Jerry was a successful OB/GYN on 61st Street in Manhattan. He would go to work each morning with a bagel and coffee in hand and walk briskly to his office. While he was there, he saw his patients, gave his opinion to drug companies over the phone, and vacuumed his own office every night. He covered his desk between jobs. He was making $2000.00 an hour and teaching at the hospital to cover his medical malpractice insurance. He was a television doctor and frequently appeared on major network morning shows. His clientele included supermodel Naomi Campbell, wealthy Long Island housewives, and all the ladies at Bloomingdale’s.

He lived in a three-million-dollar row house with his wife, a tax attorney, and dined every night at any restaurant of his choosing, but it always ended with drinks at Gino’s with Harry Winston’s brother, while celebrities like Gwyneth Paltrow They dined in the back of the restaurant. He was married several times and had about 150 suits in his closet. He always took the subway or the bus and never took a taxi. He once received an expensive watch from one of his patients for saving his life.

He would always get financial statements in the mail which Bobby, his receptionist, would always check and then tell everyone how rich he was. His children were successful professionals and he was involved in many businesses, including McDonald’s franchises and telecommunications businesses. He rented out his office to two other doctors and berated himself for not buying the building when he had the chance. He was well respected by everyone and had a great sense of humor, but how did he get into this lifestyle? It was not easy.

He began his life as an immigrant child with seven siblings living in a tenement in New Jersey. His father was a merchant and the children took turns dressing for school around the kitchen oven. There was never enough food to eat. Anyway, he was a good student and when he wanted to go to university, the army paid for it and he in turn paid the army with his time in Korea, where he was a surgeon.

When he came back to the US, he had a job where he had to work with a nurse who was drunk all the time. She was so miserable that she saved all her paychecks and she told me that she used to live on tomato soup. She would take the ketchup packets and put them in a saucepan of water and that would be dinner. Eventually, she saved enough money to open her own practice and get out of the daily grind with people she didn’t want to work with. Every time she saw Jerry, she always asked me “Did you eat?” That was always foremost on her mind, having enough to eat, even if she was a hot crusty bagel or the street vendor.

Now, to get back on topic, the best way to establish your own practice is to get a job…you may be saying “What? That doesn’t make any sense.” If she does. You need to get a hospital job or a similar job that pays for your malpractice insurance. This is a significant disadvantage that can come between you and opening your own practice. The average cost of malpractice insurance is at least $35,000.00. If you can get the hospital to pay for you, then you have discharged serious debt. Even if your parents are going to finance your own practice for you, who will come? How will they pay you? You still need a job to round up clients, get credentials, and offload the cost of your malpractice insurance onto someone else. You are the survivor. This is the most practical solution.

Ideally, you should have 2-3 jobs. Your job at the hospital to cover the cost of your insurance, your job at someone else’s practice so you can build a relationship with patients, get a paycheck you’ll save for your practice, and get credentialed with insurance companies. If you are daring and after you are established, you can decide not to take any insurance at all. You may find that you earn much more money, faster and with less hassle. Then there is your practice. When the time is right, which means you have your financing in order, have established a good relationship with patients, and are cleared by as many insurance companies as possible, then you can switch to your own practice. You’ll phase out work at someone else’s practice and let patients know where you’ll be moving. He should have built up savings, taken out a loan from a loan company, and made friends with his patients. Any free time will be spent building your practice. Make sure telling patients about your practice doesn’t violate any non-compete or non-solicitation agreements you may have. Better not to sign those things from the beginning if possible. Try to look to the future with the decisions you make. His goal is not to rush, but to make this a turnaround project that has a schedule of about 9 months, yet another reason to have multiple jobs. This also prevents calamity.

Use your attorney to open your personal corporation and negotiate your commercial lease, you can also use your attorney as a real estate agent or just use a real estate agent. You need an objective opinion on the location and appearance of your new office. The three most important words in real estate… location, location, location. They will see things you don’t see, like accessibility. You should also do your homework on the demographics of your potential location and whether you can see another doctor in your specialty. The litmus test is knowing the waiting time for a date with other competitors. If the waiting time is more than two weeks, there is room for another doctor.

Another hurdle to overcome is not having enough money for unexpected expenses. You may have credit, but you’ll need to save a lot of cash for office-related expenses like computers, software, medical equipment, and staff. Try to get as much as possible on credit and use your loan money for the rest. Staffing is very expensive, so it’s best to avoid it when starting out.

Advertising for interns, business interns and doctors. Use them as a medical assistant, nursing intern for a nurse, business intern for administrative work, and to answer the phones. If you have to pay an employee, make sure you have their payroll money each and every week, otherwise you will have difficult problems to solve. Using interns is the best way to find new recruits, you can test the waters before making a bad hiring decision.

To do office rental, be sure to rent your office when you are not there for other doctors. Even if you don’t need it, it’s best to do it when you’re just starting your practice. You want to ensure success.

If your practice is small and you want to minimize salary and benefit costs, you may consider streamlining your billing and collections functions by selecting practice management system software that handles revenue cycle management and medical records, as well as filing. of claims, such as SkyEMR. Enable patients to use the Internet to request appointments, provide demographic information, manage prescription requests, obtain lab and other test results, pay bills online, and perform other administrative functions that can be performed through the appropriate EMR software.

You should review your numbers and project the following elements:

Patient Care Income: Admission Days Outstanding, Days Outstanding Payment, Units of Service, Payers, Estimated Gross/Net Income, Contract Allowance and Bad Debt Allowance, Other Sources of Income.

Expenses: accounting, contributions and public relations, consulting fees, continuing medical education, due dates/subscriptions/books, capital equipment, equipment rental, general insurance, information technology support (for both start-up and ongoing support), malpractice insurance if applicable, lab fees, legal services, maintenance/repairs/cleaning (do it yourself), marketing and advertising, medical supplies, office supplies, postage, rental/lease charges, salary/ salary/benefits, taxes, phone/telecommunications, travel, interest, depreciation, monthly medical retirement, professional services, website, other expenses. You can also hire a graphic design intern to make a free website for you. Advertising in different schools.

Once you have a good idea of ​​your address in each of the categories listed above, ask your accountant to run the numbers over a 5-year period. If your break-even point is later than you want it to be, adjust your assumptions. Go back and forth between assumptions and numbers until you feel comfortable with your practice’s expectations, as well as how much you’ll need to borrow from the bank.

As for your accountant, you should have a monthly amount that you pay him that will cover all your bookkeeping expenses and also cover all your questions. You want to be able to pick up the phone every time you have a question and get an answer within a reasonable amount of time.

Tips for opening your own practice

– Get a job at the hospital to cover your malpractice insurance

– Get another job to build a client base and complete accreditation processes or opt out of insurance.

– Secure a loan

– Use your credit

– Have a lawyer negotiate the lease of your business and incorporate for you or be your real estate agent

– Hire a real estate agent

– Use interns and give excellent letters of recommendation.

– Rent your office in the hours that you are not

– Take all the free lunches you can get from the pharmaceutical reps. schedule them

– Streamline your practice with the right EMR and go paperless

– Project your expenses

I hope this helps. Good luck with that!

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