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Should I take the plunge?

Discussion in 'Practice Management' started by Cinderalla, Mar 6, 2007.

  1. Cinderalla

    Cinderalla Welcome New Poster

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    I thought I'd finally join this site because I've been thinking of startig my own clinic. I've only worked in community health so i have no idea about how to start and build a private clinic! Just the thought of it makes me a bit nervous!

    I guess i have two questions:

    What are the best sales methinds to get patients in the door?

    Also how long does it normally take, on average, to build a fulltime clinic?

    thanks, Cinderalla
  2. williac

    williac Active Member

    Hi Cinderella -

    Yes it is a bit of a stress transiting from Public to Private (your own) Practice.

    My Tips:

    1. Find an under-serviced area (it's easier to get going).
    2. Check population demographics (old area = old clients, mixed = variety)
    3. Advertise (it's expensive but you have to do it).
    4. Network - (contact everyone you can think of).
    5. BE REALLY GOOD AT WHAT YOU DO. Word of mouth is the absolute best point of ongoing referrals.
    6. Be realistic - it takes time to start from scratch (6-12 months min). Open part time while continuing public work. Dilute public hours/days as the practice builds.
    7. There is a huge amount of 'behind the scenes' work to be done when running your own practice - if your not confident how to do the business side of things get external help.
    8. Good luck.

  3. Craig Payne

    Craig Payne Moderator

    The advice I was given a very long time ago was to budget for 1 patient the first week, 2 the second week and 3 the third and so on ..... but hope for more. The advice was aimed at ensuring you have the resources in place to survive while it grew.
  4. ja99

    ja99 Active Member


    Good on you for taking the plunge!

    In addition the the aforementioned points, make sure you visit all local Practitioners. I visited GP's, Chiropractors (I even spent half a day observing the Chiro to learn a bit about his Practice, after which he made an appointment for him and his Wife! His Parents also became regulars), Physios, Osteopaths etc etc. Sometimes other Pod's can refer if they have too much work, or you will do House-Calls and they won't. THESE 'GRASS-ROOTS' SOURCES OF REFERRALS WILL COST YOU NOTHING (except a referral pad to send patients to you, and perhaps a bottle of Cab-Sav at Christmas to show your appreciation)

    Set your fees the same as other Pod's, undercutting will not, in my experience, grow your Practice any faster! I tried a morning clinic where it was around half-fees just to help out those less-fortunate and keep busy, but to be honest the response was not great!

    Advertise in the Yellow pages first, but also put a catchy ad in the local newspaper. I found a great response initially in the "local rag" but it does tail off after a few months. It almost seems better to advertise for a few weeks, then rest it for a month and repeat. It wasn't a half-page ad either, just a Business Card size with the relevant details.

    I suppose the best advise is to watch your costs! In the early stages, you can't dictate your income, but at least you can watch what you spend. I even photocopied flyers and delivered them into letter boxes (Name, Address, conditions treated etc...) , gained exposure, and got fit at the same time! I've done well financially, but years ago was walking the Streets delivering flyers...don't be afraid to sow the seeds now to reap the rewards later!

    Best advise...Find a great location...location....location....get cheap rent, even turn on the waterworks if necessary! I found a great location and was busy within 3 months! However, like you said, I kept other work (Nursing Home, locum etc ) to pay the bills until I was quite busy.

    Ask other Pod's advice, especially the ones whose Busy Clinics you wish to emulate. Their advice won't always work for you! But you don't need to "re-invent the wheel" either. One colleague even took local GP's out to Dinner, but discovered no extra referrals anyway.

    Remember, the World is full of "knockers" who will pour cold water on your aspirations, but stay focused and be persistant. I believe Colonel Saunders (Kentucky Fried Chicken Founder) had to call on over a thousand prospects before one bought his recipe.

    To quote the greatest Teacher of all..."seek and you shall find, knock and the door will be opened to you"...

    Good luck and feel free to ask any questions little or large!
  5. Atlas

    Atlas Well-Known Member

    If one of your goals is to create a successful business, IMO, you better have one/more of the following:
    - one hell of a work ethic. To my knowledge the average community health centre pod or physio consults on average about 7-9 patients a day. Whatsmore, 4.30 pm and your out of there.
    My guess is that the average self-employed practitioner would get through at least 15, and be prepared to work 6 days, with some of those days 8am to 7pm.
    You don't get the salary sacrifice benefits in private practice, and when you go on holiday, money stops but bills don't.
    One possible answer to public waiting lists may be private mentality.

    - more style than substance

    - a hell of a lot of substance.
  6. George F

    George F Member

    I work as a community pod for a pct and see an average of 16 patients a day, and most other pods i know working for neighbouring pcts do the same.
    Last edited: Mar 7, 2007
  7. Craig Payne

    Craig Payne Moderator

    George - Welcome to Podiatry Arena.

