomes."