Action Plan For Residents
Planning a new practice involves lots of numbers -- and number crunching.
BY MICHAEL D. BROWN, B.S.B.A., S.P.B.C., C.H.B.C.

Many last-year ophthalmology residents are so focused on surviving that final year that they simply forget to plan for their future. They don't have a plan for opening a practice, don't have provider numbers, and they know nothing about marketing. They assume that by putting their name on a door -- John Doe, M.D. -- patients will immediately flow in. That's not going to happen in today's healthcare environment.

You can't start a practice without numbers. That's why you should begin making applications for your medical license and third-party provider numbers at least 6 months before you intend to open a new practice. As part of your advance planning process, you'll also need to determine how much you intend to spend to begin marketing yourself and your new practice. You should know the amount of your first-year marketing budget -- and have a comprehensive marketing plan -- at least 8 months before you open your doors to patients.

Obtaining any necessary medical licenses. As a resident in your final year, you should already have a medical license in the state in which you're doing your residency. But what if you plan on opening your practice in a different state? You'll need to be licensed in that state, too. This process and application can easily take 6 months. You'll need to gather all the required data to fill out the license application. This includes:

• basic personal data such as name, address, phone number, date of birth and social security number
• complete educational information, including schools attended, degrees received and location of your residency. All these citations must be accompanied by the appropriate dates
• any personal identifying numbers already acquired, such as DEA
• malpractice, liability and any other insurance information
• pertinent practice data, such as where you plan to practice, when you plan to begin, and your area of specialization.

Once you've sent in your application, you'll need to take what I call a "bulldog approach" to make sure that the application gets processed and you receive your license. Begin calling the state licensure department weekly to make sure that your application hasn't fallen through the cracks in the system. If you have the opportunity, personally visit the licensure department at the state capitol and try to "walk" your application through so that it receives immediate attention.

Florida is a particularly difficult state for ophthalmologists to get licensed because the state has a quota system for many specialties. If you're applying for a license in Florida, you should adopt a "super bulldog" approach by calling and visiting the licensure department regularly.

Obtaining third-party provider numbers. Getting your provider numbers is a laborious process that can easily take 3 to 6 months. Questionnaires are long and complex. You must continue to follow up regularly with the payers until your numbers are assigned and validated. You won't be able to bill a payer until you have a number.

Begin months in advance of opening your practice by asking all the major carriers in your market for a provider application. Complete your applications and submit them as quickly as possible. Here again, use the bulldog approach by calling the carriers weekly and visiting their offices personally when that's possible. Making yourself known to the carriers will help you obtain your provider numbers much sooner than if you just take a passive approach.

If there's a delay in assigning you provider numbers, you'll need extra capital in your operating budget to tide you over until payments begin to come in.

Developing a first-year marketing budget. The initial success of your practice will depend on letting prospective patients know that you're coming to their area and telling them what your plans are. To do that, you'll have to develop an appropriate marketing strategy and be able to fund it.

Many ophthalmology residents have no marketing dollars available to them. That's why I suggest that you establish a line of credit with a bank as a way to obtain the money necessary to fund your first-year marketing plan. You should also approach the local hospital in the area in which you plan to practice to see if the hospital will offer you an incentive package to join their group. Hospitals will, at a minimum, generally promote and advertise a new physician in the local media. If you're fortunate enough to get money from a local hospital as part of an incentive package, this could also be used for marketing.

Your success will largely be determined by the amount of advance planning that you do. As a resident or relocating ophthalmologist, you need to realize that planning is everything. By beginning your planning a year in advance of opening you can get your name known by the local hospitals, the media and the overall community. You can also begin meeting the optometrists in your area, get to know the competition and perhaps even do a few free seminars to attract potential patients. If you're buying an already established practice, you'll want to meet or at least contact as many of the practice's patients as you possibly can.

In today's environment, you can't become successful by mistake. It's not possible. The more that you plan, the greater your chance of succeeding with a new practice.

Michael D. Brown is president of Health Care Economics, Inc. in Indianapolis. He can be reached at (317) 845-5100, or via e-mail at Mdbrown@ameritech.net