    I have secret inside info (ie I know everyone's IP address), so can tell that Cinderalla and Atlas are in Australia and you in the UK. Atlas is refering to a common Australia situation (we get reports back from students about those kinds of numbers all the time), but I certainly know community centre podiatrists who do see more than that.
  8. George F

    George F Member

    i didnt realise Atlas was quoting the australian situation, but as mentioned in the U.K the patient numbers must be different
  9. Atlas

    Atlas Well-Known Member

    Sorry George, I don't know too much about the UK situation, as Craig has said.

    I guess patient numbers can be a bit misleading. I know of a podiatrist in Ivanhoe (Victoria, Australia), and Gippsland (Victoria, Australia) that probably see between 7-12 patients an hour?

    I would love one of these guys to teach me how to do a fair dinkum assessment and treatment in 5-12 minutes. But I would doubt that they would regularly fix their patients' problem in a few visits....just my hunch, no solid data.

    I think work ethic then, is about patient contact hours providing quality care. I have no doubt the CHCs in Australia provide quality care. But I doubt the average CHC staff worker would be matching the patient-contact hours that the average self-employed private practitioner would put in.

    Last edited: Mar 7, 2007
  10. First Step

    First Step Member

    "I think work ethic then, is about patient contact hours providing quality care. I have no doubt the CHCs in Australia provide quality care. But I doubt the average CHC staff worker would be matching the patient-contact hours that the average self-employed private practitioner would put in." :mad:

    I work for a CHC and privately for myself... yes Atlas six days a week.
    Don't question the work ethic of CHC Pods and try to justify it with client contact hour %. We all know client time is where private pods make their money and thats why we try to see as many clients as possible during our 4/6/8/10/12hr day( I know some private colleuges that work a 4 hr session for the day and that's enough for them; personally I work a 7.5) and then follow up those things that can wait after our private practice doors have closed.
    I don't even think a hard working man such as yourself would follow up non-contact client related business in your own time if you worked for a CHC. :confused: And it is for this reason that pods that work publicly have to set aside some time in the day to do these things.

  11. Atlas

    Atlas Well-Known Member

    But I doubt the average CHC staff worker would be matching the patient-contact hours that the average self-employed private practitioner would put in.

    I stand by what I said. And I haven't even begun talking about the non-contact hours put in by the average self-employed private practitioner.

    I'd love to find a several hours per week sitting around a round-table talking about handovers, grants, stats and projects...and still get paid for it. I might put it to the boss tomorrow and see what she thinks.

    Whatever. Just my opinion based on numerous observations of CHC allied health across the board.
  12. trudi powell

    trudi powell Active Member

    Getting away from CHC and private clinic debates.....

    Getting started and doing it right can make the first year very easy or very hard.

    Don't miss out on the next issue of the Yellow Pages !! Otherwise it could be up to 18 months from when you book your ad to the latest release. Each area has a different closing date, so that is one of the main dates you need to check before considering a lease.

    Start out Right !! Don't buy cheap and then buy-up when you get more patients. Think of the kind of clinic you would consider going to yourself and emulate that.

    Word of mouth is at least 30% of your business, so don't turn a patient away, they can lead to a whole family of referrals.

    Pick your area well and inform not just your local Chiros, Physios and Drs but also all the surrounding Podiatrists, out of respect for the Profession. Make sure your district work together as Podiatrists and realise there is plenty of work for all and work together during Foot Health Week etc and not try and undermine each other. You're joining an area as a new professional, so start as you would like to continue.

    If you are prepared to put in some long hours to start with, you will do well!!

    It is worth the move to private practice, but remember it is a business and your livelihood, so do the right thing by your patients and they will happily pay for the service you give them.

    And don't give credit to anyone. If they can't at least pay by credit card .....how did they think they would pay for treatment when they booked in ?? You would expect to pay when you receive treatment from someone, same as your patients expect to pay on the day when they receive treatment from you..... unless they think they can get away with it !! And there are always some that think they can get away with not paying !!!

    Do the right thing by your new patients and you are on your way to a very busy business ! Good Luck !!
  13. Atlas

    Atlas Well-Known Member

    Probably the best advice in this thread.

    And I know the 'proper thing' is to warn your future competitors of your pending arrival to the area, but, IMO, you have nothing to gain by doing so.
  14. trudi powell

    trudi powell Active Member

    Dear Atlas

    I know that some may not agree with letting your fellow practitioners know you are now their competition. But... the curtesy of advising the Podiatry profession as well as other professions can actually help you. Especially if you are already experienced.

    A letter advising of your state or country of qualifications and years of experience, with a brief of ' who you are ' can stop alot of mis-information.

