Opened My Own Practice

[InvestingDoc]

Hi,

This past 12 months included quite a few changes to my life. It ranged from me buying a house, finding out that a multibiliion dollar group was aggressively taking over our hospitalist contract and pushing us out only to replace us with less expensive doctors and NP's. I also got married, had my wife undergo a tumor resection in her jaw, and I started up my own practice.

It has been quite a roller-coaster to say the least. However, staring up a practice has been one of the most rewarding things that I have done. If you're on the fence about it, I would absolutely say go for it!

A lot of people on this forum talk about fellowship or hospitalist jobs and there is nothing wrong with that. I wanted to make this post to answer any questions that any residents or attendings have who might be thinking of going solo or opening up a practice. Or maybe you're just curious about what going into business is like.

I started to write my business plan about 12 months ago. Initially, the plan was for two other doctors to join me and go into business together. Eventually, due to life circumstances, both of them ended up backing out leaving me to decide if I go forward solo, find a new partner, or give up on the idea.

When we got the word that our hospitalist contract was terminated and that a private equity backed group was coming in to take over, I decided to just move forward by myself. The writing was on the wall that the hospitalist job was coming to and end and I was tired of working 80-90 hour weeks while on duty. Oh, and FYI the new hospitlaist are making about $50,000 less a year than what we were making with our previous job as a hosptiliast. They also are required to supervise mid levels and potentially see more patients. I wasn't willing to sign on with this group for more work and less pay.

My clinic opened doors June 2018 and since then have built the practice up quite a bit. At this point I am seeing about 55-70 patients a week working M-F 8 to 5 with at least one half day for administrative duties. I'm still nowhere at busy as I was as a hospitalist. Last year as a hospitalist, I accumulated a little over 10,000 RVU worth of bills that I submitted. Its still too early to say was it might be for a year long term for my solo business but definitely not that many RVU's.

There have been so many headaches along the way. The biggest is dealing with insurance. I'm out over $40,000 in lost claims to Aetna, BCBS, Cigna, and United as my credentialing team assured me I was in network when that was not actually true. So, I essentially had well over 100 new patient visits that I ended up seeing for free or only collecting a co pay. Many people have brought up possibly going DPC but this was a no go for me since it does not align with my long term vision and desire to have quick growth.


I spent about $13-14k dollars to start up my practice by leasing a space that already had all the major things that a doctors office needs. My costs seem pretty low to start it up since I built my website myself and update it myself. However, factoring in the money lost to insurance companies, my opportunity costs to start up the clinic is probably just under 6 figures.


The biggest shock that I have in clinic coming from residency is how much I love clinic. I absolutely hated clinic in residency. It was cumbersome, I rarely saw the same patient twice, it was full of non compliant patients, and clinic felt like it was often in the way of my other education on wards or in the ICU. I feel like this is quite opposite from my clinic experience in residency, which makes me love coming to work.

When I was going to start up my clinic, I heard a lot of doom and gloom from people, mainly other physicians. Looking back, almost all the people who were quick to give me advise or be very negative against my plan of starting a new clinic had never even attempted to do something similar. Almost everyone had been a life long academic physician or employed by a large group. The biggest negativity was that its almost impossible to make it solo without going DPC.

Well, I'll be checking in this week and try to answer as many questions as I can if there are any. Have a great day y'all.

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[bronx43]

I salute you, good sir. People with entrepreneurial spirit like yourself give me hope that our profession is not done for.

How are you marketing/advertising? Internet/social media? Newspaper? Billboards? Word of mouth?

 

[InvestingDoc]

I salute you, good sir. People with entrepreneurial spirit like yourself give me hope that our profession is not done for.

How are you marketing/advertising? Internet/social media? Newspaper? Billboards? Word of mouth?

I have been knocking doors, letting specialist know that I'm around, available, and that I'm open for business. I started with other solo or small practices and worked my way up from there to larger groups.

Because of my blog, I've learned some bit amount of SEO and how to get views to a website. I built my own website, focused on SEO, tags, pages, load times of the pages.

Google is by far the biggest driver of traffic to my business. Each dollar I spent on Ads with google returns about $6.50. Money extremely well spent.

