MORE LESSONS LEARNED
Promote yourself, they advise. Let’s say you’re moonlighting at
an urgent-care clinic. Maybe you’re seeing patients who need to
monitor chronic health conditions – and who don’t have a primary-
care physician. So refer them to a good one: you. “Come see me at
my regular office,” you can tell them.
Be creative. “We have what’s called a hybrid model,” Visser said.
“We take insurance, and then we have a separate concierge practice.
Patients can pay a membership fee for that, and they get access to
us – like our cellphone, same-day appointments, stuff like that.
The medicine is the same for every patient, but concierge patients
get a little more access and availability.” It’s more personalized,
Langley said: “A lot of patients like to be able to text or email us,
just to put their minds at ease. It doesn’t always require a visit. The
nice thing, though, is it allows a little bit of breathing room on the
main side of our practice to not see as many patients.” So they and
their three fellow providers can average about 15 patients a day,
rather than 25.
Don’t be afraid of making mistakes. “We were young and had time
and just made mistakes – that was kind of our thing,” Visser said.
“So we made mistakes, learned, moved on. Made more mistakes,
moved on. We kept doing that till we figured it out. But I like now
that I know these things, so if I want to hire somebody and they’re
doing something, I can see if they’re doing it the right way.”
Langley
Adapt, rather than grumble about new rules and regulations.
put together a three-year plan and gave it to the bank, and they wanted to “Right now,” Visser said, “to start a practice, you’re going to have
give us money!” to partner in these large groups to keep track of data for Medicare,
“When we started,” Langley said, “what we wanted from the bank is for all the health insurance plans, because most of our payments
about half of what we received. So, because there are two of us, and our are going to be based on the data we’re collecting: Are people
budget required a salary for two docs, we learned very quickly that if we getting their colonoscopies? Are their sugars good? Are their blood
didn’t moonlight” – that is, work extra M.D. jobs – “we wouldn’t survive. pressures good? That’s going to dictate whether our rates go up,
At one point, we ended up working at six different locations.” down, stay the same. We have to collect that data somehow, and
In fact, they still do a bit of moonlighting. we have to submit it somehow. We’ve partnered with some systems
“We started a practice almost right out of residency, so we didn’t have that do data collection for us. We pay a small fee, but it’s definitely
time to save,” Visser said. “We tried partnering with a hospital and then worth it. If you can’t figure out how to change with the market,
went to the bank. If we were to do it again, I would probably take out the you’re going to get paid less. You’re going to see more patients,
minimum from the bank and moonlight sooner than we did to reduce debt. you’re going to get more stressed out, and you’re going to burn out.
“When we started we had five patients a week for a few weeks, and we
We don’t want that.”
hadn’t gotten on insurance plans. I mean, we were making nothing for the
first few months. Going through those tough times and learning on the go
gave us some great knowledge not taught in medical school or residency.
“We’ve been open for six years now and just expanded into a new
building with five full-time providers. We’re happy where we are right now
and look forward to continuing to grow.”
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