The start–up phase of a new practice is very critical to its future success. Early mistakes can lead to inefficiency, decreased productivity, loss of revenue and unnecessary expenses. With proper guidance during the start–up phase, a new practice can save both time and money and become productive in a relatively short period of time. Doing it right the first time makes both "sense and cents!"
Dr. Carlos Correa's recent experience illustrates the correct process. After practicing internal medicine in the Chicago area for 10 years, the malpractice environment became so bad that he began to look for another place to practice. "I had never been sued," states Dr. Correa. "Yet I was paying exorbitant professional liability insurance fees. I finally decided that I had to get out, just to make a decent living. Because of my Cuban ancestry and being bilingual, San Antonio was a natural choice for me."
Southwest General Hospital pursued Dr. Correa and in August of 2006, he agreed to relocate to San Antonio and join its medical staff. That month he retained the services of Avante Practice Management, LLC, to assist him in the process of opening his new practice. The first thing he did was create a check list of all the tasks that would need to be done prior to opening the new office. The list was long. It included finding a location, designing the office layout, creating a new company, contracting with managed care insurance companies, obtaining business and malpractice insurance, evaluating electronic practice management systems and electronic medical records systems, purchasing medical equipment and office furniture, hiring staff and marketing, etc. He created timelines and target dates for each item in the matrix, and then he and his partner (Mary Wall) divided up the tasks.
As the saying goes, "The devil is in the details."
The list included more than 50 items and each item could easily include multiple tasks. Luckily, some of the items could be worked on simultaneously, but others could not be started until another task had been completed. "The planning phase is crucial," says Dr. Correa. "We did not want anything to fall through the cracks. So we made an effort to have good communication and coordination. In spite of that, there are some things that you just cannot control. So, you have to be flexible and be prepared to make adjustments as you move forward."
Using a consultant can be an advantage to a physician in a number of ways. Dr. Correa continued to practice medicine in Chicago during most of the pre–opening phase, so the time he had to allocate to the opening of his new clinic was extremely limited. Therefore, Mary and I were able to take care of most of the items on the list and manage most of the details for him. "I would fly down to San Antonio every three weeks or so and Jay would have numerous appointments set up," Dr. Correa explains. "We met with attorneys, CPAs, insurance agents, architects, contractors, EMR reps, graphic artists, medical and office supply vendors, etc. I joined the Bexar County Medical Society and the members were nice enough to let us use their conference rooms for some of our meetings with various vendors. They were very hospitable."
Dr. Correa's wife, Heather, also accompanied him on his visits to San Antonio in order to look for a home. "Combining house hunting with the practice start–up activities made for action–packed stays in San Antonio," says Dr. Correa. "Some days Heather would be off with our realtor while I was making the rounds with Jay. I had never done anything like this before, so it was an amazing experience for me. We managed to get everything done that we needed to and I left my Chicago practice in late December."
On January 1, 2007, Dr. Correa and his family made the drive from Chicago to San Antonio. The month of January was spent getting settled in the family's new home and finalizing details for the opening of the new practice. "As soon as the office was built out, we had to move in the medical equipment, office furniture, computers, phone system, medical and office supplies, and get ready to start seeing patients," says Dr. Correa. "We also ran a couple of newspaper ads and did a mail out to our target market to announce our opening in February. Now we are in the process of training for our new, electronic medical record system," says Dr. Correa.
"I am very happy about being able to practice medicine in San Antonio," Dr. Correa remarks with a smile. "We love San Antonio and the people here. It was obviously a big decision to make the move, but it all went smoothly and the end result is that I am now practicing in a new, beautiful office next to Southwest General, and enjoying it very much. Plus … I am paying a lot less for professional liability insurance!"