I attempted facebook ads and it basically got me nowhere. If you sign up with yelp you get free ads for 30 days. This drove some more views to my website but no extra business. So, I decided not to continue with yelp ads.

The largest marking has been word of mouth. My patients are happy, they bring their family, friends, and tell their coworkers. This is basically free marketing that has lead to many new patients.

 

[bronx43]

I have been knocking doors, letting specialist know that I'm around, available, and that I'm open for business. I started with other solo or small practices and worked my way up from there to larger groups.

Because of my blog, I've learned some bit amount of SEO and how to get views to a website. I built my own website, focused on SEO, tags, pages, load times of the pages.

Google is by far the biggest driver of traffic to my business. Each dollar I spent on Ads with google returns about $6.50. Money extremely well spent.

I attempted facebook ads and it basically got me nowhere. If you sign up with yelp you get free ads for 30 days. This drove some more views to my website but no extra business. So, I decided not to continue with yelp ads.

The largest marking has been word of mouth. My patients are happy, they bring their family, friends, and tell their coworkers. This is basically free marketing that has lead to many new patients.

Knocking on doors is what I've been doing. One thing that I am interested in is what ways can one do to generate positive reviews on google, yelp, healthgrades, etc. My fear is having a large internet presence, but having poor reviews due to factors that are out of my control. I've seen numerous physicians get terrible reviews due to issues such as late charges, "rude staff," wait times, etc. The problem also is that it's usually the dissatisfied patients who leave the reviews.

One thing I've considered is asking satisfied customers to leave a positive review.

Also, what is your projected overhead? I'm with a multispecialty group and it's around 50-55%.

 

[InvestingDoc]

Knocking on doors is what I've been doing. One thing that I am interested in is what ways can one do to generate positive reviews on google, yelp, healthgrades, etc. My fear is having a large internet presence, but having poor reviews due to factors that are out of my control. I've seen numerous physicians get terrible reviews due to issues such as late charges, "rude staff," wait times, etc. The problem also is that it's usually the dissatisfied patients who leave the reviews.

One thing I've considered is asking satisfied customers to leave a positive review.

Also, what is your projected overhead? I'm with a multispecialty group and it's around 50-55%.

Online reviews, if we like it or not, is the way most patients review their new doctor before coming into clinic. You have to have a presence here.

Most doctors/clinics will email or ask them to leave a review. I went to an urgent care a month ago and when I was done I got a text message to leave a review and an email. It may sound silly but guess what, they have like 700 5 star reviews on google and about 400 on yelp.

My overhead right now is hovering at 30-33%. This is most likely going to go up (most likely temporarily) soon since I am out of space and have to lease a bigger office plus hire more staff.

 

[PugsAndHugs]

Thank you very much for your informative post! If you don’t mind me asking what state is your practice based in and what type of location are you in (Urban/suburban/rural)? Do you think opening up your own practice is doable in a big city (for ex like NYC, LA)?


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[Postictal Raiden]

You mentioned that your start up cost was 12k. What about employee salaries? Utilities? EMR?

From what I understand, you don’t start making money from day1. You still need to build up clientele base and wait for insurance companies to pay you. How did you manage to cover your overhead costs during the first few months of the practice?

Thanks

 

[Crayola227]

On one hand, you say as a negative that it's almost impossible to get started off the ground not as a DPC, but then you make it sound like it's feasible. Confused.

 

[Scope guy]

Hi,

This past 12 months included quite a few changes to my life. It ranged from me buying a house, finding out that a multibiliion dollar group was aggressively taking over our hospitalist contract and pushing us out only to replace us with less expensive doctors and NP's. I also got married, had my wife undergo a tumor resection in her jaw, and I started up my own practice.

It has been quite a roller-coaster to say the least. However, staring up a practice has been one of the most rewarding things that I have done. If you're on the fence about it, I would absolutely say go for it!

A lot of people on this forum talk about fellowship or hospitalist jobs and there is nothing wrong with that. I wanted to make this post to answer any questions that any residents or attendings have who might be thinking of going solo or opening up a practice. Or maybe you're just curious about what going into business is like.

I started to write my business plan about 12 months ago. Initially, the plan was for two other doctors to join me and go into business together. Eventually, due to life circumstances, both of them ended up backing out leaving me to decide if I go forward solo, find a new partner, or give up on the idea.

