Opening a Practice in the Middle of a Pandemic

 

So, COVID-19, huh? It’s been quite an experience for everybody. I had the dubious fortune to open my solo practice in the middle of a global pandemic. Fortunately for me, I opened doors after the big PPE crunch of the Spring was over. Unfortunately for me, I was unable to take advantage of the CARES Act loan forgiveness programs. The other downside is that patients are deferring a lot of non-urgent medical care. It’s been a little under three months since I fully opened, and I have to say that I still think I did the right thing.

 

How to tell people your practice exists

It’s all well and good to do door-to-door marketing. In fact, you should visit every primary care doctor and optometrist in your market to let them know that you exist and what your practice can offer. Unfortunately, with the pandemic in full swing, I was unable to meet everyone face-to-face.

The alternative that I settled on was calling every primary care doctor and optometrist in my market as well as mailing them all an introduction letter. I was able to meet a handful of docs in person (socially-distanced, masked, and no handshakes). I brought some fancy chocolate for the office, promotional pens, business cards, and referral forms. The in-person meetings were easily the most effective as they resulted in a handful of referral sources actually sending me patients. I have only netted one steady referral source from my telephone and mailing campaign. Once there is a widely distributed vaccine, I will hit the road again for more in-person meeting. In the meantime, I make a phone call every 6-8 weeks to inquire about their referral needs.

Advertising is another very important way to spread the word about your practice. I’ll get into it in more detail in a separate, dedicated post. However, the highlights are that I bought a billboard for one month, radio ads for six months, and pay per click ads (Google ads). I started all of this toward the end of my first month, and I think this has had a positive influence on my practice growth.

 

Growth is still very possible, even in a pandemic

When I started, I saw a handful of patients my first week. By the end of month one, I had seen on average a couple patients per week. Despite all that, I was dangerously close to being cash-flow neutral (due to my extremely low overhead and heavily negotiated contracts). During my second week of my second month, I saw more patients than I had during my entire first month. As I’m writing this (a little over two weeks into my third month), I have already seen more patients in month 3 than I have during the first two months of practice combined. I also did my first surgery this week and booked a few more. Since insurance reimbursement tends to lag behind the date of service by a few weeks, I anticipate breaking even or possibly making a small profit this month. As you know from a previous post, low overhead is key to becoming profitable quickly. My growth rate is on pace to become regularly cash flow positive between months 4 and 6. At that point, I'll be able to take extra profit as a distribution in addition to my salary or increase my salary and take a distribution (whatever my CPA recommends). 

 

What about pre-pandemic?

As you’ve seen in the previous paragraph, starting a practice is a pretty slow proposition. I believe this is doubly true in the middle of a pandemic. As a direct comparison, let’s look at one of my friends opened his practice in 2018. He did aggressive marketing and wound up seeing no fewer than 5 patients per day during his first month! I attribute some of that to opening pre-pandemic and some of that to his more aggressive marketing strategy. In any case, his subsequent growth had him seeing 15-20 patients per day within 3-4 months. 

 

Is solo practice still a good idea?

I still think I did the right thing. It has been somewhat anxiety-producing to have several days without seeing a patient, but I am much happier than I was being employed. The freedom to see and treat patients as I see fit is incredible. There have been zero office politics and no clinic administrators telling me how to practice medicine. I spent a significant amount of my downtime so far working on my business instead of working in my business, and that has helped enormously. Now most of my administrative work is essentially on autopilot, which allows me to spend most of my downtime with my family, exercising, and reading for pleasure.