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Thursday, March 08, 2007

Going Solo?: Determine what is absolutely essential.

Opening your own medical practice is not cheap, even when done on the cheap. The real trick to keeping costs low is to question the need for anything and everything. Do you need 2 rooms or will 1 suffice? Do you need to purchase an electronic medical record or will paper work for now or can you build your own system? Do you need 2 staff members or can you function with one? I believe that this is the essence of the micropractice movement, first popularized by L Gordon Moore in primary care and on the specialist side, as I have been told, by The Independent Urologist (risking obvious shameless self-promotion).

When I left the safety of group practice I had one major constraint common to all start-up businesses: no money. That constraint forced me to question every thing I had been taught or had learned. Here are a few examples.

• I was told I would need at least 2000 square feet. I rented 1100.
• I was told I would need 3 phone lines, I took 1
• I was told I would need a staff of 3+ me. I have me + 1 other full timer.
• I was told I would need to start staff at $14/hr. I started at $9.
• I was told I would need people with experience. I hired people with none.
• I was told I would need a copier. I still don’t have one, 1 year later.
• I was told I would need an answering service. I haven’t.
• I was told to never give patients’ unfettered access to me. I do.

And on and on and on! When you do decide to go off on your own, it is imperative to question everything. Frankly, you’ll need to anyway or you’ll rack up huge debt and risk bankruptcy unnecessarily. It’s just a change in mindset, but it is an important one. Determine what is absolutely essential. And do that and only that.

Thanks, Dr S.