I would like to start to get things going to open my own practice, as I graduate from residency in 1 year. Where do I start? Can I start working in nursing homes or by doing house calls without having a physical office? Any advice would be appreciated!
Help! Where do you start when you want to open your own practice?
- Thread starter DrDMC
- Start date
You need to get your own malpractice insurance, like PICA. You should call the insurance companies that service your patients and let them know that you want to be on their provider list. You will need to provide a W-9 form for self employment, and also get a national provider number. Decide whether or not you wish to be a corporation and get a corporate tax no. or simply use your own social security number. Getting a good accountant is a great idea.
W
whiskers
In addition to previous poster and getting on ins plans etc
0.5 Don't smoke crack and don't do drugs. Don't be dishonest and don't fool around with your hot young secretary who will try to seduce you. In fact at 1st dont hire a secretary b/c you can't afford it probably.
With that said.
1. Where do you want to practice
2. Visit area/ visit with family docs in that area tell them of your intentions and ask if there is a demand.
2.5 visit hospital find out about credentialing etc
3. Figure out how you are going to finance this... you can do it for no loans to 500k in loans.. each case is different.
4. Buy a used chair and some necessary equipment /office supplies.
4.5 Buy/lease prime medical realestate.
5. buy supplies but don't go crazy on them
6. buy tiny yellow page advertisement.
7. Talk to locals about yourself. seem interested in them too. Join a church etc etc etc etc. (very important)
8 Don't be afraid to give out free advice.
9. The biggest thing is you will need at least 2k/month to pay bills and your own living expenses assuming you have 0 in school debt.
Remember that you won't see much surgery @ 1st and that biopsies of irregular lesions pays well and catches a lot of bad actors.
Taping and strapping is a good thing to bill as well. Make yourself out protocol cards for every common scenario and follow them for every patient. blah blah blah.
Always ask, is there anything else wrong with your feet. If you notice a lump or a bump ask about it and tell them you can treat it if it bothers them. etc Don't be pushy, be professional and tell them what you want them to do.
So much more to say.
If they got the flakes and are there for something else, ask if it itches and treat for tinea etc.
Always be on the look out for other pathology that you can treat even if they aren;t there for that. That;'s what they pay you for. In the beginning this is very impt. SInce you don't have many patients probably/ Diabetics are great because they usually have lots of pathology.
Consider, starting fresh vs buying out a old tymer.
I don't think I would pay any money for his patient lists b/c many may be dead or may have been a one time visit only. Plus they might not like you.
0.5 Don't smoke crack and don't do drugs. Don't be dishonest and don't fool around with your hot young secretary who will try to seduce you. In fact at 1st dont hire a secretary b/c you can't afford it probably.
With that said.
1. Where do you want to practice
2. Visit area/ visit with family docs in that area tell them of your intentions and ask if there is a demand.
2.5 visit hospital find out about credentialing etc
3. Figure out how you are going to finance this... you can do it for no loans to 500k in loans.. each case is different.
4. Buy a used chair and some necessary equipment /office supplies.
4.5 Buy/lease prime medical realestate.
5. buy supplies but don't go crazy on them
6. buy tiny yellow page advertisement.
7. Talk to locals about yourself. seem interested in them too. Join a church etc etc etc etc. (very important)
8 Don't be afraid to give out free advice.
9. The biggest thing is you will need at least 2k/month to pay bills and your own living expenses assuming you have 0 in school debt.
Remember that you won't see much surgery @ 1st and that biopsies of irregular lesions pays well and catches a lot of bad actors.
Taping and strapping is a good thing to bill as well. Make yourself out protocol cards for every common scenario and follow them for every patient. blah blah blah.
Always ask, is there anything else wrong with your feet. If you notice a lump or a bump ask about it and tell them you can treat it if it bothers them. etc Don't be pushy, be professional and tell them what you want them to do.
So much more to say.
If they got the flakes and are there for something else, ask if it itches and treat for tinea etc.
Always be on the look out for other pathology that you can treat even if they aren;t there for that. That;'s what they pay you for. In the beginning this is very impt. SInce you don't have many patients probably/ Diabetics are great because they usually have lots of pathology.
Consider, starting fresh vs buying out a old tymer.
I don't think I would pay any money for his patient lists b/c many may be dead or may have been a one time visit only. Plus they might not like you.
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It is imperative that you use an accountant that you trust. Do not attempt to juggle your finances without professional advice.
As previously stated, attempt to get on every insurance panel that you can in your geographic area. This will "put you in print". Insurance companies have directories they distribute to patients and on-line directories that are updated more often that patients refer to frequently.
Naturally, no patients can utilize your services if they don't know you exist. Therefore, you must let people know you're available to provide services. Go to hospital staff meetings and introduce yourself or start knocking on doors. It's something I didn't really like to do, but had to do to let myself be known.
Obtaining a nursing home is very difficult, but a great source of income. Meet with the director of nursing and ALWAYS make yourself available, even if it's to see one patient. Often, these facilities are owned by a large group that owns several facilities, therefore if the DON likes you, there is the possibility you can eventually be offered several more facilities.
Additionally, volunteering your time is a good way to get your name out in the public. Speak with local sports teams/high school coaches to offer your expertise or services at local events. You can lecture on specific sports injuries or offer your services at weekend games, etc.
See if there are any local running clubs and offer your services if there are any 5K or 10K races. Offer a weekend "shoe evaluation" or gait evaluation for the runners.
You've got to be creative. The idea is NOT to give away your services but to let people know you exist and let them know your value.
NEVER, NEVER bring a potential patient into your office with the "premise" that it will be a complimentary visit and then charge for that visit. Not only is that unethical, but it is fraudulent.
