Solo Family Medicine Practice

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NuMD97

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This is tangent to another thread, but perhaps more specific: Besides garnering patients from the ED, how does one go about successfully establishing a solo practice? Or does one need to be in a group for "X" number of months till a patient base is sufficiently created and then go solo, or what other options are there?

This is primarily addressed to the FM attendings who monitor this board.

Thanks in advance for your replies,

Nu

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Not a FM, but I did start a solo practice a couple of years ago. It was not terribly difficult, but does require a lot of groundwork, a modest understanding of the business, and a moderate degree of comfort with debt.

First off -- an experienced and qualified consultant is invaluable. There are numerous legal, financial, regulatory, and sorted red tape mazes, each associated with varying degrees of pitfalls, involved. It takes a fair amount of time to accomplish everything, so it is best to start planning and implementing a good 12 months (preferably 18 although I did it in 7.5) in advance. I won't go into great detail about what the checklist is for that is beyond the scope of this discussion, and I believe that the main question was how to garner patients.

DO NOT join a group with the intentions of leaving after x months. You will create animosity and bad relationships with your peers, and it is just poor form. Not to mention that you do not have to operate in this fashion to make a go of it (and be successful).

Primary care has several advantages for starting up a solo shop over most specialties -- the vast majority of your patients are self referral (i.e. you do not have to break into already established referral patterns), a shortage exists in most locales, and it takes far fewer patients to compose a "full panel" being the first that come to mind. Once you have decided where you want to live, call around to the local MD's (in your specialty) posing as a patient in order to see how many are accepting new patients and what the wait times may be. You may want to consider mixing up the insurance base as well (sometimes be MC, BC/BS, MA, self-pay, etc) in order to guage how "truly" underserved an area is.

Once you feel comfortable that there is enough demand in your preferred geographic area you can start looking for office space. I would definitely lease at the beginning (in most cases indefinitely, but that is a point of contention and depends in large part upon the unique environs in which you will be practicing). Keep the space large enough that you do not feel cramped, but as small as possible to avoid paying too much lease. The same goes for the staff -- keep their numbers down as well.

Run an ad or two in the local papers prior to opening. This should generate a fair amount of calls, so be sure to not run the ad until you have someone ready to answer the phones.


There is a ton more, but you get the drift. Focus on cash flow at the beginning rather than just the [profit].

Year one will be lean (most likely), but you should be able to pick up and fly by mid year 2.
 
Not a FM, but I did start a solo practice a couple of years ago. It was not terribly difficult, but does require a lot of groundwork, a modest understanding of the business, and a moderate degree of comfort with debt.

First off -- an experienced and qualified consultant is invaluable. There are numerous legal, financial, regulatory, and sorted red tape mazes, each associated with varying degrees of pitfalls, involved. It takes a fair amount of time to accomplish everything, so it is best to start planning and implementing a good 12 months (preferably 18 although I did it in 7.5) in advance. I won't go into great detail about what the checklist is for that is beyond the scope of this discussion, and I believe that the main question was how to garner patients.

DO NOT join a group with the intentions of leaving after x months. You will create animosity and bad relationships with your peers, and it is just poor form. Not to mention that you do not have to operate in this fashion to make a go of it (and be successful).

Primary care has several advantages for starting up a solo shop over most specialties -- the vast majority of your patients are self referral (i.e. you do not have to break into already established referral patterns), a shortage exists in most locales, and it takes far fewer patients to compose a "full panel" being the first that come to mind. Once you have decided where you want to live, call around to the local MD's (in your specialty) posing as a patient in order to see how many are accepting new patients and what the wait times may be. You may want to consider mixing up the insurance base as well (sometimes be MC, BC/BS, MA, self-pay, etc) in order to guage how "truly" underserved an area is.

Once you feel comfortable that there is enough demand in your preferred geographic area you can start looking for office space. I would definitely lease at the beginning (in most cases indefinitely, but that is a point of contention and depends in large part upon the unique environs in which you will be practicing). Keep the space large enough that you do not feel cramped, but as small as possible to avoid paying too much lease. The same goes for the staff -- keep their numbers down as well.

Run an ad or two in the local papers prior to opening. This should generate a fair amount of calls, so be sure to not run the ad until you have someone ready to answer the phones.


There is a ton more, but you get the drift. Focus on cash flow at the beginning rather than just the [profit].

Year one will be lean (most likely), but you should be able to pick up and fly by mid year 2.

I very much appreciate you taking the time to so extensively reply to my query. The details that you provided are most helpful. You almost make it sound so simple. Obviously, one needs to do extensive research into this before one invests so much, but it is an interesting beginning.

Thanks for taking the time,

Nu
 
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I am interested in learning what that checklist is. Would you explain more? Thanks for your help.
 
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