The Mrs. finally bit the bullet today and let her boss know that she will be opening up her own medical practice. This is a Chicago story because we’re swimming against the tide, moving from NW Indiana to Illinois while the big story is the tide of doctors going the other direction. So is it possible for a doctor to open up a brand new (no existing patients) practice in a state in a malpractice insurance crisis? We’re going to find out and I’ll be chronicling the story here and in my individual blog Flit(TM).
5 thoughts on “An Entrepreneurial Adventure”
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At least you are guaranteed minimal competition! The balance of supply/demand will certainly be in your favor.
Actually, it hasn’t gotten as bad as West Virginia or we’d be staying in Indiana and my wife would do hospitalist work for two years to run out her noncompete terms. She’s got plenty of patients who love her and would follow her to give her a starting base.
Your spouse might look into opening an all cash (i.e. no insurance accepted) practise. I know a doctor in a neighboring town who has done just that: Dr. Robert Berry http://www.emergiclinic.com. He seems fairly successful. He was featured in the WSJ about this time last year.
I don’t know if Erik’s idea makes sense from a business standpoint, but it is very appealing from a patient’s perspective. Physicians are generally pleasant and helpful, but third-party payment has transformed many doctors’ office staff into surly bureaucrats who do not know how to treat customers who foot their own bills. Perhaps there is a competitive edge for physicians who are sensitive to these issues.
Unfortunately, starting a cash patient practice from scratch requires a great deal more capital. The problems are several:
1. You lose your referral base from the insurance companies which provide a great deal of free advertising.
2. The loss in referrals have to be made up with paid advertising of one form or another which requires an increased level of startup funds
3. The insurance companies not only provide you with free advertising but a form of vetting that patients use as a rough measure of quality. They trust that their insurance companies are not going to provide them with a list of quacks. If you already have a thriving practice, your patients know you and you can drop insurance companies and the patients that stay provide their own word-of-mouth testimonials.
We’re actually looking at MDVIP as a possible route as we would be the only MDVIP physician in Chicago land and the MDVIP label might provide enough cachet to make up for the insurance company freebies. Starting out from ground zero without anybody behind you is just not practical with the amount of free cash we have today.