In the past, doctors used to advertise "Free initial consultation" and when patients showed up, IF they had good insurance the doctor would not bill the patient, but would often take x-rays, etc., and bill the insurance.
THAT is fraud.
So, I'm not advocating that you give away your services, but if for some reason you do decide to offer a "free screening" for runners, etc., than it must be simply a "free screening" with no strings attached.
On the other hand, you must let patients know that a screening does NOT involve an in-depth history, examination and treatment, but is simply a cursory exam to recommend further treatment or to let them know that no additional treatment is needed.
When I did this, I actually handed all the patients I screened a sheet explaining that it was simply a "screening" and that no treatment would be rendered so there was NO misunderstanding.
Get out and pound the pavement.....you can not provide your services if no one knows you exist.
As previously stated, attempt to get on every insurance panel that you can in your geographic area. This will "put you in print". Insurance companies have directories they distribute to patients and on-line directories that are updated more often that patients refer to frequently.
Naturally, no patients can utilize your services if they don't know you exist. Therefore, you must let people know you're available to provide services. Go to hospital staff meetings and introduce yourself or start knocking on doors. It's something I didn't really like to do, but had to do to let myself be known.
Obtaining a nursing home is very difficult, but a great source of income. Meet with the director of nursing and ALWAYS make yourself available, even if it's to see one patient. Often, these facilities are owned by a large group that owns several facilities, therefore if the DON likes you, there is the possibility you can eventually be offered several more facilities.
Additionally, volunteering your time is a good way to get your name out in the public. Speak with local sports teams/high school coaches to offer your expertise or services at local events. You can lecture on specific sports injuries or offer your services at weekend games, etc.
See if there are any local running clubs and offer your services if there are any 5K or 10K races. Offer a weekend "shoe evaluation" or gait evaluation for the runners.
You've got to be creative. The idea is NOT to give away your services but to let people know you exist and let them know your value.
NEVER, NEVER bring a potential patient into your office with the "premise" that it will be a complimentary visit and then charge for that visit. Not only is that unethical, but it is fraudulent.
In the past, doctors used to advertise "Free initial consultation" and when patients showed up, IF they had good insurance the doctor would not bill the patient, but would often take x-rays, etc., and bill the insurance.
THAT is fraud.
So, I'm not advocating that you give away your services, but if for some reason you do decide to offer a "free screening" for runners, etc., than it must be simply a "free screening" with no strings attached.
On the other hand, you must let patients know that a screening does NOT involve an in-depth history, examination and treatment, but is simply a cursory exam to recommend further treatment or to let them know that no additional treatment is needed.
When I did this, I actually handed all the patients I screened a sheet explaining that it was simply a "screening" and that no treatment would be rendered so there was NO misunderstanding.
Get out and pound the pavement.....you can not provide your services if no one knows you exist.
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What program are you coming out of and where are you looking to set up?
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Obtaining a nursing home is difficult because a lot of recent graduates are all getting similar advice and looking for a nursing home to supplement their income.
Many existing practices ALREADY have approached the nursing homes in their geographic area because these facilities are an excellent source of ancillary income, and many "older" practitioners that did not perform surgery actually counted on these facilities for a significant amount of their income, and had several nursing facilities that they "serviced" weekly.
These facilities have always been sought after by our profession. Those that were new to practice used them as a way to supplement their income while they built up a practice. Those that had an established practice used these facilities to EXPAND their practice and utilized associates, etc., to staff the facilities while bringing in a nice stream of income. Those that did not perform surgery or did not have busy offices often had a "collection" of these facilities that they traveled to and that served as an excellent boost to their income.
Nursing home/assisted living facility patients don't cancel appointments and are a "captured" audience. If it rains or snows they don't cancel. They don't cancel because their car won't start or they can't get a ride. They don't cancel because the train or bus is running late, etc., etc.
So, THAT's why obtaining a nursing home isn't always easy. There's often a LONG list of DPM's ahead of you waiting to get in the door.
Many existing practices ALREADY have approached the nursing homes in their geographic area because these facilities are an excellent source of ancillary income, and many "older" practitioners that did not perform surgery actually counted on these facilities for a significant amount of their income, and had several nursing facilities that they "serviced" weekly.
These facilities have always been sought after by our profession. Those that were new to practice used them as a way to supplement their income while they built up a practice. Those that had an established practice used these facilities to EXPAND their practice and utilized associates, etc., to staff the facilities while bringing in a nice stream of income. Those that did not perform surgery or did not have busy offices often had a "collection" of these facilities that they traveled to and that served as an excellent boost to their income.
Nursing home/assisted living facility patients don't cancel appointments and are a "captured" audience. If it rains or snows they don't cancel. They don't cancel because their car won't start or they can't get a ride. They don't cancel because the train or bus is running late, etc., etc.
So, THAT's why obtaining a nursing home isn't always easy. There's often a LONG list of DPM's ahead of you waiting to get in the door.
It can be difficult to get a nursing home. If you know of older pods looking to reduce their number of hours/week they may be willing to let go of a nursing home. You can ask around too. You can let your colleagues in the area know that you are willing to do house calls in the event that they get a house call that they do not wish to spend time on.
As more and more pods go the surgical route, make sure that the long term care facilities know that they are YOUR priority. Offer them 24/7 service, something that current pods who are only "supplementing" their businesses with do not offer. Always be courteous and available.
There are underserved areas of the USA that are in need of conservative care podiatry. It's very location dependent.
As more and more pods go the surgical route, make sure that the long term care facilities know that they are YOUR priority. Offer them 24/7 service, something that current pods who are only "supplementing" their businesses with do not offer. Always be courteous and available.
There are underserved areas of the USA that are in need of conservative care podiatry. It's very location dependent.
