Published: March 1, 2024

Solving the Private Practice Puzzle: An Interview with Mary T. Mitskavich, MD

Investing in and preserving the future of private practice through Academy leadership and generosity.

Mary T. Mitskavich, MD, current Treasurer of the AAO-HNS Otolaryngology Private Practice Section (OPPS) and founding Vice-Chair of the Private Practice Study Group (now OPPS).Mary T. Mitskavich, MD, current Treasurer of the AAO-HNS Otolaryngology Private Practice Section (OPPS) and founding Vice-Chair of the Private Practice Study Group (now OPPS).Mary T. Mitskavich, MD, is a private practice otolaryngologist at Coastal Ear, Nose, and Throat, LLC in New Jersey, of which she is the founder and managing partner. She is also the Treasurer of the Academy’s new Otolaryngology Private Practice Section (OPPS).

Having achieved her own success in navigating private practice, Dr. Mitskavich has chosen to give back to the otolaryngology community with her time, leadership, and expertise as well as through a recent, generous $200,000 donation to the Academy.

She was instrumental in the successful transition of the Private Practice Study Group to section status, serving as the founding Vice-Chair and was subsequently elected as the inaugural Treasurer of OPPS. The OPPS has flourished since inception at last year’s AAO-HNSF Annual Meeting & OTO Experience and will be leading the upcoming first OTO FORUM in April. “My most gratifying commitment has been the time spent with the Academy. The selfless dedication of the members is inspiring. This donation is an investment in the future of private practice,” she said.

“We must advocate for private practice before it is swallowed up by hospitals, insurance companies, or private equity,” she said. “We need to focus on getting medical students and residents interested in private practice. We must nurture the next generation of private practice leaders.”

"Collective action is needed. I ask that all members give what they can, whether it is your time or donations, to keep up the momentum.”

Some of Dr. Mitskavich’s donated funds will support 15 resident travel grants to the Spring OTO FORUM. (Those interested in applying for a travel grant should contact to learn more.)

Her Path to Private Practice

Prior to attending medical school at the University of Pittsburgh, she worked as a pharmacist.

After graduating from the University of Pittsburgh residency program, Dr. Mitskavich worked at two private practices, but soon decided she wanted to open her own. Since then, and not without a fair share of challenges, her practice has grown to include 10 physicians, three offices, and a surgery center.

“I was drawn to the challenge of operating a private practice. The rewards in terms of autonomy and agility more than make up for the challenges,” said Dr. Mitskavich.

Opening a practice is a huge undertaking, and the work isn’t done once the office opens its doors.

“I just remember putting a business plan together, donning my best suit, briefcase in hand, and going to the bank to try to secure a loan to start a practice. Only then did I learn that my husband and I didn't have the collateral for a loan,” she recalled. Dr. Mitskavich ended up using 6-month interest-free credit cards to get her practice off the ground.

Still, there was more to do. Fortunately Dr. Mitskavich knew the demographicsFinding an office and staff, getting credentialed with insurance payers, setting up a digital medical record system, and managing a proper revenue cycle were all complicated pieces in the puzzle of starting up a new practice.

Once it started, though, the practice kept growing. Coastal Ear, Nose, and Throat now handles a wide scope of otolaryngologic pathology, including neurotology, head and neck, rhinology, plastics, and pediatrics.

Lessons Learned

Recounting all the things she had to learn starting out in private practice, Dr. Mitskavich has plenty of advice, especially to other women physicians. She stresses being your own advocate and asking the difficult questions, even when it is uncomfortable.

“When I was looking for my first positions, I didn’t ask about financials, call equity, direct care patient expectations, payer mix, a list of providers that had left, and if I could speak with them. If I had asked the right questions, my initial path forward may have been different,” she said.

She stressed the importance of being persistent and not giving up when you hit obstacles. Starting a practice is often not a straightforward journey, and sometimes you have to learn from your mistakes.

Resources for Private Practice Success

Dr. Mitskavich wishes that all the resources that the Academy and other organizations now provide existed when she was starting out. Despite the arguably more difficult landscape of starting a private practice today, she finds OPPS resources like their ENT Connect forum, sessions at the AAO-HNSF Annual Meeting & OTO EXPO, and webinars useful­­—even as a seasoned professional.

She is particularly excited about the inaugural AAO-HNSF OTO FORUM, April 5–6, in Alexandria, Virginia, which she recommends to anyone involved with or interested in private practice. The practical knowledge and networking opportunities will make it worth the trip.

Despite the challenges associated with private practice, Dr. Mitskavich shared her hope that other otolaryngologists will choose this path going forward.

“I believe in the power of private practice to survive and thrive,” said Dr. Mitskavich.

More from March 2024 – Vol. 43, No. 3