When we got the word that our hospitalist contract was terminated and that a private equity backed group was coming in to take over, I decided to just move forward by myself. The writing was on the wall that the hospitalist job was coming to and end and I was tired of working 80-90 hour weeks while on duty. Oh, and FYI the new hospitlaist are making about $50,000 less a year than what we were making with our previous job as a hosptiliast. They also are required to supervise mid levels and potentially see more patients. I wasn't willing to sign on with this group for more work and less pay.

My clinic opened doors June 2018 and since then have built the practice up quite a bit. At this point I am seeing about 55-70 patients a week working M-F 8 to 5 with at least one half day for administrative duties. I'm still nowhere at busy as I was as a hospitalist. Last year as a hospitalist, I accumulated a little over 10,000 RVU worth of bills that I submitted. Its still too early to say was it might be for a year long term for my solo business but definitely not that many RVU's.

There have been so many headaches along the way. The biggest is dealing with insurance. I'm out over $40,000 in lost claims to Aetna, BCBS, Cigna, and United as my credentialing team assured me I was in network when that was not actually true. So, I essentially had well over 100 new patient visits that I ended up seeing for free or only collecting a co pay. Many people have brought up possibly going DPC but this was a no go for me since it does not align with my long term vision and desire to have quick growth.


I spent about $13-14k dollars to start up my practice by leasing a space that already had all the major things that a doctors office needs. My costs seem pretty low to start it up since I built my website myself and update it myself. However, factoring in the money lost to insurance companies, my opportunity costs to start up the clinic is probably just under 6 figures.


The biggest shock that I have in clinic coming from residency is how much I love clinic. I absolutely hated clinic in residency. It was cumbersome, I rarely saw the same patient twice, it was full of non compliant patients, and clinic felt like it was often in the way of my other education on wards or in the ICU. I feel like this is quite opposite from my clinic experience in residency, which makes me love coming to work.

When I was going to start up my clinic, I heard a lot of doom and gloom from people, mainly other physicians. Looking back, almost all the people who were quick to give me advise or be very negative against my plan of starting a new clinic had never even attempted to do something similar. Almost everyone had been a life long academic physician or employed by a large group. The biggest negativity was that its almost impossible to make it solo without going DPC.

Well, I'll be checking in this week and try to answer as many questions as I can if there are any. Have a great day y'all.

Good luck with your new venture and I am sure it will be successful.

A question for you, were you being paid per RVU in your hospitalist job? If so how much per RVU

 

[InvestingDoc]

Thank you very much for your informative post! If you don’t mind me asking what state is your practice based in and what type of location are you in (Urban/suburban/rural)? Do you think opening up your own practice is doable in a big city (for ex like NYC, LA)?


Sent from my iPhone using SDN mobile

I'm in Austin and yes I do think its definitely possible.

 

[InvestingDoc]

You mentioned that your start up cost was 12k. What about employee salaries? Utilities? EMR?

From what I understand, you don’t start making money from day1. You still need to build up clientele base and wait for insurance companies to pay you. How did you manage to cover your overhead costs during the first few months of the practice?

Thanks

Here is a rough breakdown of what my start up costs were.

• EMR $100 / month
• Billing $300 / month
• Credentialing for insurance companies $2,000
• Business Owner’s Policy (BOP) $758/year ($63/month) *covers me for accidents in the clinic such as if our glass door fell off the hinges or a chair broke when someone sat on it and they break a bone*
• Malpractice $1250/year ($104) For my first year, this goes up year after year
• Lawyer/ Establish PLLC $1002
• First Month Rent + Front Staff $5,250
• Supplies to start up Clinic (this ranges from ordering checks from the bank, square POS service for taking credit cards, to ceftriaxone for STD treatments, EKG machine $400 from ebay used, vaccines) ~$5,000

I started the credentialing process about 2-3 months before I even opened doors, so when we opened I was already credentialed with some payers. The fastest one to get credentialed was Medicare. They also backdate to the day you apply, which private insurance companies do not.

We turned cash positive in month number 3. During my weekends off I drove 4 hours away and picked up locums hospitalist shifts to cash flow things.

