MIX IT UP

  private practice

Switching Practices

Four steps can help you create a seamless transition from commercial to private practice.

BRETT HAMILTON, O.D., ROUND ROCK, TEXAS

ILLUSTRATION BY ESTHER BUNNING

I began my practice in 2003 as a commercial leaseholder next to an optical in a two-door setting. Under this agreement, I was responsible for hiring employees, examining patients, paying rent and paying and collecting on accounts on patient fees, telephone, Internet, diagnostic supplies, contact lens purchases and sales (my chain optical allowed me to sell contact lenses), etc.

Eight years later, I yearned for the private practice I envisioned while in optometry school. But I had a mortgage, children and was paying student and diagnostic equipment loans, so I wasn’t sure it was feasible. One fact told me it was: I had 10,000 patients as a result of the optical chain’s volume. If I transitioned 25% of these patients, while simultaneously adding new patients in private practice, I would be able to pay my loans and support my family. My private practice has been open since 2012.

Here, I discuss how you can make this transition.

1 Look for/negotiate advantages in your commercial contract.

The first step in the transition to private practice occurs before you sign a contract with a commercial practice. If you feel that you may want to pursue private practice in the future, look for a commercial contract that will ease the transition.

For example, my contract prohibited me from opening a new practice within one mile of any of the commercial practice’s offices for one year after leaving that practice. My private practice is 1.5 miles from the commercial practice, so I could open immediately.

Walk away from contracts which have a non-negotiable, non-compete clause. You don’t want to invest five or more years into a job that could stunt your move into private practice.

The contract may also include stipulations about the ownership of office technology (see number 2). In addition, realize you have the power to negotiate. No chain optical wants to be without a doctor for long.

2 Own the technology.

Many optical chains offer diagnostic equipment, a phone line, EHR and an electronic recall system at no charge to their doctors. As they own the equipment, they have access to your patients. Your telephone number is your No. 1 tool for generating appointments. Therefore, retain that number. Some corporations may offer you a free number. If you choose to accept this, also invest and market exclusively through your own line so that patients will have YOUR number when you move.

This technology also includes the EHR and patient records. Patients want to continue with the practice that owns their records unless the customer service is horrendous and/or the new business is too far from the commercial location. Also, EHR captures important demographic data, enabling you to customize your new business to your patients’ needs.

Electronic recall systems import patient addresses, cell phone numbers and e-mails into their database, granting you unlimited access to your patients via text and e-mail.

The bottom line: Owning the technology enables you to keep most of your patients as you transition to private practice.

3 Locate your practice near your patients.

Analyze your top zip codes using your electronic recall system or EHR, and open your new practice closer to where your patients live. Providing a convenient location for your patients gives them another reason to stick with you.

You may start your new location from scratch, or you may purchase a practice from a retiring doctor near your commercial location. I pursued the second option.

With 100% financing from the bank (zero down for a 10-year term with $60K in working capital for the first year), I bought a private practice from a retiring doctor 1.5 miles from the commercial practice.

I used roughly half of the working capital to update the optical. I decided to buy because it cost little more to buy a practice than build one from scratch, and it supplied six to eight extra patients per day to my schedule.

4 Create loyalty among both patients and staff.

Provide excellent patient care from the start to bind patients to you and prompt referrals. For starters, hire friendly employees who have team-player personalities. (Determine ideal candidates during the interview process by asking how they would handle various patient scenarios.) Your staff is the first encounter patients have with the practice, so they must reflect positively on you.

Something else to keep in mind: Many patients connect with employees as much as they do with the doctor, so instill staff loyalty by being fair, respectful and taking notice when a job is well done. This way, staff members will follow you into private practice as well.

Another way to create patient loyalty and referrals is to develop a specialized skill, such as vision therapy. Specialties require patients to see you more than annually, so they establish a need for patients to follow you into private practice, while generating revenue in your commercial practice. When I was in commercial practice, I offered vision therapy.

The more patients you see, the more likely they are to follow you into private practice. Facilitate patient visits by using relief doctors when out of the office. Some patients will follow their records into your private practice, even if they’ve never seen you.

Further propagate patient encounters by offering competitively priced examinations and accepting all insurances, including Medicaid. When you reach private practice, many patients will have switched to better insurance panels. Because you were willing to see them on the less desirable plans, you will retain them in private practice. In addition, you’ll have the option of dropping these lesser plans when you are in your new practice.

The end result

By retaining patients from my commercial practice, acquiring new ones from the purchased practice and adding revenues from optical sales, I was able to keep all the employees from both the old and new practices.

I hired the selling doctor to work two days per week. Now, I see approximately the same number of patients per month as I did at the commercial location. The two extra employees and doctor help with patient care without putting additional strain on me. Our gross and net revenues increased by 44% and 27% respectively in the first year. OM

Dr. Hamilton is a graduate of SCO and has specialized in pediatric vision. E-mail him at brettwhamilton@yahoo.com, or send comments to optometricmanagement@gmail.com.