Opening a solo practice

[dr_ankle]

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Hello everyone,

I am in the process of opening my own solo practice, and wanted to see if anyone would have some advise for opening on their own. I decided at this point not to purchase an existing practice, as I have heard some not so great stories from friends who had done it and got burned (shady billing, medicare issues, etc). Also if anyone is willing to share how much they had to invest initially to open a practice, that would be greatly appreciated. I am looking to open a standard practice, a mix of some surgeries/mostly in office stuff. I am not necessarily concentrating on one particular area of podiatry. I already have a credentialing company working for credentialing, so I can be ready to start as soon as I have secured a location, but I want to make sure I am not missing any important points along the way.

Thanks

edit: Also, if there is anything that you did not expect while opening that you wish you knew beforehand, that would be very beneficial also

 

[wysdoc]

I'm going to send you to a thread where @Feli documents their process over time Costs and figures... startup Solo podiatry office

 

[dr_ankle]

I'm going to send you to a thread where @Feli documents their process over time Costs and figures... startup Solo podiatry office

Thanks! appreciate it 👍

 

[heybrother]

I'm working on a huge post on it, but my starting advice is just - ask AI to write you a huge plan. Its worth doing, but it will consume your life. I'm like 3-4 months into a new practice and am finally getting to the point where I don't have something new to work on every day.

My presumption if you are credentialing is you have already formed a LLC/PC, applied for EIN, written to the IRS for S-Corp, NPI2. Not sure the logistics of doing 855i with CMS/PECOS if you don't have a location yet. Real estate, liability insurance, malpractice insurance.

My advice is to starting doing your accounting/book keeping asap. I was months in before I got Xero and it took a lot of work/training/trying to get it right and learn it and its a lot easier to just be adding your receipts along the way instead of adding them from an Excel after the fact.

You'll be tempted to buy used equipment. It saves money, but it can blow up in your face. I just had a used Midmark chair I bought crap out and it was my "good chair".

I used PICA or whatever its called for my malpractice to avoid paying tail, but it turns out you can just switch from one malpractice to another so that's something to think about.

Realize that when you pay staff you have to pay their taxes also so don't just think payroll is $dollars-per-hour x hour. There's always going to be more to it.

Read up on 835s, ERA, EFTs, Medicare Advantage, copays, etc. Helps to know your local plans. Helps to understand what a good rate is. Know that you are going to have to negotiate - maybe your credentialing company does it for you. Some people are big believers in that - I'm not. No one cares more about your practice than you do. Use AI to write your internal company HR documents. Recognize you are supposed to have lots of plans for things like exposures to sharps, chemicals, etc.

Don't buy anything from a medical supply company until you speak to the rep they assign you. After I made a purchase the rep went through and dropped the prices on a bunch of the supplies I bought to make it competitive.