I get excited when I run into entrepreneurial thinking in a physician, so I smiled gleefully when I read Dr. Richard Schoor's recent post in his Independent Urologist Blog.

As a solo practitioner "fighting the good fight", he writes that there are competitive advantages to being the small practice in a sea of big groups, and these include:

1: Flexibility — you can be flexible, adaptive, and change-ready. These are important characteristics to possess in the face of shifting reimbursements schemes, regulations, and managed care rules on top of major advances in communications and health information technologies.

His other points are (you can read the rest of the post here):

2: Cream-skimming.

3: Tech-savvy.

4: Alternative delivery methods.

5: Patient preference.

6: Regulatory changes.

To this list I would add:

• Avoid the overhead bloat
• Find and exploit a key point of differentiation (e.g. "the physician who grew up in the neighborhood and chose to come back", "The practice where your time is more important than ours" etc.)
• Act big, with an active informative website/blog that attracts not only the attention of your patient market, but that also interests and excites your local media -- PR is the BEST form of free advertising.

Good entrepreneurial analysis, Dr. Schoor!