For some physicians, the idea of going into private practice strikes early in their training. For others, it comes at the end, when they finally have to choose a practice setting. And for others, it arises after they have spent several years working for someone else.
But no matter when it comes to mind, it’s good to get some top-level pointers from physicians who have succeeded in working for themselves.
Carolynn Francavilla Brown, MD, a family medicine physician and obesity specialist, is one of those. She is the sole owner of Green Mountain Partners for Health in Lakewood, Colorado, which she co-founded in 2015. She is also the immediate past chair of the AMA Private Practice Physicians Section (AMA-PPPS) Governing Council, which seeks to preserve the freedom, independence and integrity of private practice so that physicians who choose to practice in that setting can provide compassionate personal medical care for their patients.
Over the years, she has provided guidance to countless physicians aspiring to private practice through AMA interviews. Following is a brief collection of her tips for starting a private practice.
Dr. Francavilla Brown will be a featured speaker at the AMA Independent Practice Accelerator Workshop, taking place Sept. 11–12 at the AMA headquarters in Chicago. The workshop is designed to give physicians the essential knowledge, practical skills and confidence to launch or strengthen an independent practice in a concentrated, high-impact format. Learn more and register now.
For starters, don’t overthink it
“We know to be excellent at medicine requires a lot of training, so we assume, as physicians, to be good at anything else takes that amount of effort, and it doesn’t,” Dr. Francavilla Brown said in a webinar produced by the AMA-PPPS featuring insights from young physicians who have successfully built careers in private practice.
“Business can be quite complicated, but it also is fairly straightforward in that, at the end of the day, you have to make more money than your business costs to run,” she said. “It is much less complex than what any of us are doing as physicians.”
The AMA’s “Getting started in private practice” resource page highlights eight steps to starting a private practice and other resources for getting started, including expert guidance on payment and contracting.
But do keep your options open
No matter when you make your move to private practice, you should know that your existing employment contract can often be make-or-break to your success, so make sure you pay attention to its terms. A case in point: the noncompete clause.
“When you go to get your first job, you're going to be really excited because you're going to get a paycheck and you're going to get days off and you're thinking about all the things in the contract that are the things you want,” Dr. Francavilla Brown said. “What happens when you go to leave that job?”
The noncompete clause—aka a “covenant not to compete,” which often includes a geographic radius—is a particularly important contract term for one reason: You’re probably not going to stay in any job forever.
“Don't be afraid to walk away from a contract that may not serve you,” Dr. Francavilla Brown said, “because you probably will want to exit it at some point.”
Look for opportunities to learn
Much of training, at both the medical school and residency levels, takes place in larger academic hospital systems. Because of that, getting a firsthand view of physician private practice can be a challenge for physicians.
Dr. Francavilla Brown was fortunate to get exposure through a medical school preceptorship. She said seeking out opportunities to view different types of practices during training, particularly through elective experiences during residency, can broaden your horizons.
“While you have that chance as a student or a resident, look for unique opportunities in terms of setting,” she said in an episode of the “AMA Thriving in Private Practice” podcast, which looks at the transition from residency to private practice. “In family medicine, we have this focus on rural. We always make sure our residents in Colorado get exposed to what it looks like to work in a rural setting.
“But that also may be looking at private practices, looking at a solo practice. What might it look like if you were the only doctor? What does it look like to be part of a private practice that maybe has a dozen or a hundred doctors, but it's an independent practice? I think exposing yourself to a variety of settings and locations, when possible, with those electives, is really powerful too.”
There’s no shortage of help
Starting your own physician private practice means that you have to fill in a lot of the blanks. But for every question, the medical community has a resource, Dr. Francavilla Brown said on the podcast.
“In family medicine, I use resources all the time. If a cardiology case gets to a place where I can no longer manage it, I'm going to consult with a cardiologist,” she said, noting that the same thing applies to questions about private practice.
“If there is a legal question—if there is a HIPAA question, if there is a supply question, if there's a technology question—there is someone out there that has that answer,” she said. “And that may be hiring someone, that may be networking and finding that person. But there is an answer to every question you have when starting a private practice.”
It takes astute clinical judgment, as well as a commitment to collaboration and solving challenging problems, to succeed in independent settings that are often fluid, and the AMA offers the resources and support physicians need to both start and sustain success in private practice.
Embrace the financial reality
“I was part of a leadership conference recently, and someone there had the best quote: Don't bring emotions to a math fight,” she said in an interview about mistakes physicians should avoid when entering private practice. “Does the rent you're paying make sense? Are you going to be able to make a return on that? If you're taking insurance, what do you actually get from insurance companies? If that’s not sustainable, then you may have to take cash or be out of network.”
Taking insurance is a particularly important issue, Dr. Francavilla Brown noted, because it constrains how much you can charge for services.
“In another business, you’d set your own rates. But if you take health insurance, you can't raise them. So you really have to control your overhead,” she said.
The AMA STEPS Forward® podcast, “Private Practice: Attending to Business,” has expert guidance to help navigate business operations and efficiency solutions to create and support a thriving business.
It may be tempting, but don’t go DIY
Physicians are accustomed to making referrals to help patients get the best care available, and they should keep that practice in mind when working for themselves.
“Just like in medicine, there is someone who has the answer for everything,” Dr. Francavilla Brown said in the podcast. “So if you have a financial question, there are accountants. If you have a legal question, there are lawyers. If you have general questions, there is your medical society.”
The AMA Private Practice Playbook introduces foundational terms and concepts that apply to private practice. It also breaks out the professional advisors who can provide invaluable guidance as you develop a business plan for day-to-day and long-term operations.
Epilogue: Consider the workshop
Other featured speakers at the AMA Independent Practice Accelerator Workshop will include:
- Bryan Batson, MD, chief executive officer of Hattiesburg Clinic.
- Phil Boucher, MD, founder of Frontier Pediatric Care and PractOS.
- Michael Jerkins, MD, cofounder and president of Panacea Financial.
- Edward Kroger, MD, professor of practice at University of Houston Bauer College of Business.
- Bobby Mukkamala, MD, immediate past president of the AMA.
- Neal Shah, shareholder of Polsinelli.
You will have the opportunity to:
- Build your skills in business fundamentals, revenue cycle management, patient acquisition and retention, technology selection, compliance and more.
- Get expert insights on navigating common challenges.
- Apply what you learn through structured activities.
- Network with peers and access the AMA’s professional support network.
CME credit will be available for eligible sessions. Registration includes all workshop sessions and materials, as well as access to asynchronous AMA independent practice educational content.
The workshop is just one part of the AMA Career Advancement Collective, a powerful suite of educational programs and training will help physicians develop and advance at every stage of their career.
These include the:
- AMA Peer Support Workshop, Oct. 28–29.
- AMA Physician Leadership Academy, a 12-month hybrid program that combines in-person and virtual learning, Oct. 7, 2026–Sept. 22, 2027.
Learn more and register for one of these career-shaping events now.
