Setting up a private practice - what advice do you wish you had been given before starting?

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Hi, just wondered if i could pick your brains? I'm am currently trying to set up my own practice (to begin with as a purely domicillary practice - but with plans to get a clinical base). I've been reading all the (well not quite all - if i did that i would never get this business started) posts on here and have picked up loads of tips/ideas, and, a list of things to worry about that i hadnt even thought of.

So my question is; what do you know now that you wish you had known when you started your practice?

and; what is the best advice you can give to a new start up (from scratch - can not at present afford to buy a patient list - and is buying a patient list worth while?

and finally, if you have a website what are your top tips to get it prominent in search engines - is it worth investing in google ad words?

thanks - and looking forward to your responses

 

I can't help with much of the other points as I do not have my own practice - I basically do daily consultancy/contracting type work in 5 different locations on a self employed basis. As a result I have to market myself as an individual rather than a practice - so it may not be totally relvant to you - but I do know a bit about web advertising having designed my own website.

Firstly you must know your audience. Who are you targeting/what is your patient base? If its a 60 years+ demographic for 'routine' treatments a website may well be a waste of your time. If it is a 20-40 year old population then its the way to go in my opinion.

If you have someone professional do your website for you not only will it look the cats whiskers and they should do your search engine optimisation (SEO) for you. Pricey though. If you build your site yourself (there are plenty of packages which spoon feed you and are like generating a powerpoint rather than you having to learn html or java coding) then it is much cheaper and you have more flexibility - but you will have to research SEO yourself. I do not profess to be an expert - it is a vast subject/skill - and people who are good at it do it full time and get paid very well for it. But you can pick up the basics online.

One thing which makes a website more visible (and therefore affects its google ranking) is the number of other web pages that link or point to it. this is why most people have a twitter/facebook/blog/linked in account nowadays - it all drives traffic to your website. Another other thing you can do is register with all the free online directories (like craigslist etc). There are loads of these little things that you can do to increase your visibility.

There are also certain "do's and don'ts" regarding the design of your webpage. Once you have taken the trouble to get people there you want them to stay around long enough to see what you offer and book in to see you right? Alot of this is common sense - think about what puts you off of a website when you visit one. People are busy - they need to be able to find the information they want fast and they dont want bright colours or flashing animation etc etc - otherwise they'll just hit the back button and click on the next one down on google. Again loads of hints and tips on this available online - I can go into more detail if you like.

I personally do not pay for any advertising such as google adwords etc so can't give you any guidance there I'm afraid. But my stats tell me I get 10 hits per day on average, and I receive at least 2-3 enquires via email per week. For a site that costs me £10 a year and not a penny more I'd say thats acceptable to me. I'm of the belief that if you have good SEO and your website is clean, tidy well organised then it will do the job you need it to.

As I say I'm no Bill Gates, but hope my geeky ramblings help somewhat.

Ian

 

Visibility and presence is everything. Having spent 2-3 years trying to do little pieces of advertising and finding cheap ways of doing things, I managed to arrange with a local newspaper with a large distributorship to treat someone in their organisation with foot pain.

I did a biomechanical analysis - I have a simple 2D set up - and provided some orthotics - low cost prefabs as the problem was not severe plus an analysis report with pretty pictures. It took me 2 hours and cost me £30. They then agreed to give me a cheap advertorial in the paper(£400 for a full page write up + advert - which is cheap where I live). The write up was reviewed by me prior to publishing and I gave them key things to include +images.

Everyone benefited. Paper got some advertising revenue, member of staff got treated for free and I got a good advertorial with plenty of feedback - picked up 20 patients in the first 3 days and have had 6-7 on average per week thereafter. Has easily paid for itself and given me greatly increased visibility to the general public.

Generally associating yourself with other local health professionals and networking is the key. Referrers are better than individual members of the public. Hope this helps.

Robin

 

sorry if this isn't want you want to hear, but I would start up in a room, preferably rented from a local GP practice (GPs could really teach you about business).

pts actually mostly prefer to attend somewhere, than having their privacy invaded ( obviously the housebound are exceptional to the rule), and will save you spine/neck from early damage.

