Solo practice: The cheese stands alone. As do I, alone against the whims of vision plans; city, state and national taxes; each individual patient’s whims, flutters and flurries; staff members’ texts and cell calls; and lizards trapped in the foyer. (More on that later.)

Why would anyone ‘vahnt to be alone’? For me, it all started at Holmesburg Prison. Now, I’ve had my moments, but it’s not what you think. Pennsylvania College of Optometry had an eye clinic at Holmesburg. This was both a community outreach program and an opportunity to see many patients. Where else would you be able to learn such important private practice pearls as (a) how to make “jailhouse schoolboys,” and (b) what happens to eyes when one snorts day-old green peas to get high?

(Before you get misled, “jailhouse schoolboys” are not prison prom dates, but rather these cleverly constructed, foldable wire-rimmed glasses that the guys made in metal shop. The lenses were regular window glass. Oh, did I mention my experience in picking glass from corneas?)

A classmate asked me why I liked working at the prison clinic. It was because of this: If I ran screaming down the hallway, they had to open the gates and let me out.

This is the way I feel about private practice. If I run screaming down the hallway, they have to let me out. This has never actually happened, because my wife (who is also my office manager) is in charge of opening the gates. So, I’ve always resisted the impulse rather than face the Wrath of Renee. Even so, don’t think for one minute I haven’t at least thought about it.

When the economy was booming, many of my peers built multi-doctor, multi-location practices or invested heavily in new construction of glassy, sassy office buildings, monuments to their success. Me? I went from eight employees to two and moved into a small, but new and well-located, building with two little exam rooms. They told me I was crazy.

When the economy stalled, one of my grow-grow-grow colleagues called me and told me that my decision to downsize proved that I must be a “financial genius.” No. I just wanted life to be less hectic, that’s all. That’s the solo practice mentality.

There are PROS and CONS (pardon the prison reference) to any mode of practice. The PROS of flying solo include:

• Not putting up with twice the ego—unless of course you already have twice the ego, which is not too far off the mark for most of us in solo practice.
• Nobody eating your secret stash of cookies that you keep in the “doctor’s restroom.” (Renee never reads this stuff.)
• No pages torn out of the swimsuit issue, the only magazine that never makes it to the waiting room. (Again, I tell you that Renee never reads this column!)
• No time spent trying to calm down a patient who thinks your partner is an idiot.
• No heartache when a patient requests the partner because the patient thinks YOU are an idiot.

CONS include:

• When you’re on vacation, so is your income, a potential double-whammy when Renee finds that diamonds are “cheaper” in Jamaica.
• When the doctor forgets to call a patient, YOU are in fact the doctor who forgot to call the patient.
• When the phone rings at your house just as you finally get home from the office on Friday and the patient says, “On Wednesday, I got hit in the eye” … well, I will let you finish that sentence.

Solo practice is when the lizard, trapped in the foyer, runs screaming down the hallway, and you get to be the one who opens the door and lets him out!

Lucky lizard.