 

[InvestingDoc]

On one hand, you say as a negative that it's almost impossible to get started off the ground not as a DPC, but then you make it sound like it's feasible. Confused.

I'm not DPC, I take insurance. We could have built practice DPC but growth would have been much much slower.

 

[InvestingDoc]

Good luck with your new venture and I am sure it will be successful.

A question for you, were you being paid per RVU in your hospitalist job? If so how much per RVU

Yes I was paid per RVU about $34 per RVU not including benefits (disability, CME, life insurance).

 

[cbrons]

Interesting. How do you go about researching if doing this would be worth it in a given town? For example, I am thinking of moving out to the mountain west with some towns of 40k people.

 

[bronx43]

Interesting. How do you go about researching if doing this would be worth it in a given town? For example, I am thinking of moving out to the mountain west with some towns of 40k people.

Look at what other clinics are already present. To run a healthy primary care practice, you need at least 2000-3000 patients. If there are other clinics, find out if they're even accepting new patients, and if so, how far are they booked out.

 

[michaelrack]

I started the credentialing process about 2-3 months before I even opened doors, so when we opened I was already credentialed with some payers. The fastest one to get credentialed was Medicare. They also backdate to the day you apply, which private insurance companies do not.

don't you have to put down on the medicare application the first date you saw a medicare patient at the location? so how did you get the medicare app in ahead of time

 

[InvestingDoc]

don't you have to put down on the medicare application the first date you saw a medicare patient at the location? so how did you get the medicare app in ahead of time

I hired a credentialing team to do all my credentialing for me. They did not tell me that I had to put date that I first had a medicare patient in my clinic. I put down all my tax info, address, phone number, fax, licensing info and that was basically it. I honestly cant remember much about medicare credentialing since it was so much easier than the private payers and so much faster...I will have to look back through my records.

 

[michaelrack]

The Medicare application May have been a little different than I have done if you were registering as a clinic rather than an individual provider

 

[RNtoMD87]

Here is a rough breakdown of what my start up costs were.

• EMR $100 / month
• Billing $300 / month
• Credentialing for insurance companies $2,000
• Business Owner’s Policy (BOP) $758/year ($63/month) *covers me for accidents in the clinic such as if our glass door fell off the hinges or a chair broke when someone sat on it and they break a bone*
• Malpractice $1250/year ($104) For my first year, this goes up year after year
• Lawyer/ Establish PLLC $1002
• First Month Rent + Front Staff $5,250
• Supplies to start up Clinic (this ranges from ordering checks from the bank, square POS service for taking credit cards, to ceftriaxone for STD treatments, EKG machine $400 from ebay used, vaccines) ~$5,000

I started the credentialing process about 2-3 months before I even opened doors, so when we opened I was already credentialed with some payers. The fastest one to get credentialed was Medicare. They also backdate to the day you apply, which private insurance companies do not.

We turned cash positive in month number 3. During my weekends off I drove 4 hours away and picked up locums hospitalist shifts to cash flow things.

This is much cheaper than I would've expected. If only I was an MD I could afford this now lol.

 

[InvestingDoc]

This is much cheaper than I would've expected. If only I was an MD I could afford this now lol.

It is cheap but that was be design. Instead of going and finding a space that I had to lease, build out/ furnish, I decided to join up with a surgeon who is almost never in clinic and has everything built out. I more or less came in, put my name on the door, got my own phone line and started to see patients.

If I went out and leased a space on my own and had build out costs, this would have been much more expensive.

The space itself is one of the biggest costs. Here in Austin, commercial property is pretty expensive. Most highly desirable places are renting at about $25-$35 per sq ft per year plus NNN. This ends up adding another $10ish to the price. So, a 3,000 sq ft clinic is going to cost upwards of $9,000 a month just for rent. Pretty high cost if going solo and if you rent out a huge space to start with. You can find less expensive places but they will be out of the way in less desirable locations.

 

[Mangal]

Thank you for sharing your start up. It has been of much inspiring for me, as I would love to run my own clinic some time in the future.


