23 Tips for Starting and Running a Private Practice

Nathan Wei, MD


June 06, 2017

During my 4 years of medical school, 4 years of residency, and 2 years of fellowship, not once did I receive any type of exposure to how to run a business.

I suppose it didn't matter to those who were going to stay in academic medicine. However, for those of us who elected to go into private practice, it was an incomplete education.

In my 30-plus years of private practice, I've had ups and downs. I have had victories as well as ignominious defeats. So for those of us in the trenches, and on the basis of my experiences, I'd like to provide a few pointers on how to start—and run—a successful practice:

1. Formulate a business plan. This should be heavily weighted on the numbers—meaning the economics of what it takes to operate a private practice.

2. Create a USP, or "unique selling proposition." This is a brief statement of why someone should see you as opposed to somebody else. You should not use such words as "quality" and "service." I have yet to see somebody say, "We offer mediocre quality and poor service."

Here are some good examples from the past. When Domino's first started, their USP was "fresh, hot, pizza delivered in 30 minutes or less or your money back. " Federal Express's USP when they first started out was, "When it absolutely, positively has to be there before 10 AM."

A USP is different from a tagline. Taglines often read as stupid; a good USP does not.

3. Your entire practice needs to be run on systems, and each person in your office should be aware of how these systems work. This will prevent the "Sally knows how to do it, but nobody else does" syndrome.

4. Be unique yourself, and be unique in how the public see you. People aren't going to knock down your door just because you're "he of good doctors." People such as Dr Phil and Dr Oz may take this a bit too far, but assuming you're competent at what you do, a public image can't hurt.

5. Early on, expect to do grunt work. This means giving talks, meeting and greeting, and doing other things to help make sure people know who you are.

6. Recurring newsletters and correspondence can be critical. The newsletters should contain news of interest to you and prospective patients. This does not mean the newsletter should be all about what you do. That's boring. The newsletters should feature a patient and what makes them interesting (with their permission, of course). Perhaps they have an unusual hobby, etc. Maybe include recipes, jokes, or cartoons—anything to increase personal engagement.

7. Financially speaking, don't be afraid of going negative. By that, I mean you may need to forgo your initial consultation fee; however, you can make this up on the back end. This will involve your looking at the math.

8. Make sure your cash flow is gaining. You'll have to know how to analyze a profit and loss statement, as well as a balance sheet.

9. Hire wisely. Make sure you have a system in place. Remember, when interviewing a perspective person, it is important to go over the traits that are important for your practice. Also, remember that people will behave the way they behave. In other words, a good question to ask is, "When X happened to you, what did you do about it?" You can predict future behavior by learning about past behavior.

10. Hire slow, fire fast. This goes not only for employees, but also for patients. Doctors tend to hold onto both employees and patients for much too long. Life is too short to go through that stress.


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