Midsize group practice (6-15 practitioners)

Midsize group practice overview

Group practices consist of multiple dermatologists working together within a shared business structure. These can be independent partnerships, large integrated groups, or practices owned by private equity.

Why dermatologists choose this

• Shared administrative and overhead responsibilities.

• Access to internal referrals and a built-in patient base.

• Opportunities for mentorship, collaboration, and work-life balance.

• Stability and immediate income, especially appealing post-residency.

• Less pressure to manage business logistics early in one’s career.

How this model works

Employment and structure

Dermatologists may be employees, partners, or contractors. Practices vary from physician-owned to hospital-owned or private equity. New physicians often start as salaried employees with potential for partnership.

Patient care model

Physicians typically see a high volume of patients, supported by centralized scheduling and nursing staff. Internal referrals are common, especially in multispecialty groups, and care is often team-based, involving physician assistants or nurse practitioners.

Administrative support

Billing, credentialing, HR, compliance, and marketing are generally handled centrally. The group provides the EHR system, malpractice insurance, and supply management. Larger practices may offer in-house IT, pharmacy, or pathology services.

Compensation and incentives

Payment structures vary and may include base salary, RVU-based bonuses, or profit sharing. Partnership tracks often require buy-ins and include profit distribution. Benefits usually cover retirement plans, CME support, and paid leave.

Technology and operations

Most group practices invest in centralized EHR systems, patient portals, and digital marketing tools. Technology enables standardized documentation, scheduling, billing, and performance tracking. Practices often adopt teledermatology, online appointment systems, and in-office digital tools to improve access and efficiency. Compliance and IT are usually handled by a dedicated support team or outsourced vendor.

Career growth

There are opportunities for leadership roles such as medical director or board positions. Larger groups may offer subspecialty clinics or research opportunities. Business exposure is limited unless you become a partner or shareholder.

When this model makes sense

• For new dermatologists seeking a supportive, structured environment.

• When financial stability and predictable income are priorities.

• For physicians wanting to avoid solo administrative burden but retain some clinical control.

• When practicing in a high-demand area where team-based care improves efficiency.

Success factors

• Determine if the group is physician-led, hospital-owned, or private equity-backed.

• Review how clinical decisions are made and what administrative support is available.

• Pay close attention in your contract to non-competes, bonuses, and productivity expectations.

• Participate in practice decisions, quality improvement, and professional development.

• Even in a group, you should build your brand; your patient relationships and reputation matter.

Potential challenges

• May have less flexibility with scheduling, staffing, or clinical decisions.

• Risk of burnout in high-volume or productivity-driven models.

• Compensation growth may be more incremental than in private ownership models.

Real-world example

Brett Coldiron, MD, FAAD, founded a small group practice after leaving academia in the 1990s. Over time, his Skin Cancer Center grew into a nationally recognized practice that treated more than 50,000 skin cancer patients. He saw firsthand how group practices have faced challenges, with declining insurance reimbursements and increasing consolidation. But he emphasizes the value of independence, control, and long-term earning potential in running his own group.

Early career advice

• Evaluate not just salary, but culture, growth potential, and clinical freedom.

• If joining a group, understand their long-term vision — are they staying independent or planning to sell?

• Consider the long-term income potential; while large groups may offer stability, owning a smaller group can lead to greater rewards.

• Learn from mentors and partners; group practices offer valuable exposure to diverse practice styles.

• If independence is important to you, consider starting in a group and transitioning to ownership later.

Related AAD resources

• Practice types: See our full menu of resources on practice types, from solo to institutional.

• Get started: Access our guide to getting started in practice, with resources on practice types and policies and procedures.

• Employment guide: See all our resources on contracts, questions for employers, and more.

This content was created with the particular needs of early-career dermatologists in mind. See the rest of our Career Launch resources for young physicians.