Sent from my iPhone using SDN

 

[tenacious11]

Thanks for sharing your experiences. Very Informative. Please keep us posted. Thanks

 

[FluidStaccato]

I'm a little late to the forum but I recently opened up my own practice 2 months ago. Its been pretty slow patient wise but rewarding. My biggest issue right now is the insurance credentialing. I tried to save money by credentialing on my own starting over 6 month ago and I've only just gotten on Medicare's panel. I've pretty much been rejected from the panels of all the other major insurers (United, Blue Cross, Humanna etc).. quite demoralizing given the hard work I've put in so far. You would think that the barriers to getting paid as a private practice MD given the time you put in to get thru med school, residency, fellowship etc shouldn't be so difficult. Thinking about going DPC but am still holding off on that as a last resort. Any recommendations on how to get on these insurance panels?? My next resort is to pay some company to do this for me but like your initial post, I haven't heard the best reviews about these companies in general.

 

[InvestingDoc]

I'm a little late to the forum but I recently opened up my own practice 2 months ago. Its been pretty slow patient wise but rewarding. My biggest issue right now is the insurance credentialing. I tried to save money by credentialing on my own starting over 6 month ago and I've only just gotten on Medicare's panel. I've pretty much been rejected from the panels of all the other major insurers (United, Blue Cross, Humanna etc).. quite demoralizing given the hard work I've put in so far. You would think that the barriers to getting paid as a private practice MD given the time you put in to get thru med school, residency, fellowship etc shouldn't be so difficult. Thinking about going DPC but am still holding off on that as a last resort. Any recommendations on how to get on these insurance panels?? My next resort is to pay some company to do this for me but like your initial post, I haven't heard the best reviews about these companies in general.

Hi,

Did they give you a reason why they rejected you from being in network? Medicare was my quickest one to get in network, it took about one month. BCBS was the second quickest and Aetna was the longest at 9 months to get in network. Oh God, Aetna was such a disaster of a company to deal with and continues to be a disaster.

I paid $2000 for a company to get me credentialed and it was not a great experience. However, spending hours on the phone with insurance companies was also a terrible experience to talk to them about my credentialing status. So, it is a trade off and your time might be better spent on doing locums, pay the fee knowing there will be some frustrations and move on.

At this point I think you are stuck paying a company to help you out since you need to get in network sooner rather than later.

Are you in a state where you can jump on a large group insurance panel? That way you can just talk to them about getting in their network, they usually take a fee, but the headache is much less. You usually also get the higher reimbursement rate since they argue for higher rates due to the larger size of their clinics.

 

[FluidStaccato]

Hi,

Did they give you a reason why they rejected you from being in network? Medicare was my quickest one to get in network, it took about one month. BCBS was the second quickest and Aetna was the longest at 9 months to get in network. Oh God, Aetna was such a disaster of a company to deal with and continues to be a disaster.

I paid $2000 for a company to get me credentialed and it was not a great experience. However, spending hours on the phone with insurance companies was also a terrible experience to talk to them about my credentialing status. So, it is a trade off and your time might be better spent on doing locums, pay the fee knowing there will be some frustrations and move on.

At this point I think you are stuck paying a company to help you out since you need to get in network sooner rather than later.

Are you in a state where you can jump on a large group insurance panel? That way you can just talk to them about getting in their network, they usually take a fee, but the headache is much less. You usually also get the higher reimbursement rate since they argue for higher rates due to the larger size of their clinics.

Thanks for your response! I'm practicing in S. Florida and apparently the panels out here are closed to my specialty which is primary care and primary care sports med - specifically Aetna, Fl Blue Cross/Blue Shield, United, and Humana which are unfortunately among the bigger insurers. I was able to get on medicare pretty quickly doing this myself (6-8 weeks) but its taken me months just to go thru the process of going back and forth with the private payers only to hear that the panels are full. I'm still waiting to hear back from a hand full of other private insurers..

In regards to a group panel, I did happen to get on one local hospital's group panel but I'm not sure how beneficial that will be since I don't do any hospitalist work and thus don't have direct access to those patients. Also while the group panel contracts with the major payers such as the ones mentioned above, it doesn't automatically place me in network outside of the group. Thus while I can receive reimbursement for a patient on the hospitals insurance group panel who is covered by United for instance, I wont be reimbursed for seeing a patient covered under United who is not on the group panel.

