Nicky Jardine on Hot Docs
Over the years I’ve helped scores of doctors design and launch their general practices, including one practice that was a finalist in the national RACGP Practice of the Year Awards and another that was awarded RACGP Practice of the Year for Queensland.
For many doctors the decision to open their own medical practice and embrace the entrepreneurial path of being self-employed is a daunting exercise and a decision requiring careful planning and a considerable investment of time and money. For most, the decision to start their own practice is well and truly the biggest decision they will make in their career as a medical professional, especially considering that as a practice principle you are not just responsible for yourself but a team of staff.
To help ensure the setup of your practice is as successful as possible, I’ve put together this article covering some of the most common mistakes and challenges I’ve seen crop up again and again. My hope is that this article will shed some light on the dos and don’ts when starting your practice.
- Shop around for your finance. There are many banks and finance companies ready to throw money to doctors. However, check the terms and small print carefully. If you are leasing IT, medical supplies or furniture make sure that your lease payments have no more than a 3 year term.
- If the bank or finance company is willing to manage the escrow for your startup invoices, make sure the costs are included in their fees. Alternatively, ask your management company to coordinate the escrow on your behalf.
- When you are ready to drawdown the loan, make sure you take time to get the best possible deal.
- As well as covering the setup costs make sure you borrow enough funds from the bank to cover operational costs for the first year (I will explain more about this in the marketing section).
- In order to acquire finance you will need (1) Cash flow projections for the first year, (2) A business plan, (3) Personal income tax returns, (4) A list of assets and expenses.
- Be careful not to over capitalise with an exorbitant fit out in the first year.
Let’s be completely honest. Every doctor thinks they will have the best medical centre. This is human nature. But in reality, no matter how popular you are with patients, and no matter how great your medical centre looks aesthetically, people don’t want to visit you. They want to visit a very nice restaurant or cafe or bar. They are coming to you because they have to. This means it is up to you to be creative in the way you market yourself.
- Branding is foremost. As surprising as it sounds your logo can make you or break you because it is often the first thing a potential patient sees. An outdated and tacky logo makes you appear outdated and tacky. A fresh and modern logo makes you appear fresh and modern.
- Having a great website is also extremely important. Make sure the site is easy to use and informative. Remember this is the place people will go if they are on the fence on whether to choose you or another practice.
- Forget hard media (eg. newspapers, magazines). These advertisers are very expensive and when was the last time you looked in the paper for a doctor? Instead, endorse your services through social media, blogs on your website and by sending emails to your clients.
- Hire people who share your values and present well as every staff member is a part of your marketing team — acting as the face of your practice each and every time they come into contact with a patient.
- Gather patient feedback regularly by speaking to your patients about your centre. Ask them what they like and don’t like and how they think you could improve.
- Offer your patients a comprehensive service so they don’t have to go somewhere else for additional services, and utilise the Medicare item numbers appropriately.
- Most of all, make sure you have enough money to market your business as you will need to spend the first 12-18 months marketing. The reality is even if you have worked at a centre just down the road your patients may not follow you. You have to market to your demographics and always have a plan in place for acquiring new patients to your practice.
Staff can make or break your practice. In my experience good staff embody the following characteristics:
- Experienced, but no bad habits
- Bubbly, but professional
- Efficient, but not assertive
- Great customer service skills, but not overly friendly
- Excellent business skills, but not too expensive
Whilst the above criteria are good to know, the reality is that no matter what a person’s resume and references look like, hiring can be hit and miss. To reduce your chances of hiring the wrong person try your best to hire people with the same philosophy as you. This means doing your best to get to know people in an interview by letting them talk as much as possible about not just the role but their ambitions and values.
Keep in mind that hiring an experienced person is not always the answer. What is often a better indicator of success is hiring someone who is willing to work to your vision.
Also, make sure you pay your staff appropriately. If you pay them too little, as soon as another job becomes available, they will leave you and you’ll be forced to go back to recruiting, which will only cost you more time and money hiring and training.
Once you have a team up and running set each member of your staff clear KPIs and, most importantly, praise them when they are doing well. Sometimes praise is better than a raise!
Finally, be careful of nepotism. It may seem great at first being surrounded by family and friends, but when they are not following your vision it can quickly become a very uncomfortable experience. The best thing is to leave friends and family out of the workplace and instead make sure they are available for that much deserved glass of wine at the end of the day.
Systems take time to develop but it is still a good idea to have a plan in place from day one to ensure you look professional and protect yourself and your staff from litigation. This said, here are a few tips to help you start out on the right foot.
- Keep your practice accreditation at the forefront of your mind from day one.
- Don’t make up systems as you go along. It never works. Systems need to be white boarded, discussed by all members of the team, and documented from day one so you don’t leave yourself open to litigation.
- Speak to your professional indemnity insurance company. Ask them about what systems you need to in place so they can protect you.
- If a system is not working, rewrite it. Rome wasn’t built in a day.
The fifth pillar to a well established general practice is service. The service you provide to your patients is the most pivotal aspect of an operational practice. This doesn’t just mean service from your doctors, but from all of your staff.
Gone are the days of the medical receptionist sitting at their desk looking down their nose at those checking in, or the doctor not looking a patient in the eye. Today, most patients call their doctor by their first name and want the same in return. They see their ‘family practice’ as just that… family. These patients need to feel like they belong and that no matter what happens in their life that their doctor and their practice is there for them.
This said, continually speak to your patients about how they feel about your practice and the service it provides. Make your medical centre a warm and caring place to visit and don’t be a stranger. Get to know your patients, their family, even their pets. Remember, your patients are your best referrers and they will support you and your practice if you support them.
Sound scary? It shouldn’t. Building a medical practice is fun. Sure, there are ups and downs, but there are ups and downs in all decision-making, even when you work for someone else. Put in the hard yards at the beginning and always put your patients first and you will undoubtedly find a successful and rewarding career as a practice principle.