BY ERIKA MCCARTHY, MMS SENIOR EDITOR AND WRITER
Image by andreswd via Getty Images.
Dr. Robert Gagnon
When Dr. Robert Gagnon looks back on the decision to open his own family medicine practice, what surprises him most isn't what went wrong — but how little actually did.
“I think the biggest thing was the fear of not knowing if it was going to work out,” he says. “And in hindsight, it’s a medical office. It’s going to work out.”
That realization has guided Dr. Gagnon for the past 30 years as the founder of Lakeville Family Medicine, where he has built a successful independent practice defined by autonomy, service, and deep community ties. His story offers practical advice for
physicians who are curious if private practice is a viable option for them.
From Hospital Employee to Practice Owner
After completing his training at Brown Medical School and serving three and a half years at an Air Force base, Dr. Gagnon arrived in southeastern Massachusetts in 1995. He spent his first five years working for Morton Hospital, then an independent community
hospital in Taunton.
“I was treated very well by the hospital,” he says. “I had no real complaints.” But a colleague’s repeated advice stuck with him: after covering staff and administrative costs, there was little left of the revenue he was generating.
“When you run your own practice,” his colleague told him, “that’s your money.”
With the hospital’s support, Dr. Gagnon made the leap. He took over the lease, purchased the equipment at appraisal value, and kept the same office and systems in place. For patients, the transition was almost invisible.
“It was seamless,” he says. “Patients didn’t even know we had changed ownership.”
Within six months, his modest startup loan was paid off.
The Business Side
Like many physicians, Dr. Gagnon had no formal business training. The prospect of running payroll, managing staff, and overseeing finances was intimidating at first.
“I was trained to take care of chest pain and bleeding,” he says. “I wasn’t trained to run a business.”
What he learned quickly, however, is that nearly everything can be delegated. Payroll went to an outside company. Administrative systems settled into predictable routines. Once established, the business side became manageable and far less time-consuming
than he had feared.
“I think new physicians overestimate how much time they’re going to spend on the business stuff,” he says. “Most of it runs itself.”
Still, there were lessons learned the hard way. Early on, Dr. Gagnon struggled to take time off, haunted by the idea of lost revenue.
“I’d be on vacation doing refills at night,” he recalls. “I had to learn that you have to step away, or you’ll go nuts.”
His advice now? Take the time. The practice will survive.
The Importance of Trusting the Right People
Central to the practice’s success was Dr. Gagnon’s decades-long partnership with his office manager, Ann, who worked with him from day one until last year.
“She was my office wife,” he says with a laugh. Their shorthand communication and mutual trust allowed the practice to function smoothly, even when Dr. Gagnon wasn’t physically present. It was a relationship his accountant father once summarized bluntly:
trust is essential, because control has limits.
“I’d rather trust someone and deal with a problem if it comes up than spend my life worrying,” Dr. Gagnon says.
Not all staffing decisions were easy. Letting go of long-term employees and making financially necessary changes were among the hardest leadership lessons he faced. But he emphasizes that avoiding those decisions only compounds the strain on a practice.
The Pivotal Decision
If opening his own practice was one leap of faith, buying his own building was another.
“It was probably the biggest financial decision I ever made,” Dr. Gagnon says. “Signing papers and saying, ‘I’m going to pay you for the next 20 years.’”
Designing and building out the space himself brought stress but also long-term stability and independence. Owning the real estate eliminated rising rent, difficult landlords, and uncertainty.
“It was the smartest thing I ever did,” he says, adding, “patients will follow you if you move locations. They are loyal to you, not a corporation.”
The Freedom to Practice Medicine
Ask Dr. Gagnon what made independent practice worth it, and the answer comes quickly: freedom.
He coached his children’s teams. He attended school events without requesting permission. He built his schedule around patient needs rather than productivity mandates. Same-day appointments remained sacred, even if it meant the occasional empty slot.
“If I have a 15-minute break, that’s fine,” he says. “Nobody is standing over me saying, ‘You have to fill it.’”
That flexibility also allowed him to prioritize relationships — something he believes is increasingly rare.
“I’ve had four generations of a family that I’ve taken care of — the baby, the mother, the grandmother, and the great-grandmother, all in the office at the same time,” he says. “I’m part of the community. That doesn’t happen when you bounce from job to
job every few years.”
He still makes the occasional house call. He still rounds on his own patients in the hospital. And he still finds joy in discovering the hidden histories of patients — like an elderly patient who once raced stock cars.
A Message to the Next Generation
Starting a practice is not without challenges. “There were times I skipped a paycheck and sometimes did not pay myself rent due to cash flow issues,” he says. “It hasn’t happened in a long time, but it did. And the pandemic was hard because applying for
government programs was a little daunting.”
Dr. Gagnon is also candid about the frustrations of modern medicine: checkboxes, electronic health records, and administrative requirements that feel disconnected from patient care. Those pressures, more than the work itself, have made him think about
retirement for the first time.
Yet his message to young physicians is clear.
“If doctors want control of medicine,” he says, “they have to take control of their own jobs.”
Independent practice, he insists, is not outdated, reckless, or unrealistic.
“I didn’t know anything about running a business,” he says. “And it worked out. You can do this. And you’ll love your job your entire career.”
