Consultants Re-Revisited

Obviously, I like Indiana Jones 🙂

In reference to the Consultants and Consultants Revisited post, PLEASE IGNORE EVERYTHING I SAID.   Try to erase it from your brain!  I have no idea what I was smoking back then.  Consultants, for the most part, are completely worthless!  Your money will be better spent on trying to recoup a Nigerian prince’s frozen funds.

In retrospect, the main reason I ended up hiring a consultant was purely out of fear for the unknown.  Like I said, I didn’t want a small oversight to snowball into an enormous headache.  In all honesty, Google and some elbow grease is more than enough to cover your ground.  In this day and age, almost every single answer to a random question is at your fingertips.  As doctors, we tend to be an anxious bunch.  However, don’t let your paranoia get the best of you.  Every single one of you is way smarter than a thousand consultants combined.  It just happens that these guys used to have a monopoly on the connections and the know how.  Google has clearly narrowed that gap.

In the end, I was indeed able to figure out most things on my own.  I stopped using my consultant about two months after I had hired them.  Their billing practices were so shady. Although they billed me for $6,000 to $7,000, they probably put in only $2,000 worth of work.  In addition, they billed me another $1,500 or so for some work they never did for me, and I ended up spending about 30 minutes arguing with them to remove those charges.  Once again, if all their information had been accurate, maybe I wouldn’t have minded as much (Actually, I probably still would have), but some of their advice was just plain 2000 and late. (I know. I know.  This phrase is also 2000 and late.)  For example, although Medicare enrollment was being transitioned to the online PECOS system in 2010, they knew nothing about it, and instructed me to apply on paper.  Had I followed their advice, my Medicare number would have been delayed by at least 2 months.

The only true benefit I received from my consultant was their pro forma business plan template.  I have to admit, I would still pay $500 for that template today.  It helped me streamline my estimated startup expenses and monthly operating expenses.  It also gave 2 years of revenue projections, which despite being a significant gross overestimate, still provided a good platform to adjust my actual projections.  They had me collecting over $1,000,000 at year 2!  As a low overhead, low volume micro practice, I’m still not even going to reach $1,000,000 this year!  But this is what I mean about consultants being “experts” in theory only.  They only spit out industry statistics for you, without being able to customize them to your individual practice characteristics.  I truly believe that the average ophthalmology practice is a poorly run one.  Surely, you don’t want to pay a consultant tens of thousands of dollars to help you mold your practice into something “average.”

As for the employee handbook and OSHA/HIPAA manuals… 7 years since my consultant sold them to me for $1,000, I have yet to turn a single page.  It is literally collecting dust in a box somewhere in my closet.  I haven’t found a need for any of these manuals.  All basic HIPAA and OSHA rules and regulations are available online, and I kind of just made up most of the contents of a typical employee handbook on the fly.  With only one single front desk person my first 5 years, it wasn’t that hard.

In my Consultants Revisited post, I had mentioned that my consultants were worth $4,000 to $5,000 to me at the time.  Today, I would revise that number even lower, and say that they are worth only $1,500 at best.  Even if you’re a busy practicing ophthalmologist with 4 kids, there is absolutely no reason for any sound human being to ever spend $30,000 on a consultant.  The knowledge and wisdom that you attain from teaching yourself every step of your practice startup process is priceless.   I strongly strongly strongly urge you to roll your sleeves up and get to work.  It will pay you dividends many times over in the end.  It has for me.

P.S.  Howie continues to thank me for my post.  He chose not to hire a consultant after reading it, and tells me that he saved at least $15,000 from that post.  He even went back through my blog and wrote a post with all of the steps to start a medical practice!

8 thoughts on “Consultants Re-Revisited

  1. Excellent post. It really brings things into perspective since you are going back from many years to compare how you feel now. I wonder though if you feel that they are worthless now because you are much more experienced. To a new guy like me I have no idea where to even start or what form I should fill out first. Would you guys be able to give us a general idea on what to tackle first? Good job on this site, keep it up!!


  2. Although I’m now looking through the rearview mirror, you have to remember that I started this whole ordeal with absolutely no clue what to do and where to begin, just like you. I really didn’t know where my final endpoint was going to be. One step just ended up leading to another, and so forth. I didn’t even have my own blog to reference! It is true that because I am indeed much more experienced now that I realize that complete lack of value consultants bring in the first place. I didn’t know that in the beginning, and I stupidly threw money at them because I was afraid to venture out alone. Once again, consultants feed off your fear, anxiety, and lack of not-so-difficult to obtain knowledge.

    Honestly, aside from the pro forma template, I used ZERO of my consultant’s advice. For example, at the advice of my consultant, I flew to San Jose, rented a conference room in the Marriott, wore a suit, and set up bank meetings to obtain my startup loan. After all that time and effort, only one bank agreed to meet with me, and they eventually turned me down. In retrospect, that was a dumb wasteful move that yielded nada. Nowadays, you can secure a loan via e-mail without really meeting anyone face to face, which is what happened with all my loans, and without my consultant’s aid.

    Once again, consultants are the broken sail that you pray will guide you through foggy waters. Most likely, they will either lead you to your destination inefficiently or not at all. Although it’s going to take extra effort, it’s just better to learn how to make your own sail properly.

    Just hang tight. We’ll eventually provide you with a checklist of things to do, including the sequence of tasks.


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