I did speak to a credentialing svc within the last few days thats charging around 1K to help credential with a minimum of 4 insurers without any guarantee that I will be accepted onto their panels. The price goes up by about $150 for each additional insurer. Not sure if thats reasonable.

At this point I think I'm going to resolve myself to just paying the fee. I think one of the biggest things about starting your own practice is learning the ins and outs of organizing, implementing, and running a business. Now that I know the process of insurance credentialing I realize that its something I don't want to spend my time doing.

Any thoughts on advertising? Did you go at it solo via your own website, google, and/or yelp or did you use a 3rd party as well ie Zoc doc?

 

[InvestingDoc]

Thanks for your response! I'm practicing in S. Florida and apparently the panels out here are closed to my specialty which is primary care and primary care sports med - specifically Aetna, Fl Blue Cross/Blue Shield, United, and Humana which are unfortunately among the bigger insurers. I was able to get on medicare pretty quickly doing this myself (6-8 weeks) but its taken me months just to go thru the process of going back and forth with the private payers only to hear that the panels are full. I'm still waiting to hear back from a hand full of other private insurers..

In regards to a group panel, I did happen to get on one local hospital's group panel but I'm not sure how beneficial that will be since I don't do any hospitalist work and thus don't have direct access to those patients. Also while the group panel contracts with the major payers such as the ones mentioned above, it doesn't automatically place me in network outside of the group. Thus while I can receive reimbursement for a patient on the hospitals insurance group panel who is covered by United for instance, I wont be reimbursed for seeing a patient covered under United who is not on the group panel.

I did speak to a credentialing svc within the last few days thats charging around 1K to help credential with a minimum of 4 insurers without any guarantee that I will be accepted onto their panels. The price goes up by about $150 for each additional insurer. Not sure if thats reasonable.

At this point I think I'm going to resolve myself to just paying the fee. I think one of the biggest things about starting your own practice is learning the ins and outs of organizing, implementing, and running a business. Now that I know the process of insurance credentialing I realize that its something I don't want to spend my time doing.

Any thoughts on advertising? Did you go at it solo via your own website, google, and/or yelp or did you use a 3rd party as well ie Zoc doc?

If it were me I'd pay the money. I paid 2k to have a credentialing team do the work for medicare + 5 private insurances. Sounds like you know very well the headache of dealing with insurance. They do this to everyone, based on my experience and talking with other docs.


I advertise on google, built my own website and worked hard on SEO. I know this might sound funny but I did a wordpress site, paid for premium theme and started to set up my site. I watched a ton of youtube videos on how to do SEO correctly and hit the ground running. Seems to be working well with more than 10k hits per month on my website.

I was on ZocDoc but they changed their pay structure to $35 per patient that books on their platform for new patients for primary care. Doesn't matter if patient no shows or cancels. I have to pay. I said screw them and left zodoc.

ZocDoc was not a bad service but by far it was our low acuity codes but yet high number of no shows and drug seekers. Tons of people book to try to get Adderall through that app in our location.

If they don't charge you a fee its a good site to get your practice up and running. If they do charge a fee, I'm not sure it is worth it.


I tried yelp and facebook. Both didn't work well for me but I only gave it maybe 2 months so maybe my test was not long enough.

Google is king. Learn how to do your own google ads and you will pay per click and it will be your biggest draw.

 

[FluidStaccato]

If it were me I'd pay the money. I paid 2k to have a credentialing team do the work for medicare + 5 private insurances. Sounds like you know very well the headache of dealing with insurance. They do this to everyone, based on my experience and talking with other docs.


I advertise on google, built my own website and worked hard on SEO. I know this might sound funny but I did a wordpress site, paid for premium theme and started to set up my site. I watched a ton of youtube videos on how to do SEO correctly and hit the ground running. Seems to be working well with more than 10k hits per month on my website.

I was on ZocDoc but they changed their pay structure to $35 per patient that books on their platform for new patients for primary care. Doesn't matter if patient no shows or cancels. I have to pay. I said screw them and left zodoc.

ZocDoc was not a bad service but by far it was our low acuity codes but yet high number of no shows and drug seekers. Tons of people book to try to get Adderall through that app in our location.

If they don't charge you a fee its a good site to get your practice up and running. If they do charge a fee, I'm not sure it is worth it.


