In our last post, we took a look at some of what’s involved in starting your own medical practice from a business perspective. In this post, we’ll discuss other important elements to consider once you become your own boss, from staffing to marketing to patient care.

Once you’ve secured funding, found a good location, and gotten credentialed with insurance companies, the next step is staffing your practice. Some doctors do choose to go solo, but they are in the minority.

The number of physicians in solo practice was 17 percent in 2014 — down from more than 40 percent in 1983, according to a recent report from the American Medical Association. The biggest change between 2012 and 2014 was in practices of two to four doctors, which inched up just two percent, and in 2014 included more than 22 percent of doctors.

While Pamela Wible, M.D., sings the praises of being a part-time solo practitioner with no staff in Physicians Practice, most small practices opt to hire support. “Patients will ‘choose you or lose you’ just based on who you hire,” warns Linda Girgis, M.D., in Medical Practice Insider. “We started with just one employee to answer the phone and added more as we got busier.”

Day-to-day challenges

For some small practices, the day-to-day challenges of staffing and running a business are grim, as described in this post on KevinMD.com. Doctors may find themselves wearing many hats in addition to the one of physician—such as being the finance person, the IT person, and the human resources person. After learning the hard way, many doctors have adopted the “hire slow, fire fast” mentality. As a business owner, you simply can’t afford to keep unproductive employees on the payroll.

Work-life balance can easily fall by the wayside for solo or small-group practitioners. Almost half of doctors in the U.S. (46 percent) reported feeling worn down or burned out, according to the 2015 Medscape Physician Lifestyle Report. This is especially true for self-employed doctors who may work longer hours or be responsible for more bureaucratic tasks than doctors who are employees. Paying for IT support or an EMR that automates appointment-scheduling, prescription refills, etc., may be a worthwhile investment if it saves you time and stress in the long run. See our post on doctor burnout for ideas to spot it and fix it.

Some perks

Despite the challenges, however, many doctors who have started their own practices find that the benefits outweigh the cost. In some cases, that literally means the financial costs. Wible writes, “Because I’m no longer supporting a bloated bureaucracy that does not support me or my patients, I have extremely low overhead. As a result, I’m taking home three times as much income from each patient visit than I had taken home per visit in my high-overhead employed positions.” And she does this without charging patients any extra fees.

Other doctors, such as the one Davis Liu, M.D., describes on KevinMD.com, say the driving factor of starting their own practice was not the money or the lifestyle, but the patients, and providing them the best care possible without being forced to compromise their principles or bill unnecessary tests to boost someone else’s bottom line.

Patients and partnerships

When she decided to open a private practice, Wible gathered feedback from patients in person in a series of town hall meetings about what their ideal medical clinic would look like. She writes, “Now my job description is written by patients, not administrators. I’m finally the doctor my patients had always imagined.”

Wible’s approach is actually a smart marketing strategy for a small practice. According to Girgis, “The best marketing is actually meeting people face to face. We went out and introduced ourselves to people in the community: pharmacists, the police department, the township. We gave talks at senior centers and the public library.” Not only is this more effective than traditional marketing approaches like ads in the Yellow Pages or newspaper, all it costs is your time.

If you can reach out to other doctors, even better. Knowing the doctors you are referring to and vice versa helps you build trust in the medical community, writes Girgis. And doctors are more likely to refer to colleagues they know and trust.

Using patient education wisely

If you’re smart about it, you can use patient education as a marketing tool, as well. Hosting patient education seminars can be a good way to invite the public in to check out the new practice in town. Sharing high-quality patient education videos on your practice’s social media accounts and website sends the message to prospective patients that you embrace technology and are up to speed with current advances in your field.

Digital patient education materials that patients can watch from home or in your waiting room can also be a huge time- and cost-saving measure for solo or small practice owners who don’t have the staff to answer patients’ questions over and over and walk them through their treatment plans. For more ideas, check out our post on how to streamline your practice and boost revenue at the same time.

Even doctors who find that running a small practice is much harder than they expected say they enjoy being business owners. There’s just something about being in control of your own time, your patients, and your future. One doctor who went out on her own told MomMD.com she feels “more fulfilled than ever.” And Liu’s colleague reported that starting her own practice “was the best decision she made in her medical career so far.”

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