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  • Starting a solo practice/micropractice

    I would love to hear anyone's experience in starting a solo practice. I am going to open my solo practice over the next 5-6 months as my contract with current employer is not being renewed. I plan on opening an Ophthalmology micro practice, meaning I will be doing all the work of a physician,technician, practice manager and hire a front desk person. I am following the guidelines of https://solobuildingblogs.com/
    This is an excellent website BTW. I truly believe this concept is very similar to the approach for personal finances. Minimize expenses, a Do it yourself approach to learn the ins and outs of the business, and figure stuff out yourself. I truly believe within 2 years I will make more money than my employed job, and in 3-5 years will be in the 80th percentile for compensation. All while spending more time with patients, seeing less patients, and having complete control of my schedule. I know it is going to be a ton of work and I am going to have some hard times the first few months, but I am optimistic that I can create the work/life balance that I really want, and get maximum return on my time invested.
    I am sort of amazed that more physicians do not consider this, I thought there was no way to do it with Ophthalmology given we gave expensive equipment/startup costs. For IM, psychiatry and others startup costs would be minimal. I hope to hear others experience
    Thanks

  • #2
    I don’t know what would be useful to say, but this is what I’ve done for the last 26 years as a psychiatrist.
    My Youtube channel: https://www.youtube.com/channel/UCFF...MwBiAAKd5N8qPg

    Comment


    • #3
      I did this for 31 years as OB/GYN. I shared some call. I think the key is to keep your overhead low. I certainly micromanaged my expenses. I controlled my schedule too.

      Comment


      • #4
        Good for you. That's awesome. I would do this if I wanted to do full time clinical outpatient, but I prefer teaching. It sounds like you are following the ideal medical practice movement principles, which is for primary care but many would I'm sure translate well to an ophtho practice as well.

        Keep us posted on your progress. I think it benefits all of us when docs break away from corporate medicine.

        Comment


        • #5
          Originally posted by familydocPA View Post
          Good for you. That's awesome. I would do this if I wanted to do full time clinical outpatient, but I prefer teaching. It sounds like you are following the ideal medical practice movement principles, which is for primary care but many would I'm sure translate well to an ophtho practice as well.

          Keep us posted on your progress. I think it benefits all of us when docs break away from corporate medicine.
          Thanks! I plan on keeping some sort of record/perhaps blog to keep track of the progress. Very nervous but ultimately excited

          Comment


          • #6
            Originally posted by saildawg View Post
            I would love to hear anyone's experience in starting a solo practice. I am going to open my solo practice over the next 5-6 months as my contract with current employer is not being renewed. I plan on opening an Ophthalmology micro practice, meaning I will be doing all the work of a physician,technician, practice manager and hire a front desk person. I am following the guidelines of https://solobuildingblogs.com/
            This is an excellent website BTW. I truly believe this concept is very similar to the approach for personal finances. Minimize expenses, a Do it yourself approach to learn the ins and outs of the business, and figure stuff out yourself. I truly believe within 2 years I will make more money than my employed job, and in 3-5 years will be in the 80th percentile for compensation. All while spending more time with patients, seeing less patients, and having complete control of my schedule. I know it is going to be a ton of work and I am going to have some hard times the first few months, but I am optimistic that I can create the work/life balance that I really want, and get maximum return on my time invested.
            I am sort of amazed that more physicians do not consider this, I thought there was no way to do it with Ophthalmology given we gave expensive equipment/startup costs. For IM, psychiatry and others startup costs would be minimal. I hope to hear others experience
            Thanks
            Just curious, how much equipment costs are we talking about?
            This is definitely common in psych. Just need someone to answer the phone for you. Wouldn't want to do that yourself I would think.

            Comment


            • #7
              Originally posted by childay View Post

              Just curious, how much equipment costs are we talking about?
              This is definitely common in psych. Just need someone to answer the phone for you. Wouldn't want to do that yourself I would think.
              I estimate my startup costs at $150,000, with about $120,000 being ophthalmic equipment. It can vary based on your needs, and could easily spend over $300,000 in equipment alone.

              Comment


              • #8
                Originally posted by saildawg View Post
                I would love to hear anyone's experience in starting a solo practice. I am going to open my solo practice over the next 5-6 months as my contract with current employer is not being renewed. I plan on opening an Ophthalmology micro practice, meaning I will be doing all the work of a physician,technician, practice manager and hire a front desk person. I am following the guidelines of https://solobuildingblogs.com/
                This is an excellent website BTW. I truly believe this concept is very similar to the approach for personal finances. Minimize expenses, a Do it yourself approach to learn the ins and outs of the business, and figure stuff out yourself. I truly believe within 2 years I will make more money than my employed job, and in 3-5 years will be in the 80th percentile for compensation. All while spending more time with patients, seeing less patients, and having complete control of my schedule. I know it is going to be a ton of work and I am going to have some hard times the first few months, but I am optimistic that I can create the work/life balance that I really want, and get maximum return on my time invested.
                I am sort of amazed that more physicians do not consider this, I thought there was no way to do it with Ophthalmology given we gave expensive equipment/startup costs. For IM, psychiatry and others startup costs would be minimal. I hope to hear others experience
                Thanks
                I have been solo for 20+ years and initially I had just 3 employees. Front desk/biller, medical assistant and a nurse. Bare bones. I did all the ancillary work - cleaning, paying invoices, depositing checks, payroll, computers and what not. In addition to office work and calls.

