Interview with Dr. Daniel Reich, Gastroenterologist in the Queens Area
By Campbell Helm for Sapient Health
This is Sapient Health’s series of interviews with young physicians who have created thriving independent practices, eschewing overtures from hospitals and PE-backed platforms to strike out on their own. Sapient Health Management is a New York–based ASC management company helping physicians build thriving, efficient, and patient-centered surgery centers. Our first interviewee is Dr. Daniel Reich, a Queens-Based gastroenterologist.
Who is Daniel Reich, MD, and why Medicine?
Dr. Daniel Reich always knew he wanted to be a doctor. The son of a surgeon, he admired his father’s work and was drawn to medicine early on. “I liked science and thought helping people was noble,” he recalls. Although he initially assumed he’d follow in his father’s surgical footsteps, he ultimately found himself drawn to gastroenterology, a specialty that better matched his pace and personality.
Now, after more than two decades in the field and a path that has taken him from early employment to private practice ownership and ASC partnership, Dr. Reich offers practical insight for GI fellows preparing to make the next step.
Training didn’t prepare him for practice.
“I wasn’t told much,” Dr. Reich says of his residency and fellowship. “None of the practical aspects of being a physician were taught, not coding, not billing, not business management.”
While training focused on clinical development, the post-fellowship fork in the road was clear: join a hospital system or enter private practice. Hospitals offered structure, guaranteed income, and security. But for Dr. Reich, the appeal of ownership outweighed the tradeoffs. “The idea that the better you are, the busier you’ll be, that was attractive to me.”
The path to private practice
Starting a solo practice straight out of training wasn’t realistic. With little capital and almost zero business experience, Dr. Reich didn’t have the funds to create his practice and bear the startup costs, nor the confidence that he could do so effectively. So Dr. Reich explored opportunities to join smaller groups, within commuting distance from home. He ended up joining a five-doctor practice, where he worked for three years before earning a partnership.
He acknowledges the benefits of hospitals and multispecialty groups, but also the structural limitations. “In those setups, the internists feed everyone, and specialists often take a backseat in compensation.”
For Dr. Reich, autonomy, control over his schedule, and the ability to grow based on performance were non-negotiable. “I wanted work-life balance and the ability to grow based on how hard I worked.”
What pushed him to go solo
After making partner, Dr. Reich began noticing the underlying issues in the practice’s financial structure: unclear revenue distribution and mismanaged overhead. “At first, I thought we could fix it. But I realized the problems were systemic.”
Leaving wasn’t easy. A restrictive covenant made the transition slow and difficult, but he ultimately negotiated a path out. “It took a while, but going out on my own was the best decision I ever made.”
Building from scratch
Going independent wasn’t without sacrifice. “Financially, you take a hit in the beginning. You go from making xx’ to half ‘x’ or less,” he recalls. But with the support of his family and a long-term vision, he kept at it.
He started sharing a small space with his father and hired a friend’s wife to help with credentialing and billing. Early patient flow came through platforms like ZocDoc. “It took a year or two to feel busy,” he says, “but eventually, I built something sustainable and profitable.”
Financial reality check
“I thought being the fifth guy in a group would be the peak of income,” Dr. Reich reflects. “But that’s only true if the group is run well with low overhead, smart billing, and ancillary income.”
He emphasized how overlooked ancillary income can be in physician circles. It may not replace your clinical earnings, but it can drive meaningful revenue with less effort if built into your practice thoughtfully.
“Some practices are inefficient and don’t realize it. That’s worse than knowing you’re underperforming,” he adds. “Once I was on my own, I made more in a couple of years than I ever did in the group and more than I ever would have.”
Private equity and hospitals? Not for him.
Dr. Reich is skeptical of private equity (PE) ownership. “It makes sense for a 65-year-old looking to retire soon. But at 51, I see 15–20 years of work ahead.” While PE offers an upfront cash check, that is offset by a decline in future earnings, not to mention the shackles of being an employee. “There’s a crossover point where you make more money not taking the deal – sure, you get a big check up front, but they make more off your work in the long run.”
He’s equally uninterested in hospital employment. “Sure, the hours might be better. But I don’t want a suit telling me how many vacation days I get.”
The business side of medicine
One of the strongest themes in Dr. Reich’s interview was the importance of understanding the business side of medicine. “Hospitals and vendors make money off your work. You need to understand ancillary income, anesthesia, pathology, and office ownership.”
He’s quick to point out: “It’s not greed, it’s business. If you're entrepreneurial, there are ways to maximize the value of the work you're already doing.”
Lessons that stuck with him
During his training, Dr. Reich was taught the importance of mastering the “three A’s”: be available, affable, and able. It’s a simple framework that stuck with him and continues to shape how he practices medicine.
Advice for new fellows
Dr. Reich believes strongly that trainees should approach medicine as both a practice and a business. “No one teaches you this part,” he says. “But you have to learn it.”
His advice, in addition to treating patients with care and respect:
Understand billing and overhead.
Don’t ignore ancillary income.
Think like an entrepreneur.
Build relationships and seek mentorship.