I tried yelp and facebook. Both didn't work well for me but I only gave it maybe 2 months so maybe my test was not long enough.

Google is king. Learn how to do your own google ads and you will pay per click and it will be your biggest draw.

Awesome! Yea Zocdoc quoted me at the same price and actually wanted to charge me $85/patient if I also wanted to list myself as primary care sports medicine on their website. I passed on that one pretty quickly.

Hey thanks so much for the advice! I also just stumbled on your website which has a lot of great info as well.
I'll definitely look into SEO's as this is something that I'm not too familiar with. Any videos or other resources you could rec on this?

 

[InvestingDoc]

Awesome! Yea Zocdoc quoted me at the same price and actually wanted to charge me $85/patient if I also wanted to list myself as primary care sports medicine on their website. I passed on that one pretty quickly.

Hey thanks so much for the advice! I also just stumbled on your website which has a lot of great info as well.
I'll definitely look into SEO's as this is something that I'm not too familiar with. Any videos or other resources you could rec on this?

This is a good into to wordpress and yoast SEO

You can keep going down the rabbit hole of google videos though for how to get each post to rank as high as possible with keywords and links.

$85 per patient is insane. They called us and we did metrics on our patients. My no show rate is about 5% while my zocdoc no show rate was hovering at 15%. Due to many of the codes being 03's, zocdoc would have basically made as much money or more money per some of the visits than I would have. It was an easy way to say no.

They try to trick you by saying, put our website link and calendar on your website and those are fee. That is one of the dumbest things I've ever heard.

YOU are paying for the website, the SEO, the advertisement to get clicks on your website, then you're going to funnel them to a third party software where they can book with another PCP right down the road in seconds. LMAO....yeah thats a hard pass.


I have been trying to put more work into my website lately (my hobby investing doc one). Now that the practice is off and running, I have a bit more time to focus on it.


Oh, the last thing that I forgot to mention. Online reviews matter. Even if you have to get a friend to see you in clinic and review you, you have to have online reviews in 2019 and beyond. It may suck, but its a reality.

 

[FluidStaccato]

This is a good into to wordpress and yoast SEO

You can keep going down the rabbit hole of google videos though for how to get each post to rank as high as possible with keywords and links.

$85 per patient is insane. They called us and we did metrics on our patients. My no show rate is about 5% while my zocdoc no show rate was hovering at 15%. Due to many of the codes being 03's, zocdoc would have basically made as much money or more money per some of the visits than I would have. It was an easy way to say no.

They try to trick you by saying, put our website link and calendar on your website and those are fee. That is one of the dumbest things I've ever heard.

YOU are paying for the website, the SEO, the advertisement to get clicks on your website, then you're going to funnel them to a third party software where they can book with another PCP right down the road in seconds. LMAO....yeah thats a hard pass.


I have been trying to put more work into my website lately (my hobby investing doc one). Now that the practice is off and running, I have a bit more time to focus on it.


Oh, the last thing that I forgot to mention. Online reviews matter. Even if you have to get a friend to see you in clinic and review you, you have to have online reviews in 2019 and beyond. It may suck, but its a reality.

Great! Couldn't be more grateful for your advice. Thank you again and I look forward to following more of your journey over on your website!

 

[qwerty89]

Consider reaching out to ZDoggMD. I'm sure he would love to interview you and get your take on starting a solo practice.

It's also free advertising.

 

[bananas85]

I have a question regarding calls. I am told that you have to have someone on call 24 hours to be credentialed with the major insurance companies. Does that mean you take all the calls every night and evening. This can get hectic with a full patient panel.

 

[InvestingDoc]

I have a question regarding calls. I am told that you have to have someone on call 24 hours to be credentialed with the major insurance companies. Does that mean you take all the calls every night and evening. This can get hectic with a full patient panel.

So what I understand is that you only need to have a way for patients to contact you after hours. This can be a voicemail system that you check the next day. That was what my rep told me.

Our pediatrician and my primary care doctor that I go to for my wellness visits charges about $20 per call after hours. We started to do the same.

Even without doing that, I get about 3 after hours calls per week and in the past year have not gotten a single call overnight.

If you find yourself and your clinic getting tons of after hours calls, you should be charging for them.