Small group practice (6-15 practitioners)

Small group practice overview

Small group dermatology practices typically consist of 2-10 physicians who work collaboratively under private ownership. These practices offer a middle ground between solo practice and large groups, combining the benefits of shared responsibility with greater autonomy. While still the most common practice setting in dermatology, small groups face increasing challenges from financial, technological, and market pressures.

Why dermatologists choose this

• More clinical freedom than large or corporate settings.

• Flexibility in scheduling, workflow, and practice style.

• Support from peers without the isolation of solo practice.

• Opportunities for collaboration and informal mentorship.

• Option to buy into ownership without starting from scratch.

How this model works

Employment and structure

Dermatologists in small groups may join as employees or associates with the potential for partnership. Ownership is typically physician-led, allowing for collaborative decision-making. Contracts vary widely but are often more personalized and negotiable than those in large or corporate models.

Patient care model

Care may span general medical, surgical, pediatric, and cosmetic dermatology, depending on the practice's focus. Clinicians typically manage their own patient panels and can tailor treatment approaches with minimal oversight. Referrals, billing codes, and procedural offerings are often determined by the physicians themselves.

Administrative support

Small groups may employ administrative staff to handle billing, scheduling, HR, and compliance, but physicians may still be involved in management decisions. Without centralized corporate infrastructure, tasks like marketing, supply ordering, and vendor relationships often fall to physician leadership or shared team roles.

Compensation and incentives

Compensation models vary, from base salaries to collections-based pay, with many practices offering productivity bonuses and eventual profit sharing. Benefits such as CME stipends, malpractice insurance, and health plans are common but may not be as extensive as those in hospital-employed roles. Over time, ownership in the practice can lead to higher earning potential than employed models.

Technology and operations

Small group practices must manage their own EHR systems, ensure HIPAA and OSHA compliance, and maintain their digital presence through websites, patient portals, and online scheduling. Marketing efforts such as social media are often handled in-house. Clinical documentation, prior authorizations, and digital communication with patients can add non-clinical workload, and maintaining a steady new patient flow is critical to sustaining growth and visibility

Career growth

Advancement in small groups may involve partnership tracks, expanded procedural offerings, or clinical leadership roles. While there’s often less emphasis on administrative hierarchy, physicians have greater input into how the practice grows and evolves. This model allows for personal and professional alignment with the practice’s mission.

When this model makes sense

• For dermatologists who want more autonomy without the burden of solo ownership.

• When you value close collaboration and a personalized work environment.

• If you’re looking for a balance between income, flexibility, and clinical freedom.

• Ideal for early-career physicians who want mentorship and eventual ownership opportunities.

Success factors

• Join a practice with a culture of openness and shared decision-making.

• Ensure clarity on expectations around compensation, partnership, and patient volume.

• Understand the scope of your administrative involvement and related demands.

• Ask about billing practices, EHR systems, and cosmetic service offerings.

• Plan for long-term growth by exploring ownership options and future exit strategies.

Potential challenges

• More hands-on involvement in business operations than in large groups.

• Administrative support may be limited or uneven across functions.

• Income can fluctuate based on collections and payer reimbursement trends.

• Buy-in or ownership terms may not be clearly defined upfront.

• Increased competition from larger groups and private equity firms.

Real-world example

Danette D. Bentley, MD, FAAD, a dermatologist at Pure Dermatology and Aesthetics, chose a small group setting because she didn’t want the full burden of running her own business. She valued having another physician to collaborate with, especially early in her career when she had many questions — from billing to patient management. Dr. Bentley emphasizes the importance of joining a practice where at least one colleague is approachable and willing to mentor: “I was fortunate to work with a doctor who was knowledgeable and approachable. I asked her everything.”

Early career advice

• Ask how the practice plans to adapt to industry changes, such as tech demands and declining reimbursement.

• Get clarity on the timeline and terms for partnership or ownership, if that’s a long-term goal.

• Inquire about how cosmetic services are integrated and marketed.

• Make sure you understand what level of administrative involvement the practice expects.

• Choose a setting where mentorship is accessible and team culture is a good fit.

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.