TRANSITIONS IN PRACTICE
DO YOU WANT MY HONEST THOUGHTS ? REFLECTIONS ON MY FIRST YEAR IN SOLO PRIVATE PRACTICE
AUTHOR Lori Williams , MD
Most physicians should not
start their own medical practices . You have too much to risk . If you have a reasonable working environment , tolerable co-workers and a steady stream of paying work , this article is not for you . I ’ m happy for you . You have been blessed . Continue on and heal others .
I never found what you have . I found bad contracts , overbearing office managers and inequitable compensation . I was not able to meet the demands of working for other people and the needs of my family . In my mid-40s I realized that no one was going to hire me for the job I wanted and needed . So , I opened my own office a year ago .
Starting a medical practice is a huge and exhausting undertaking . It is not for the faint of heart . Before making the leap , I suggest taking a moment to make sure you have asked yourself the following questions and answered them honestly .
Do you have the social support to take this huge risk of your time and money ? In the end , this may be the only question really worth discussing . I have a husband with a steady job and benefits . Can you live on loans for three years and figure out medical insurance ? Probably . Physicians have done it . They have built amazing practices . This always takes time . It will be three years until you are profitable . Count on it . Can you make the changes to your life that this requires ? Can you handle that stress ? On the other hand , can you use this as an opportunity to invest in yourself if you have the security to take the risk ? Look at your tax burden . Could you have some business losses at first and pay less tax ? These are great questions for an accountant with small business experience and your recent tax returns .
Do you have the steady temperament of a shopkeeper ? Can you give up extensive travel and other escapes that would keep you from being in the office and answering the phone ? It ’ s hard to run an
office when you are not in it quite a bit . Your office becomes your second home . Many physicians want more freedom . I understand that it is nice to be able to escape from the demands of patients and bills . What is the price of that for physicians ? We have lost control of how our practices run . Sometimes this ever-growing bureaucracy helps , and sometimes it controls and exhausts us and our patients . I don ’ t mind at all paying my bills and talking to patients on the phone . The answer to this question is different for every physician .
Are you willing to learn by making mistakes ? Are you willing to ask for help ? Starting a practice requires learning many things outside of medicine . It ’ s hard to accept that you must write a business plan and get a loan . You can learn to do this ( call the Small Business Alliance ). It ’ s miserable to realize you must recredential with insurance companies ( yes , it really can take six months to a year ). I had to buy a fax machine to even get started with this . Seriously . Physicians are not great at this process because we want it to be fair . It ’ s good training for dealing with suppliers and insurance claim denials down the road . It teaches patience .
You are not alone . Call me . Call your medical societies . The American Academy of Ophthalmology has been a lot of help now that I have figured out what I need . As physicians , we need to help and mentor each other . My co-resident opened a practice right out of training . I have asked him questions and visited his office to try to figure out how to do this . I am very grateful for his help . I ’ m happy to help you and pass this blessing on .
I opened my practice last October . The pandemic began closing businesses and schools in March . My office manager left . My babysitter quit . Every small business has questioned how to survive during this time of crisis . PPP loans . Unemployment . Patients too scared to come for needed medical care . We don ’ t get to pick the times we live in . Do the best you can . Despite all of this , I would do it all again . Having my own medical practice has been the best job I have ever had . Dr . Williams is a practicing ophthalmologist at La Vie en Rose Eye Care Specialists .
DECEMBER 2020 13