Should you start your own practice and be an entrepreneur or should you seek hospital employment? 

For some physicians, the answer is crystal clear – you want to start your own practice. You want more autonomy to make decisions that will allow you to take better care of your patients. Starting a medical practice can be the most rewarding undertaking you ever experienced, but it can also be exceedingly challenging. 

Starting a practice should begin months before a healthcare provider finishes his/her residency or decides to leave the employment of a hospital or another group. Do not put yourself in a position of urgency. As motivated as you may be to get your practice up and running, you will need to rely on the help of others who will likely not share your sense of urgency.

If you don’t have 6 months to devote to starting your practice, you take the risk of having to see patients gratis if you intend on participating with third-party payers.

If you intend to open a concierge practice, the time-consuming credentialing process will not slow down the progression, but you will still have to contend with multiple individuals and organizations (real estate, construction, lenders, technology, communications) to complete the project.

Healthcare providers who can start a new business without a lender are rare. Undercapitalization is the number one reason for business failure. Too little money can sink your practice, but too much or the wrong kind of money can be just as detrimental. 

A business plan is important in obtaining funding and making future decisions about how the practice will run. 

What services will you offer? 

What amount of space will you need and how can you best utilize this space?

What insurance payer mix will make you most profitable?

How much will your EHR/PM cost?

How will you market your practice? 

Projecting to the closest dollar amount to your revenue expectations, and then creating a list of all potential expenses, will help you determine a loan amount. 

Project the expenses for what you will need before you open the doors, after you open the doors, and operating expenses for the first year, to include equipment as well as consulting expertise (attorney, accountant, medical business advisor).

Being able to project the worst, most likely, and best-case scenarios, shows you understand the landscape of your business. With 2 years of tax statements and a Personal Financial Statement, you are ready to speak with a lender.

Recruiting and hiring is a skill. Hire highly motivated staff that are as invested in your success as you are. Until you are certain that an individual can understand, demonstrate, and abide by your vision and values 100% of the time, do not offer them a job. If the environment is a fast-paced practice, hire staff that are self-motivated and can keep up with you. Hiring the wrong people can be extremely expensive considering how much you will invest in them to learn your software systems, equipment, and workflow processes. More importantly, surrounding yourself with the right people will make the patients’ experience more positive. No one has more time, energy or money invested than you, so it is vital to make a consistent evaluation of your staff.

Improving patient care with proper use of technology is exciting. The industry understands that the EHR is necessary to bring these improvements to fruition. The good news is you have likely been through the use of an EHR. The bad news is there are 100+ choices when seeking an EHR, ranging in quality, functionality, and price. As you prepare to open your practice, it is vital to choose software that works best for you and meets your future growth requirements. The proper choice now can save you tens of thousands of dollars over the life of your practice and make your daily work manageable.

Important questions to consider when purchasing/leasing an EHR provider:

How long has the company been in business?

What do they put into R&D each year?

Do they have providers of your specialty using their software? 

Can you speak with their customers?

Do they customize templates and are there additional costs when changing these?

Do you host the system or is the software cloud-based?

Can you expand the system and what is the cost? 

Many EHR products include the Practice Mgt. system with billing software, scheduling, and demographics. Each piece is important, leveraging the technology in a way that appears seamless to the patient.

Healthcare providers don’t like this phrase, but it is the truth. Yes, patient care comes first and foremost but without having a sound business plan and structure in place, it is very difficult to properly serve the patients you see. Problems and success compound with every decision you make. Having a sound and executed business plan can mean the difference in creating a better patient experience, allowing for better equipment and hiring of competent and vested staff. All of these decisions lead to having a successful career.