Struggling Practice?

As I read through the forum, I come to the conclusion that either some podiatrist is doing very well, and others are not. Why is this in our profession? Is this something unique to podiatry?

Residents and new practitioners don’t have any guidelines for starting a new practice and podiatry school doesn’t really offer any courses on insurance, where to start a practice and general pitfalls that can drag a practice down. I know that when I got out of residency, I didn’t have a clue concerning insurance companies and general business tips to get a practice up and running. I can honestly say, it took me roughly 2 to 3 years to get all the kinks out. I’m going to post a few tips on general business principals to help residents and new practitioners get started in a solo practice:

1. SOCIOECONOMICS- It may sound silly, but why go and practice in an area filled with podiatrists. There has to be a general need for podiatry in your area. Is your area a retirement community or a busy business community with young families? These answers will guide you to what type of patients you will see and what services you can provide. Also remember that location is EVERYTHING. Try and be in areas accessible to people with good parking. These little things can make or break your practice.
2. INSURANCE COMPANIES- What insurance companies are there? Make sure you can get on all the plans in your particular area BEFORE you settle. What are the ratios of private vs. managed care? If you live in an area of managed care, some plans will not take new practitioners on board, cornering you out of the market.
3. CODING- Take a good course in podiatry coding and all know all its nuances. Medicare has great courses you can take that will introduce you to the rules and regulations concerning podiatry and how to code.
4. STAFFING- When you first start practicing, start SMALL. You build a practice with competent employees who are willing to help you succeed. Finding good staff for your office will be your biggest ‘new business’ challenge. I’ve seen all too many practices start out in fancy buildings with a large staff, only to see them go under. Remember that your staff can break your practice. The key to a successful practice is keeping your OVERHEAD down. Start with just the essentials.
5. BUILD BUSINESS RELATIONSHIPS WITH YOUR COLLEGUES- If you don’t have any business contacts like other doctors, you will not have a good referral base. Your best advertisement is the way you treat your patients. Word will get around and your practice will flourish. But in the beginning, no one knows you. You can send letters to your colleagues advertising your services. But don’t advertise your credentials and get cocky. Just keep it simple explaining your services and that you will be available to them if needed.
6. DO EVERYTHING - If you have to go to a nursing home and see patients, and then do it! What ever it takes to keep your practice afloat is important in the first years of practice. Even if you’re a fancy, surgically trained podiatrist, basic podiatry skills will be your bread and butter of your practice.
7. GET A SMALL BUSINESS LOAN AND A GOOD CPA – In the first years of practice, a good CPA will help you keep your taxes down by providing you all the avenues of tax right-off. This will allow you to continue loan payments without going under. Every year, there are new tax laws that may provide you an opportunity to keep your tax base down.
8. PAY OFF YOUR LOANS QUICKLY – The sooner you are financially independent from your financial institutions, the better off you will be. Don’t go out a buy a fancy house, fancy cars and toys before you have paid off your loans. When you start turning a profit in your practice, put every penny into paying off your loans. I was able to pay off basically 2 ($100,000) loans in the first 3 years of practice. It can be done.
9. HAVE A STRONG WORK ETHIC – Not every patient walks into your office wanting to have surgery. Keep surgery as an option for your patients, but exhaust conservative measures of treatment. Be energetic in your work and have a solid work ethic. Define your treatment plans and goals with your patients and lay out the plan of action. Patients are looking for a confident doctor who knows what he/she is looking for. Look at your own treatment plans for the most common ailments such as heel pain, general arthritis, skin conditions, etc. Have a starting point and end point for each of these treatments.
10. ENJOY WHAT YOU DO AND DO IT HONESTLY – Patients sense whether you are happy with your profession. If you’re not happy, your patients will not be either. You may want to step back and determine whether this is the right profession for you.




Podiatry is a great profession if you play by the rules and enjoy what you do. Remember, these are just general tips, and I’m sure there is more. Feel free to add to this thread with any more ideas.

Al Kline DPM
http://www.podassociates.net