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Starting a dermatology practice

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  • Avatar gogiants6590 
    Participant
    Status: Resident
    Posts: 5
    Joined: 01/17/2019

    I had a question about starting a dermatology practice for any practice owners on here. I was wondering what it would cost(a rough ballpark) and how much time it would take to have a full schedule (say 30-40 patients a day) in a VLCOL area where they are few other dermatologists for a general dermatology practice.

    #206363 Reply
    IntensiveCareBear IntensiveCareBear 
    Participant
    Status: Physician
    Posts: 221
    Joined: 12/22/2018

    Nobody can answer these questions for you, man. You need to project the numbers yourself and make a biz plan, which you will need anyways for the loan.

    Cost all depends on what rent and bills and staffing and billing service or billing staff and etc etc rates will cost in that area. The furniture and computers and equipment and instruments will be pretty standard anywhere.

    Patient load and growth rate depend entirely on amount of marketing and competition. Marketing is cheaper and more effective in rural areas, but there are also simply less people. There may be places where you could be up to 10+ patients within a year, but other places that would require tons of marketing. Have you considered renting a suite in a professional building attached to a hospital? They have insane rent but will get you good visibility and easy networking. That is worth considering as your primary office or at least a satellite office.

    When I looked into it years and years ago (different specialty), I figured a budget of at least 0.5M, probably 1M to be safe, would be the minimum to give cushion for success. That was a suburb on the fringe of a metro… medium COL area but very wealthy and well-insured patient base. I didn’t go through with it due to financing rates and it being more of a “want” than a “need”… I know myself, and it probably would’ve consumed me 7 days per week, at least for a few years. That was also back when there was a lot of uncertainty about what ObamaCare was going to do to reimbursements… although I thought (hoped?) it wouldn’t affect my target area much.

    When you start from scratch, there is obviously significant lag time before the appointments start to fill, even more time before payments are rolling in steadily, yet staffing and rent and bills start costing you from day 1. In the beginning, you will just be sitting around and seeing 0-3 patients per day and filling out paperwork to get onto insurances, planning marketing, or driving around trying to meet with family docs. You still have to pay a staff member or two $100+ on those days and pay full rent/bills/etc… some equipment can be financed, but that can entice you to buy more or newer stuff than you truly need… and credit will sneak up on you, esp if you don’t get the office busy in a hurry.

    GL if you go for it. I’m just bringing up points for consideration. You need to sit down and do the math on all costs from a receptionist to computers and printers and scanners to marketing to electricity bill to phones and phone bills to autoclave to uniforms to blah blah etc. When you know how much all that will cost, you have a much clearer picture. Call around the town on many medical office and general rental spaces to ballpark rate. Success is certainly possible. Many of my buddies have done it (though they all bought out another struggling/retiring doc and updated/marketed the practice, not started from scratch) with various degrees of stress and success. Good people to talk to on this might be dentists in that community you are targeting… until the GFC when lending tightened, dentists nearly all did private practice via start from scratch or buy out another doc. The Medical Entrepreneur book by Hacker (a derm) is pretty good too. You will do well.

    "Hmm, that sounds risky." - motto of the middle class

    #206366 Reply
    Avatar Physicians Capital Management LLC 
    Participant
    Status: Physician, Financial Advisor
    Posts: 32
    Joined: 07/17/2017

    You should go for it.  It would not take long to get to that volume.  The wait time for derm is phenomenally long.  I would definitely try and own the building.  If you PM me, I can give you a tip on how to get an ultra low loan rate.  What area of the country is?  Provide some more details for more robust advice.  Do you currently have any debt?

    #206375 Reply
    hatton1 hatton1 
    Participant
    Status: Physician
    Posts: 3030
    Joined: 01/11/2016

    Look do not be frightened.  I started an OB/GYN practice for about $25K.  Derms are in high demand.  Unlike a lot of practice types you can choose to do stuff insurance does not pay for while waiting for insurance credentialing.  Look for used equipment where possible.  I saved a lot by doing this.  Look around for people retiring their practice.  You can pick up exam tables, lamps, supplies that way.  Look in target or Walmart for decor.  When you are starting out minimize employees.  Look for people who can do more than one thing.  The harder you work setting this up the less it will cost.

    #206401 Reply
    Liked by Hank, Docbeans
    Avatar HumbleInvestor 
    Participant
    Status: Physician, Small Business Owner
    Posts: 149
    Joined: 12/28/2016

    IntensiveCareBear gave lot of good suggestions and good luck if you decide to open your practice. I am not familiar with derm practices and your question about desired patient volume raised my curiosity. A 40 patient day per provider means 12 minutes per patient in a 8 hour work day Is that enough time for proper care? What are typical marketing activities that work better?

    #206423 Reply
    Avatar SLC OB 
    Participant
    Status: Physician
    Posts: 498
    Joined: 06/23/2018
    A 40 patient day per provider means 12 minutes per patient in a 8 hour work day Is that enough time for proper care? What are typical marketing activities that work better?

    Click to expand…

    I believe this is pretty typical for Derm… doesn’t take long to burn off a lesion or do a skin cancer check.

     

    #206425 Reply
    Miss Bonnie MD Miss Bonnie MD 
    Participant
    Status: Physician
    Posts: 497
    Joined: 02/14/2017

    OP – if you’re on Facebook, there is a group for those starting a new practice and more. PM me if you need exact name.

    "Being rich is having money; being wealthy is having time."

    Miss Bonnie MD --> Wealthy Mom MD @ http://wealthymommd.com

    #206463 Reply
    Liked by Tim

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