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Starting a lean plastic surgery practice- is it possible?

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  • Avatar fiomi 
    Participant
    Status: Physician
    Posts: 20
    Joined: 04/15/2019

    I have a older family member who runs what I consider a “lean” surgical practice.  It’s just them, their spouse and hiring help for in-office OR days.  They own their office, take insurance and cash, paper charts, do their own billing and overall seem to keep things simple w/ low overhead.  It seems insurance is the biggest complexity and hiring spouse can have many benefits.  I came across this blog, https://solobuildingblogs.com/ and it seems to have good stuff in it.

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    Hi, thanks for your response. Really appreciate your input and will check out the blog you mentioned. It’s great to hear it’s possible to do something like that- keeping it simple with low overhead. Yes, my understanding is that insurance is what will create the most headache and work (predetermination letters, denials, pre-auths, delayed payments ,etc, etc.) I debated going just straight cosmetic but feel like that’s too restrictive. I do like some functional/reconstructive work and want to keep that a part of my practice. I also hope that by taking insurance at the beginning it will be a way to have patients come in the door and get to know me, my practice, etc. Rather than keeping it straight cash/cosmetic only. Thanks again for your input!

    #212376 Reply
    Avatar fiomi 
    Participant
    Status: Physician
    Posts: 20
    Joined: 04/15/2019

    I started my own Ob/gyn practice after being in my hometown for a year. I had some patients. It is certainly doable. I think sharing space makes a lot of sense. So does sharing employees. As you build a clientele you can then leave I did this at first

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    Hi, thanks for your response! So happy to hear you have done it. What was your practice model/setup when you first started… In terms of sharing space, employees, etc? Thanks again for your input.

    #212377 Reply
    Avatar fiomi 
    Participant
    Status: Physician
    Posts: 20
    Joined: 04/15/2019

    Sounds really smart, stay lean, maintain shared space (so long as they treat you fairly), then open your own thing when you’re ready

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    Hi, thanks for the support! I am hopeful that this can work, start small, grow, and then move on to building and creating my own thing. Alternatively, if things work out well with the person I’m sharing with we’ve discussed partnership model, etc. Right now I’m just trying to figure out the logistical details of doing this. Thanks for your input!

    #212379 Reply
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 6059
    Joined: 01/12/2016
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    What is the angle of the practice? If you’re talking billing/coding I assume you’ll be doing recon as well as aethetics. Do you have a transition plan or something in mind?

    I dont think you’ll like sharing employees, etc…you’ll want them trained for just your stuff, etc….and they will feel more loyalty to one or the other, they can leave etc….without much input control from you.

    I think maybe defining the practice and the first five years is a great start. Agree you’ll likely quickly outgrow this place and it will be annoying to move so early on.

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    Hi, Thanks for the response. My business plan and defining the practice is a work in progress! While things are slow at the beginning I’m hoping to make some income from doing injections (fillers, neurotoxins, etc.) Also considering taking some ER call and/or doing locums work..but I want my focus to be on building my practice. I know it’s a catch-22.

    I do want the majority of my practice to be cosmetic but plan to do some functional/reconstructive work and take insurance. You’re right about the employees- I’ll need to consider that. Given they are loyal to the provider who is employing them…not me.

    Thanks again for your input!

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    You want to be cosmetic, then focus on only that up front. Everything non cosmetic will only bring more of that and take time away from it and slow down eventually getting to just cosmetic if its what you want. Its easier to simply be one way or another. Cosmetic is dead simple. Cash, thats it. No frills, coders, billers, etc…Whatever it is you want to do most spend the most of your time courting only that and let it build.

    Otoh, doing just face would be tough, but complementary if with a body person next door. You do you, but no way I’d do that personally, but some people are into it obviously. Consults longer, pts older (sicker), cases last longer, follow up longer, they dont tell all their friends like augs, more revisions, etc…I’d rather do 4-8 augs in that time period.

    I pretty quickly cut out face entirely, no revisions except exchanges (not worth time/risk) or otherwise home runs, and it wasnt long before I was packed. Every region/practice different of course.

    #212419 Reply
    Liked by fiomi, Tim, hatton1, Hank
    Avatar fiomi 
    Participant
    Status: Physician
    Posts: 20
    Joined: 04/15/2019
    Whatever it is you want to do most spend the most of your time courting only that and let it build.

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    Definitely see your point. I really like this “Whatever it is you want to do most spend the most of your time courting only that and let it build.”

    #213307 Reply
    Liked by Zaphod, Tim
    Zaphod Zaphod 
    Participant
    Status: Physician, Small Business Owner
    Posts: 6059
    Joined: 01/12/2016
    Whatever it is you want to do most spend the most of your time courting only that and let it build. 

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    Definitely see your point. I really like this “Whatever it is you want to do most spend the most of your time courting only that and let it build.”

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    Its really good, focusing, and self reinforcing. Of course you still have to pay bills but keep it in mind as a way to steer your practice to what you want it to be eventually.

    #213583 Reply

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