 

first of all....do your investigating.
search locations:
pick a location with good accessability for patients...ie an existing medical building.
look at competition in the surrounding area.
have a good look at businesses and factories in the area as these will be potential clients.
consider the businesses in the area that provide insurance coverage to their employees.
find a place where doctors will be willing to refer to you due to location.
bang out letters to doctors to introduce yourself for patient referrals.
Hope this provides some help.

 

I have not had much success with web pages....i find most people will go to their doctor first and then check the phone book.
I would recommend investing more into the Yellow Pages than the net.

 

I find the exact opposite. Most people I see wouldn't dream of opening the yellow pages/phone book. It's simply about identifying your audience and then how to target them most effectively. A lot of patients I see don't even have a GP so google is their first port of call for everything.

 

It depends on the audience as you said before. If you envisage that your client base will be 60+ y/o and looking for standard podiatric treatment, the GP, yellow pages route is likely. However, for the 20-40s active patients, the thought process is

My heel is sore
Google heel pain
Find out what I think it is
Find someone in my area who deals with it
If their website is clear enough and they don't charge too much -book an appointment or send an e amil enquiry

I get equal traffic of website to yellow page, perhaps slighty more website. More than that, however, is word of mouth and professional referrals, chiropractors, osteopaths, physios, orthpaedic consultants,personal trainers etc

Good luck

Robin

 

Plan, Do, Check, Act.
Take all the stuff everyone is telling you and sit down and write a business plan for your business.
Focus on the three (equal) fundamentals of Marketing, Operations and Finance.
Then put your plan into pratice.
Review as you progress, improve as opportunities arise.
Good luck.
Owen
ps: business is all about customers and their expectations.

 

Thanks for all the comments: just a few more questions... (if you dont mind!)
- how would you go about finding rooms to rent in surgeries - is it just word of mouth, or, would it be worth contacting the local PCTs to see if they keep a list/information?
- and does anyone use a virtual receptionist is it worth the outlay to ensure the call is answered (when I'm treating) or just hope that people will leave messages?
Thanks so much for the advice (and Ian could you post a link to your website so i can have a look at what can be achieved!)

 

I've sent you a PM with the link

Ian

 

My wife has a small private practice on saturday mornings. She contacted local pharmacies, the 2 GP practices, a few hairdressers rolleyes etc.

Out of 25-30 letters, only one GP practice offered. Back then it was a hole of a room, but now its just been completely modernised and impressive to patients.

Have you considered approaching other local private pods to see if they have surplus work? They just might need a little relief, and a network buddy!

 

Key for rooms in my option.

Value for your buck/pound - don´t over pay it
location, location,location
clean looking, not a dump

Key for opening practice
let as many people know that your there for as little money
letters to other healthcare professions.
website
noticeboards in Gyms
contact local diabetic groups etc.
Word of mouth is key.

also have the thought that all money that comes in for a period of time will got back into the clinic.

Also check out this link Starting a small business top 7 reasons why small business fail

 

May be worthwhile contacting Those in charge of Birmingham (Local Improvement Finance Trust) LIFT buildings.

http://www.baslift.co.uk/NHS/index.html

In reply to your second question: I use a company called Real Time Reception.

I would recommend them.

Good luck,

Mandy.

 

Thanks for those links and the advice its fantastic; got a massive (and growing) list of things to think about and sort out!
Thanks for all your help x

 

If you don't use a receptionist and use a land line answerphone system invest in caller ID - I often get potential clients who neglect to leave a phone number!

When I started I advertised in Yellow pages, made myself know to the wardens of sheltered accomodation and set flyers to local hairdresssers - lots of women complain about their feet to their hair stylists.

 

I had a virtual receptionist before my practice was big enough to employ a part timer. It is very useful. Patients hate leaving messages and hate waiting for replies. Having someone doing it in business hours is great. Initial set up for me was £120 approx for mobile phone, literature, stationanry etc. Monthly charge was £25-35(can't remember)After that, it was £1 to answer a call, and £1 per message/email/letter sent out therafter. Obviously it depends on how many phonecalls are being fielded but it was definately a cost beneficial way for me to do things. Also, they will generally offer services like accounts/dictation etc which when you get busy will be very helpful.