                The most important is thing is to bill correctly. Collect copays and deductibles up front. Use equipment for a long time rather than buying the latest. Develop a good reputation so that patients seek you out.

                Good luck.

                Comment


                • #9
                  Originally posted by Kamban View Post

                  I have been solo for 20+ years and initially I had just 3 employees. Front desk/biller, medical assistant and a nurse. Bare bones. I did all the ancillary work - cleaning, paying invoices, depositing checks, payroll, computers and what not. In addition to office work and calls.

                  The most important is thing is to bill correctly. Collect copays and deductibles up front. Use equipment for a long time rather than buying the latest. Develop a good reputation so that patients seek you out.

                  Good luck.
                  Very sound advice, in reading solobuildingblogs, they make the exact point of collecting upfront. Billing I will manage myself as EMR and PM software simplify the process. If something doesn't get paid I will learn from it and not make the same mistake twice. I plan on spending a large amount of my time learning best billing and collection practices while my patient numbers are small.

                  Comment


                  • #10
                    Are you going to DIY your bookkeeping? QuickBooks is what most practices (in my experience) use. Would just recommend a little training if you're handling payroll - QB is very easy to use and very easy to scr3w up. Try to find a CPA who has at least 1 ProAdvisor in house to do an occasional review and cleanup so you can be proactive and track profitability, tax projections, etc.

                    Good luck - this sounds like an exciting opportunity for you!
                    Our passion is protecting clients and others from predatory and ignorant advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

                    Comment


                    • #11
                      Originally posted by jfoxcpacfp View Post
                      Are you going to DIY your bookkeeping? QuickBooks is what most practices (in my experience) use. Would just recommend a little training if you're handling payroll - QB is very easy to use and very easy to scr3w up. Try to find a CPA who has at least 1 ProAdvisor in house to do an occasional review and cleanup so you can be proactive and track profitability, tax projections, etc.

                      Good luck - this sounds like an exciting opportunity for you!
                      Thanks, yes I was planning on using quickbooks. Thanks for the heads up

                      Comment


                      • #12
                        Good luck as you start your practice! Since your contract is not being renewed, are you going to stay in the same location you are currently practicing?

                        I separated from my partner (general IM practice) 6 years ago and the key to my success was:
                        1.) keeping as many of my existing patients as possible (writing a letter to your patients notifying them of you new practice is a great idea)
                        2.) keeping my referrals base from specialists in my area (in your case communicating with the PCP's who can refer patients to you)
                        3.) maintaining my current insurance contracts.

                        Comment


                        • #13
                          Originally posted by saildawg View Post

                          I estimate my startup costs at $150,000, with about $120,000 being ophthalmic equipment. It can vary based on your needs, and could easily spend over $300,000 in equipment alone.
                          Have you looked at used equipment? Could be a much cheaper option and things like old slit lamps are cheap and last forever.

                          Comment


                          • #14
                            Originally posted by ROC MD View Post
                            Good luck as you start your practice! Since your contract is not being renewed, are you going to stay in the same location you are currently practicing?

                            I separated from my partner (general IM practice) 6 years ago and the key to my success was:
                            1.) keeping as many of my existing patients as possible (writing a letter to your patients notifying them of you new practice is a great idea)
                            2.) keeping my referrals base from specialists in my area (in your case communicating with the PCP's who can refer patients to you)
                            3.) maintaining my current insurance contracts.
                            Good points
                            1)Staying in same area but have a non soliciting clause, I have arranged to be able to tell patients and my former practice will give my new adress if patients come in and ask
                            2)Yes I plan to do this, and target new ones based on my new practice philosophy
                            3) I am hoping to remain in a clinically integrated network from the local hospital. Medicare is still 70% of my business, but having good commercial still doesnt hurt

                            Comment


                            • #15
                              Originally posted by Yowza View Post

                              Have you looked at used equipment? Could be a much cheaper option and things like old slit lamps are cheap and last forever.
                              Yes I plan on purchasing all hardware used, but have reservations about getting HVF, OCT, and biometer used. Not because the machines themselves, but because of the software/computer components. If I can get a deal I will certainly do it.

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