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10 Things to Worry About When Starting a Practice

Discussion in 'Doctors Cafe' started by Hadeel Abdelkariem, Nov 30, 2019.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

    Apr 1, 2018
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    With entrepreneurs on the cover of nearly every money magazine these days, the allure of being your own boss has never been stronger. Though doctors can’t spend their days working in pajamas from the comfort of their couches, they can venture into private practice. If you think you can handle private practice, here are 10 things you’re going to need to worry about if you’re starting a practice of your own.


    Patient retention
    Perhaps your most pressing concern should be how many patients you will retain. Sure, you can obtain new patients. But that’s going to take time. If you want to have steady income in the beginning, you’re going to need some patients to move along with you to your new practice. If you’re a physician who has been in a group practice for a while and you’re good at what you do, some patients will likely follow you. These patients will be your economic life raft while your practice grows.

    What services will you offer in your new practice? If you’re a dermatologist, will you include botox, dermabrasion, or liposuction? What other elective procedures? If you’re a primary care physician, will you be drawing blood in house or sending patients to a lab? Know what you’re going to offer and specifically what you’re going to charge for it.

    After you have an idea of what you want to do, you need to make sure that there’s a demand for those services. The income demographics of your current and prospective patients will likely shape your practice. For example, if you’re in a city full of Millennials and Generation Z-ers, something like direct primary care might be a good option. Or, if you’re in a wealthier suburb with baby boomers, perhaps they would appreciate the white glove service of concierge medicine. Elective procedures and services are also likely to be in higher demand where there is money.

    Now that you’re certain your services will be in demand in your chosen market, you need to select where you want your practice to be. The physical location of your new practice is key. Parking and accessibility are priorities. If you’re offering elective procedures, you’ll want to be in a high-traffic area with a sleek-looking exterior. Ideally, you also want your practice to be easy to find. Visibility from major thoroughfares will ensure that patients don’t drive past you and arrive on time. You also don’t want to be too close to your competition. Setting up shop in a crowded market will add another level of difficulty to profitability.

    Office team
    It takes a village, doctor. You’re going to need some support. Carefully screen potential candidates to help manage your office and your schedule. Avoid hiring members of your family. It’s generally ill-advised to hire somebody that you cannot fire. While you’re at it, you might want to brush up on your conflict resolution skills so you’re prepared to deal with that inevitability. Perhaps one of the most critical hires will be the person at the front desk handling patient intake and answering the phone. This is the face and voice of your practice. Putting someone with poor customer service skills in this position is a recipe for dissatisfaction.

    What days will you work and when do you want to see patients? Markets full of busy professionals will want appointments before and after 9-5 office hours. Senior populations tend to be available throughout the day. If you’re a surgeon, you’ll also need to strategically account for your OR days and rounding on patients.

    Are you prepared to market your practice, or pay somebody else to do it? This step is likely more important for doctors offering elective services or procedures. However, primary care providers do not get a pass. Prospective patients will certainly check out your online presence. That means social media especially needs to feature prominently in your efforts, as does reputation management. But be mindful of HIPAA compliance.

    EHR system
    Good EHR system is a bit of an oxymoron. But at the very least, you’ll want to find one that keeps headaches to a minimum and integrates seamlessly with your billing. Your EHR system must be HIPAA compliant and ONC-Certified. You’ll also want to make sure that whatever system you purchase comes with an elite level of support service for when it inevitably crashes.

    After selecting your EHR system, you’ll want to make sure that you can keep all of that patient data safe. Hiring a cybersecurity firm that specializes in healthcare will help. In addition to ensuring that you have a secure hosting solution, good cybersecurity experts will ensure that you have a proper firewall in place, that your office WiFi networks are closed, and that all office computers and devices a properly protected.

    Support staff
    You want to stay in good standing with the law and the IRS. Therefore, you’re going to need a good accountant and attorney. Don’t cut corners here. An expert we spoke to for an earlier post says you’re going to want an attorney and an accountant that specialize in healthcare. Here’s why.

    So, you know you have what it takes to go into private practice. Now you need to make sure you take care of these 10 things:

    • Patient retention from your old practice
    • Services you’ll offer
    • Demographics of your locale
    • Physical location of your practice
    • The team that will staff your office
    • Your schedule
    • How you will market your practice
    • The EHR system you’ll use
    • How you’ll keep your patient data secure
    • Who your lawyer and CPA will be

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