Best of luck

Robin

 

One very large clanger that I dropped some thirty plus years ago was not putting aside money for the taxman. Even though I had an accountant to do my books the sudden arrival of a tax demand concentrated the mind but left me short.
Now I transfer 25% of any surplus each month into an interest account, so when the tax man wants his pound of flesh it's readily available and I make a little interest on it too!
Remember you will not just be paying tax on what you earn this year but also an advance on what they consider your tax bill will be next year.
Alternatively just get a decent accountant's advice now!

Regards
David

 

:good:
Did the same myself - very sound piece of advice. Difficult to do at start up because you want to see some returns but needs to be factored in

 

Thanks for the tax advice - luckily the big sister is a tax accountant so she's not let me forget it!
All this advice is fantastic - really getting a concrete plan together as well as some patients already!
Keep the advice coming - i'm sure i'm not the only one finding this useful x

 

If your long-tem aim is to build up a successful practice, remember to leave some non-clinic time to work on the business.

It's hard when you're starting out not to grab every bit of work that comes along, and it never gets easier to turn away business. But try and leave an afternoon if not a whole day a week eventually to work on the practice and not in it.

I'd like to point out how guilty I am of consistently breaking this rule

 

I think the best advice is don't do it too soon. I have seen people too soon out of uni do an enormous amount of damage to their reputation because they were not at a stage of their career where they could successfully treat the foot pain problems they were seeing.

Don't be in to big a hurry, there are a lot of years to make hay. The best investment you will make is working for a number of years with a mentor who will help get your skills up to a point where marketing is not as essential in the long term. Someone who can put out fires for you also protects your reputation, and all good marketing experts will tell you your brand is everything.

 

I do agree in someway that straight out of uni is not the way to go into private practice (however, I do also work for the NHS and as an associate for two other practises) but it does depend on your experience - and also the quality of mentorship available. I have recently been providing cover for a practice run by a podiatrist that does not bring much credit to the profession (one of the reasons i have up'ed my work on setting up my own practice) because as you say 'reputation' is everything.
Additionally, I believe that seeing a keen new graduate that is keen to to prove themselves and get to the bottom of the problem, is better then seeing a jaded established pod that just does the same for all patients because 'that's what works' - i often advise my patients to accept the offer of a registrar appointment when visitng their GPs as new fresh ideas and recent study often brings more to the appointment then years of 'experience'.

 

I would definitely look for a pod to work for that will provide the mentoring and skill development you are seeking. Doing it all yourself is a lot slower and it is not as glamorous as you may think. Financially I have found it takes a number of pods to be working for you to make the sort of money you can make with a good employer.
All the best with whatever you do.

 

Hello pod at home,
I would agree with Rudy and suggest you get some experience working for someone else (either as a locum or associate) before you start on your own.
That way you can see how a business runs and have someone more experienced on hand if you have a query.
I had 18 months in the NHS before I went into pp.

I also wished someone had told me how back-breaking and demoralising working in old folks homes can be. I certainly wasn't prepared for that. I certainly wouldn't advise anyone taking that type of work on unless the facilities were good and the fees at a professional level. You have only one back and will need to make it last !

regards
catfoot

 

Great post and an appropriate one to remind all interested (and within Aus)
of the
2 day Private Practice Conference in Victoria, this will focus on improving systems, marketing, including profits, retail, e-commerce and much more.

Also the Young Podiatrist & New Graduate Seminar will introduce new podiatrists and especially those dabbling with ideas of setting up a practice. Covering all ideas previously discussed, finance, tax, marketing, suppliers, insurance and many other considerations to get you set!

Check out both of the programs and registration

www.podiatryevents.com.au

Good planning! and Good luck!

 

Golden Rule to remember

It takes YEARS to build a reputation and 30 seconds to destroy it !!

NEVER be so busy that you cut corners in your Tx or shopfront to the patients.

Word of mouth is probably the best advertising you will get locally and can be the difference between success and failure.

My first accountant told me If your business dosent work in 5 years it's not going to work, which I think is very true on reflection ( they are the years you need to re-invest a big lump of your takings to secure your future which can be hard to the point of soul destroying at times I seem to remember), so if that happens don't flog a dead horse, move on.

Also for those just starting, don't go to the big accounting firms with offices etc you will pay the earth for their services.

Find a small one with a good reputation and get a quote before you commit to them.

