So, you're a general pediatrician dreaming of building your own private practice. No bureaucracy, full creative control, and the joy of shaping a practice that reflects your values. Sounds exciting, right? But then reality sets in: where do you even begin?
Dr. Neville Anderson, a general pediatrician in Los Angeles, has been there. In a recent conversation on Peds Reviews and Perspectives podcast, she shared how she went from an employed clinician to the founder of a thriving pediatric practice. Whether you're seriously considering the leap or just curious about what it takes, here are the key takeaways from the discussion.
What Is a Private Practice?
A private practice is a medical business where physicians are also the owners. Unlike hospitals or academic clinics, private practice physicians make the big decisions: staffing, scheduling, EHR selection—even the art on the walls.
The Perks and Pitfalls
The best part? Freedom. You decide how long to spend with each patient, how your office runs, and how your care looks. The hard part? You do everything. You're not just a doctor anymore—you're the boss. In good months, that means financial reward and fulfillment. In tough times, like during the pandemic, you might be the last to get paid.
First Steps: Educate Yourself and Build a Team
Dr. Anderson emphasizes the importance of learning about the process and connecting with others who have been there. Great resources include:
▪️Pediatric Management Institute and its annual conference
You don’t need an MBA, but you do need to think like a business owner. And you'll need a team. At the top of your list:
▪️A healthcare-savvy lawyer to help you set up your legal structure (e.g., S-corp in California)
▪️An accountant who understands business taxes (TurboTax won’t cut it)
Credentialing and Insurance Contracts
Start early. Credentialing with insurance companies and hospitals can take 3–6 months. If you're leaving a current practice, find out if you can carry your credentials over.
Dr. Anderson recommends exploring Clinical Integration Networks (CINs), which help independent practices negotiate better reimbursement rates by banding together.
Hospital Relationships
If you're in a region where pediatricians still do newborn rounds, getting privileges at a local hospital is key to building your patient panel. Pro tip: do this early. Some insurers require active hospital privileges for participation.
Hiring: Your Practice Starts with People
Dr. Anderson's first hire was an office manager—a seasoned LVN who became her right-hand. From there:
▪️Add medical assistants (ideally cross-trained for front and back office)
▪️Decide between an in-house biller or a billing company
▪️Understand your state’s regulations (e.g., MA vs. RN for vaccine administration)
Picking an EHR
Pediatric-specific systems like Office Practicum or PCC offer features like vaccine tracking and family linkages. Both have strong user communities and pediatric-friendly workflows. Don't cheap out here—a clunky EHR will slow you down.
Supplies and Setup
Start with what you know, then network like crazy. Dr. Anderson leaned on a step-cousin in practice management to get a sample supply list. And yes, her first exam table was a borrowed massage table. Flexibility is your superpower.
Avoid These Common Pitfalls
▪️Too-small space: It's tempting to save money, but outgrowing your office is expensive and disruptive.
▪️Underpowered tech: Invest in fast internet, solid computers, and a good EHR. It's worth it.
The Big Picture
Running a private practice is hard. Managing staff is hard. Being the one who stays late and worries about payroll is hard. But it's also incredibly rewarding.
"I built a practice that’s respected and modern, and provides excellent care," Dr. Anderson says. "At the end of the day, I do it for the patients."
She also reminds us to set boundaries and take care of ourselves: bill for your time, take vacations, and don’t give away care for free.
Final Thoughts
Think you could never do it? Dr. Anderson once thought that, too. But with the right mindset, support, and persistence, she did it. And you can too.
"There’s a whole village out there rooting for you," she says. "You can do this."
Want to hear more about starting a pediatric private practice? Listen in on our Peds Reviews and Perspectives podcast segment, "How to start a pediatric private practice".