    Years ago when I had a practice in the Sutherland Shire in Sydney, all the Podiatrists knew each other, had an end of year dinner in a cheap restaurant together and booked a full 2 page ad in the local paper during Foot Health Week together.

    We knew each others hours and abilities and if we had to make a 2nd opinion of a patient, we would gladly refer the patient back to the 1st Pod, if their diagnosis was the same.

    No-one needed to steal patients off of each other as it was a busy area ( and even more so now ). It was an area where there was no in-fighting or back stabbing and it worked very well.

    Doctors can be civil to each other, while still treating similar patients... so can Podiatrists! It makes the profession a nicer area to work in.

    I have notified all the Podiatrists in any area I have worked in of my impending commencement. And I must say it is always nice to be able to chat to your local Pod, as a collegue and not a competitor. Correct Julian ? ( a local collegue )

    People who are concerned about their own abilities may like to ' protect ' their patient load, but if your patients are going to try someone else, then it is not the 'new guy on the block's' fault.

    Like I always say.... Work as a Profession and the Profession will Prosper

    Trudi ( seeing the world through rose-coloured glasses )
  15. williac

    williac Active Member

    It's interesting reading about the Public v.s Private debate - especially as it is removed from the thought process of the initial thread.
    I work a combination of public and private (Victoria, Australia) - having recently opened my own pt practice in a regional area.
    The minimum patient load for me in public practice is 14-16 patients per day. Running half hour appts (no hour appts). I am always double booked 2-3-4 appts per day. Why - in an attempt to manage my ever expanding waiting list (currently at 4.5 months). I have never experienced the tiny through-put Atlas is suggesting.
    Have you ever worked in the public arena Atlas - or are you only going on what you have been told by others?.

  16. Jbwheele

    Jbwheele Active Member

    Dear Cinderella.

    I set up a private prac on my own in NZ after completing studies in Oz.

    Some things I recommend.
    Allow about 10 to 11 thousand people per Pod

    Rent a room from an established Physio or Chiro per patient (including Admin Eftpos Phone etc).

    Make yourself known to the Physios and GPs, Massage therapists and what you can do well, give them some presentations for continuing education points.

    Find somewhere with easy access and parking for the older customers.

    Business Cards and Fridge magnets (these are good for conversation topics / referrals when your patients have visitors over in the kitchen and its stuck to their fridge.)

    Word of mouth is the most important advertising, keep your customers by treating them well they will recommend you to friends etc.

    Get an Eftpos machine, don't rely on invoicing.

    Do not expect Sports teams to pay your accounts in a hurry, get the money off the Player.

    Sorry I won't go on too much.

    Be confident! Don't sell yourself short.
  17. ja99

    ja99 Active Member

    Quite correct Trudi!
    Although, I haven't noticed Cinderalla replying, and am wondering if any of this is useful to our Colleague?
  18. Cinderalla

    Cinderalla Welcome New Poster

    yes, yes, I've been keeping a close eye on this thread... its been a very interesting and informative discussion. I appreciate your feedback everyone,

  19. Atlas

    Atlas Well-Known Member

    I have been exposed to more than the average allied health clinician.

    Chris, I am talking about averages. Of course you will find one public health practitioner like yourself getting through 16 patients +. You may even find a private practioner who sees just 1. But if you go back to my original claims, I am talking about averages.

    Do public CHC's close at 4.30, 5, 5.30? I haven't seen any that go beyond daylight hours. Private businesses open earlier and close much later. Unless we twiddle our thumbs for most of the day, I stand by what I have said.
  20. tracyd123

    tracyd123 Member

    Hi I do agree with Chris,

    I have worked bth private and public and find the work challenging in both areas.

    Sure private practices are open longer hours and probably see more patients however there is other behind the scenes work publicly to try and maintain the ever growing wait lists.

    Talks, health promotion activities are also part of your day to provide some aspect of treatment to those who need it.

    Sure some public workers take it easy but for the vast number of motivated podiatrists out there it is still hard work in the public sector.

    I am just as exhausted after a day of public work where I see 12-13 clients as I am after a private work day of 22 clients!!!
  21. Nads

    Nads Member

    Just a quick note. I started a dom practice 1 month ago. I started by putting leaflets through peoples doors, targeting areas of high elderly population. in my first week I had 5 patients. In second 10 patients, third 15 patients and this week I had 18 patients. I now do 1 to 2 days a week doms and have been offered 3 days a week in another private practice in the next town to me.
    I couldn't afford to advertise so this was done using my computer and printer. The suprising thing is that it only cost me £1,000 to get started and I have taken nearly that already and I am rebooking every patient I have seen!!! This has amazed me as I was told that I would be likely to only get 50% rebookings.

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