Hope that helps

Cheers
Derek

 

I think it is great there is an Aust Ass looking at private Practice Issues. I wish I could be there. However I find it unethical to be suggesting newly qualified pods should be going it alone. We all suffer when there is a pod doing poor work. There should be a minimum requirement to set up on your own. I reckon 5yrs of experience should cover it. Unless your conference says very strongly don't do it then I find it hard to support.
Obviously a partnership with an experienced pod is a different situation. There just needs to be an experienced clinician to troubleshoot with.

 

Thanks for all the advice - as said before I do agree that experience and mentorship is very importent.
I have had NHS experience which is one of the reasons i thought now might be the right time to start my own practice!
And, since posting this question I have become an associate with a sucessful (business and treatment) pod who is also keen on helping me develop my own business with lots of helpful advice and guidance - as well as prviding vital employment whilst my business builds up.
So thank you all for your advice

 

Hi Pod At Home

Now it has been one year on..... I wonder how well your plans went and whether you are still in NHS + private or all private? You will also have (Im sure) some brilliant tips of your own that are still fresh in your mind to share? Please do!

Im newly graduated but realised the real benefit of a seasoned Pod's condensed experiences is priceless and decided also to work as an associate well away from home because I did not want the sticky situation where patients want to leave the practice with you! Im very grateful for the help/tips Im receiving daily and dont want to repay that kindness by taking patients away! (Having said that Im working on building my own clinic at the back of my house near shops/brilliant chemist/adviser so I can one day free-fly!).

I currently work (on my own) in a large company as an inhouse Pod with other professionals. I also do a DOMS run for another PP AND occasional Sats for her, plus Im an associate in a well established clinic working with Osteopath, and footcare assistant .... its GREAT! One day a week Im working for NHS bank staff. I could NOT have just opened in PP without this run up (but I know others have and done well so not knocking them!)

Despite the above, I really would LOVE a mentor (especially for biomechs which sometimes eludes me) as I know this can only enhance my advice/practice.

Hope you see this message

Regards
Linda

 

Hi Linda

Robert Isaacs is in your area and always willing to help, I'm sure he will see this but if not PM me and I'll sort it and get him to contact you .

Cheers
Derek

 

Grumble grumble...

But yes. Always on the end of the email for any biomechanics assistance I can offer. Also willing to spend time helping you in clinic in return for a banana milkshake from Mcdonalds. Bring questions, I'll ask you others which will hopefully help you reach answers.

 

Hi Robert

Thank you for your swift reply (albeit with your arm being bent behind your back by DTT's offer on your behalf !!!)

I would happily provide the Banana Milkshake - does that mean I could shadow you in your clinic (?)

Seeing how another clinician works is ALWAYS beneficial as it cuts through the much longer thought processes of a novice practitioners and cuts to the chase.....

So.. hmmmm.....that Biomechs study day.....did they pay you in Milkshakes???

Really enjoyed it, you made it fun!

Cheers
Linda

 

Be gentle with him Linda he is such a delicate little flower, never argues or speaks out of turn, and is very shy and retiring

Enjoy:drinks
Cheers
D

 

Much like you in that regard Del

 

:drinks

 

with regards advertising the yellow pages and thomson local pay for themselves.word of mouth is the best form of referral,it will take up to 3 years to have a reasonable income.the first year will be difficult and you should hope just to survive.it sounds pessimistic but you must think of the bigger picture.a ground floor premises is vital.i found an intoductory offer succesful,half price for your first treatment.you are just trying to get people through the door so to speak.i have been in private practice for 11 years and worth the perserverance.gud luck.

 

I have advertised in Yellow pages for ove 20 years spending A LOT of money in the process.

This year I stopped the advertising with them and have not recorded any significant reduction in patient flow from that particular scorce to the overall patient flow.

Craig made a point on here some time ago..." ask yourself, when was the last time you used Yellow Pages to find anything" ??

The internet is the way to go IMHO

I'm not sure about your suggestion of " going in cheap" to get patients either.

Quality care will always win over the 2 bob service

Cheers
D

 

Guilty!
Being a podiatrist myself , if I have pain / problems ELSEWHERE in my body - I always google, then go to the drs. That thought process is definitely true for the 20s age group!