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Best Practices for Building Your Own Successful Dermatology Practice

You’ve made it. You’ve finished medical school, earned the right to add those two initials after your name and chosen dermatology as your area of specialization. Congratulations!

Now that you’re done, have you thought about what the next steps are? Whether you’ve always planned to start your own medical practice, or just want to learn more about what it takes, we’ve gathered some expert advice, including considerations people sometimes neglect to focus on and best practices for success.

Minimize Risks, Maximize Rewards

“Starting a new practice has risks, but it also has rewards,” says Thom Schildmeyer, Vice President of Revenue Cycle, Strategy and Development at Modernizing Medicine® in Boca Raton, Florida.

Ask yourself if your bigger motivation is less risk or bigger reward. “Because that is going to determine how you start the practice and what kind of person you’ll likely be in terms of utilizing resources,” Schildmeyer says.

People motivated more by safety and stability might say ‘I need to have control.’ At the same time, they are often reluctant to spend a lot of money. This scenario creates conflict. “It’s difficult to maintain control if you’re too conservative with your spending,” Schildmeyer says. More money tends to translate to better resources and greater efficiency in the business over time. Less spending tends to lead to less revenue.

In contrast, if you’re more like people motivated by reward, you’re generally willing to spend more money upfront. Like entrepreneurs, these people invest in ‘best-in-class’ technology and equipment whenever possible.

Schildmeyer says the concerns he hears aren’t ‘I didn’t have enough money’ or ‘I ran out of money.’ “Never. I mean sure, many people watch the money or only have so much to spend to set up their practice. And that’s good to be diligent with your money. However, what I hear is ‘I didn’t plan well enough for what needs to be done.’ That’s why it’s imperative that you’re spending money on what really matters and not what’s the most or least expensive solution.”

Thorough Planning Can Pay Off

The last thing you might want to do is more homework and research after just finishing medical school. However, the investment in preparation is essential. Once you’ve figured out your motivation for opening your own practice – which can help you navigate your strengths and weaknesses – next consider these key questions: Where? Who? What? And how?

  • ‘Where?’ is usually the simplest question to answer. Do you want to locate your new practice in a particular state, city or even zip code? Remember that state and local regulations differ and can impact your practice’s bottom line. Also, some areas will have more business competition than others.
  • Who? What kind of patients do you want to treat as a dermatologist? Are you leaning toward cosmetic, medical or a mix of the two? Will you provide more invasive procedures, such as Mohs surgery? Figuring out these specifics in advance will help you plan how you configure your practice, dictating in part the kind of people you hire and the physical space requirements you’ll need.
  • What Resources Do You Need? Carefully consider the type of technology that will help your practice get up and running quickly. For some dermatologists, this can mean a stand-alone EHR system, practice management system or even revenue cycle management (RCM) service. For others, a particular combination of these systems is ideal.
  • Remember that you can hire more staff or less staff depending on the kind of technology you choose.

  • How? Although you’ll need to figure out your budget and how much money to spend, this question really focuses on people, process and technology:
    1. People.

      What kind of staff will you hire? You probably won’t be as successful if you hire Mohs-type people for a clinical practice. Mohs surgery is a low-volume, high-dollar enterprise, whereas clinical practice tends to be a high-volume, low-dollar scenario. And those different types of practices are supported by different kinds of clinical staff, Schildmeyer says.

      How much do you want to be involved in leadership? What kind of practice manager do you want to hire? “The worst thing that can happen is when you make any of these good decisions but you have the wrong person for the role,” Schildmeyer says. “It’s hard to make a change to your people because you usually don’t know something is wrong until it’s really wrong.”

    2. Process.

      Articulate in advance how you plan for each clinical, surgery or aesthetic patient to move smoothly through your practice. It’s true that the process can be changed, but changes come at a risk, Schildmeyer says.

      The more you change your technology and your process, the higher the risk of disrupting your practice’s efficiency. “If you’re changing because you’re making a lot of mistakes, you’re causing disruption. On the flip side, you have to invest in change to be able to adapt, scale up and grow.”

    3. Technology.

      The type of practice you create will also guide your technology needs. A high-volume aesthetic practice that offers multiple cosmeceutical products will require robust inventory software. A high-volume clinical practice could also benefit from effective EHR and practice management systems, or even an all-in-one solution that features an integrated RCM solution.

      Choosing the wrong technology can lead to problems. “If you go high risk and choose a technology that is not well supported, you’re already invested in it,” Schildmeyer says. “You really want to go with a tried-and-true market leader, even if it costs a little more money.”

Common Surprises

Schildmeyer says physicians starting a new practice are sometimes surprised, but not always in the ways you might think. “For example, some don’t anticipate the extensive time it can take to set up all the elements of a successful practice. And finding the right location, signing a lease, setting up all the furniture and hiring the initial staff can be so time consuming that they neglect other important elements,” Schildmeyer says.

“Another thing I hear often is ‘I wish I had planned earlier, sooner.’ It takes time to interview staff, perform due diligence, conduct background checks and complete hiring.”

In addition to planning for hiring delays, you need time to do research and look at demos when choosing practice technology. “They all know they need to have a medical assistant, they all know they need to have someone to manage the practice. But they don’t always think about how long it takes to find the right practice management system, and some end up making a rushed decision.”

What Do I Do Now?

Dermatologists sometimes focus so much on the factors they need in place to open on the first day that they forget to fully plan the billing, accounting and revenue collection part of it, Schildmeyer says. “Then all of a sudden they get caught.”

“That’s the question I get most often: ‘What do I do now?’ Other related questions are ‘I’ve got two weeks to open up, and I’ve got no one to do my billing’ or ‘My technology is tied to a billing company I don’t want to use, what do I do?’”

Your best bet to avoid being caught off guard when you open the doors of your new practice is thorough planning. Yes, it’s a lot to consider all at once, but in Schildmeyer’s experience, the dermatologists who take time to thoughtfully prepare end up spending less time scrambling and more time seeing patients from day one.

These thoughts on starting your own dermatology practice – including how to avoid common pitfalls – are intended as general areas to consider to get you started on your way. The American Academy of Dermatology Practice Management Center and the American Society for Dermatologic Surgery offer additional practice resources for members that can be worthwhile as well.

When you’re ready to narrow down your list of potential technology vendors, there are many reasons why you should include an award-winning company like Modernizing Medicine. Our dermatology-specific EHR system, EMA™, is the #1 EHR system for four years running, per Black Book Research™. Get in touch with our team and request a demo today. Call (561) 880-2998 or visit modmed.com.

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