I refuse

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Try thinking of it as an intern year for business. Be relaxed and don't work too hard since you aren't getting paid much anyways. Spend a year learning billing and asking lots of questions to the office manager. Look up the best advertising agencies and who does the best website hosting. Look for locations to open your own practice. Look at different EMR and billing agencies. You may find that one year of crappy pay has a few benefits.
 
p100 said:
Try thinking of it as an intern year for business. Be relaxed and don't work too hard since you aren't getting paid much anyways. Spend a year learning billing and asking lots of questions to the office manager. Look up the best advertising agencies and who does the best website hosting. Look for locations to open your own practice. Look at different EMR and billing agencies. You may find that one year of crappy pay has a few benefits.
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I agree. Find a "good" practice and learn a lot. Ideally a one doctor practice. With joining a solo practice, you will shoulder more responsibility however you will learn a lot. You need to learn both medicine and non-medicine aspect of running a practice before deciding to go solo.
 
JustAPedicurist said:
After many months on the job search with no success..I refuse to be taken advantage of out of residency. To the bank I go… for my business loan.

If we fail at least we went out swinging
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Cool. What’s the plan after the bank manager has to hold back laughter as he looks at your current debt + income and then says you don’t qualify for any loans?
 
Pronation said:
Cool. What’s the plan after the bank manager has to hold back laughter as he looks at your current debt + income and then says you don’t qualify for any loans?
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You could do it on 50k running real lean. Talk to Mike Crosby, he can outline a plan for you.
 
GreenHousePub said:
You could do it on 50k running real lean. Talk to Mike Crosby, he can outline a plan for you.
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This is possible if it's a cheap rent area, but you probably also want at least that much in LOC/savings just in case.
The other alternative is the part-time nursing homes or house calls or whatever to keep the lights on.

A decent staff member will eat up $5k or so in salary + benefits just on their own.
You don't want to be anywhere near that situation of missing payroll vs moving into the office.

p100 said:
Try thinking of it as an intern year for business. Be relaxed and don't work too hard since you aren't getting paid much anyways. Spend a year learning billing and asking lots of questions to the office manager. Look up the best advertising agencies and who does the best website hosting. Look for locations to open your own practice. Look at different EMR and billing agencies. You may find that one year of crappy pay has a few benefits.
Click to expand...
^^^Yes, this is the best way:
Learn a bit about office logistics and staffing and billing/coding, get some money saved, see how an office runs, practice marketing/networking, sometimes get a few connections in the area (assuming it's an area when non-competes don't hold up... Cali, NJ, DE, RI, NM, RI, others).

Fyi, if it's a state with weak non-competes, getting fired - as opposed to quitting when you depart - makes you a lot more able to litigate to stay in the area ("had no choice"), but that's a big risk to take. The best move is typically to do whatever you want (if non-competes don't hold up) or to go at least slightly outside the radius if it's a state where they're enforced.
 
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JustAPedicurist said:
After many months on the job search with no success..I refuse to be taken advantage of out of residency. To the bank I go… for my business loan.

If we fail at least we went out swinging
Click to expand...
Good luck. When I looked last year, they all required at least 1 or 2 years worth of experience outside of residency.

Even the predatory loan companies with huge interest rates will only offer a small amount that's not enough to get doors open, much less pay you enough to keep you afloat for a few months. This was also before banks started to get skittish as they have recently with interest rate increases and regional bank crashes.
 
Almost everyone I know that opened solo either had some significant savings, had a spouse with a good job, a well off family or just a normal family that lent money that was not really easy for them to give up that they needed paid back.

I have known some though to open an office with no help at all. They often looked for office sublets initially and did a lot of nursing home work or mobile podiatry work on of the side. You don't even need a podiatry chair or X-ray necessarily in the beginning. It is always ideal to sublet very close to the hospital if no X-ray.

Better to buy used equipment than max out your credit paying large notes on leases for new equipment in most cases.....unless it is a particular piece of equipment you are confident will pay for itself.

Sometimes nursing home work is low hanging easy fruit for the picking and they just want someone dependable to care for the residents and you can pick up your own facilities. Other times there are already doctors or companies that seem to have all the facilities locked down.

Sadly sometimes to pickup and keep facilities in saturated areas (always a bad idea to begin with) those in charge of deciding which podiatrist has the facility expects regular gift cards for you to have the privilege of making your riches.....I mean $20 on toenail trimming.
 
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A hand surgeon went out of business in my town recently. Lasted 2 years in private practice. Bought what was at least a $700K building. Gotta control costs. They left their 20 year hospital career behind to pursue greener grass. Interesting finding - they listed hand surgeons in town that their patients could follow-up with - there are of course more podiatrists in town than hand surgeons.

My big thing for people starting out and recognizing the tough territory is - don't do things that set you back.

-Don't get denied the area you have to be in by a non-compete
-Don't destroy good will / surgery center reputation etc somewhere you want to be
-619 isn't wrong - you have to control costs, especially staff.
-If you want to be a surgeon you have to find a job that gets you back in an OR
-Watch out for negative revenue ie. learn/understand how tail works.
-My big thing - watch out for payment arrangements that permanently take a percent of collections. Its one thing to pay Square 2.5% - that's a steal. Its another to have some arrangement where someone takes 9-12% off the top - forever. When prices are finite they decrease as a percentage of increasing revenue.
 
I highly recommend taking a PP job for a year to learn billing,coding and logistics. Find the best, least predatory practice you can and work your ass off to learn as much as you can the business side before venturing out on your own.
 
Dermato Fight Club said:
Call every podiatrist in the city you want to live in pretending you have an ingrown toenail. Whichever one can't cant you in same day or next day open up shop right across the street.
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"Hello I have an ingrown nail I want permanently removed, plantar wart and superficial hardware removed in office. Also I want to buy 3 pairs of orthotics. I pay cash. Can you get me in today?"
 
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Dermato Fight Club said:
Call every podiatrist in the city you want to live in pretending you have an ingrown toenail. Whichever one can't cant you in same day or next day open up shop right across the street.
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You’d need a way to hijack their referrals too though
 
Boba Foot said:
You’d need a way to hijack their referrals too though
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It is simple.

Patients call around and see who can get them in the same day or same week.

Also as a new pod in town, visit all the local PCPs and tell them you can get patients in same day or same week. PCPs office staff also call around trying to see who can see patient same day or same week for acute things such as ingrown nail, heel pain, infection, sprain etc. Even a simple corn wants to be seen the same day because the PCP thinks it's a wart that could kill the patient tonight.
I love those referrals and I am very happy to see them and treat it as urgent. This is the way you "hijack" the referrals since your office can see them say day or week and the other pod offices are booked out for weeks or months.
 
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