Not a neurologist but I am in private practice and I had PP colleagues who do general neurology and have a thriving practice .
The key is opening a practice in a convenient place near many internists . Convenience is key for getting these referrals. Patient volume is the key driver of revenue . You’ll want to be able to attract all the “crap consults” like nonspecific dizziness that fits nothing the neuro exam , “numbness” that fits nothing in the neuro exam , “weakness” that is really fatigue , and other point less referrals . But hey they pay the same a day complex consult. the small independent practices have EMG , MSK ultrasound and those trigger point injections , that peripheral nervous system sudomotor testing (not that I’m aware of any EBM use for that but hey it has a cpt code that pays) , and administering injections of those calcitonin receptor blocker meds for migraines and do the Botox injections as well. Despite using botox for like blpeharospams or something , some neurologist take cosmetic courses and advertise Botox for cosmetics. Hey nothing is stopping you from doing it if you get the training independently outside of residency or training . You can also always contract a mobile radiology center to do ultrasound in your office . Probably the relevant ones are carotid TCD and echo . You don’t get paid for those (radiology does) but you get a nominal fee from them for using your office space and in turn you can drive more follow up visits .
The larger independent practices do their own infusions for biologics for MS and bought their own MRI machine and hired their own neuroradiologists and that’s their money printing machine . The benefit of expanding to a larger practice (more partners ) is that you’ll be able to do hospital consults (which is meant to build follow up in the office ) without sacrificing office time and get more revenue to hire nurses for the infusions and eventually the ability to buy the MRI and hire the radiology staff .
Hope this helps . Bottom line these private practice neurologists do make bank but have to build up slowly at first and have to see many neurology referrals which should be psych referrals for somatic disorder .