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By Mary Pat Whaley, FACMPE, CPC Start Your Own Independent Practice in Five Easy* Steps
Step One: Space You will need a space to practice. Your space could be lots of things. This is a fairly good business renter's market nationwide, but you can also see patients in another provider’s office if they have extra exam rooms to rent out. Don’t overlook non-traditional space or space not marketed as “medical.” We’ve even known of specialty physicians with no office of their own seeing patients in the primary care offices that refer the patients to them. House calls are making a comeback. Telemedicine is changing the idea of what an "office" even is. Anywhere you can perform an assessment and formulate a plan can be a candidate for your space. If you are going to file insurance, having a physical address for your practice is a critical step to getting credentialed.
Step Two: Patients You will need patients. Your patient panel will depend largely on your specialty and previous history. If you are seeing patients where you are now, and believe they would come with you to your new practice then you have a great start. If you are new to the area, you'll want to start getting your name out there and letting physicians, community groups and patients know where you are. Getting a phone line with voicemail and having some basic business cards printed up are a great first step. Another critical step will be creating an internet presence. Website, social media, and content creation are all going to be critical to not only gaining patients and being found, but competing for established patients in your area. If you are a niche specialist, casting a wide net will be even more critical, as you'll be pulling from smaller, more motivated population.
Step Three: Payment You will need to get paid. A nun from a Catholic non-profit health system once told me "No money, no mission.” You have to keep the lights on - both in the office and at home – for your employees and for your family. More than that, if you close, the patients will have to seek care elsewhere - if it's available. Private insurance, government insurance, self-pay from patients, concierge and membership fees, retail and ancillary service sales, public and private grants, and charity underwriting are all part of the financial ecosystem that funds care. You have to decide which part of the system is going to pay you.
Step Four: Equipment You may need equipment. This varies widely. In some cases it could just be a desk and a laptop, or just possibly just a laptop. In some cases it will mean up-fitting and stocking an entire practice with everything from stethoscopes, to a lab, to ECG machines. With that being said, just because you are starting your own practice doesn't mean you are going to have to take out a loan to do it (really!) Take a close look at what you will actually need, consider used or refurbished items, and think about starting small.
Step Five: Help You will need help. Help takes many forms, but every practice will probably need some sort of outsourced service to run smoothly. Find an accountant you like and trust to talk about your corporate structure, your taxes and your financial statements. You may need staff for your office - or your staff may work from home in a different time zone. There are plenty of choices to make about "inside versus outside" in terms of coding and billing, payroll and bookkeeping, triage and lab services. You may even need help deciding when is the right time and where is the right place to start your practice. Understand that you may need a lot of help or a little help, but you will need help.
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