March 1, 2011: Today is opening day. I have zero patients scheduled for the day. I’ll be spending most of the day running around meeting with referral sources. I met with one internist today. He received me very kindly and positively, which breathed a new life into my spirits.
Almost an entire year to the day since inception, after all the sweat and tears, today is the beginning. Everything up to this point was the preface of my career. Now my vision becomes reality.
Later in the day: Today was a good day. I saw a few patients, most of whom were people I know, but I’m feeling a bit more optimistic and at peace now that everything has begun. It’s still a long road ahead, but I think I’ll survive.
March 2, 2011: I saw one patient today. Once again, it was a pity visit from someone I know. Eventually, all these visits will run out, and there will be a bit of a down period before things pick up. I met with 3 more potential referral sources, and will hit up another 3 in the next 2 days. Once again, most people have been quite receptive to my solicitations. One internist was actually kind enough to stop by my office to drop off some flowers and a congratulatory card. Too bad I wasn’t there at the time. I’m going to drop by his office again tomorrow to thank him for this unexpected gift.
I think tomorrow will be my first day with zero patients. I spoke to one of my solo practice mentors from residency today, and he told me that my experience sounded familiar. It was quite encouraging to hear him say that.
Somehow, I think the greatest part of my humbling and character building stages has yet to come. I hope my grip is strong enough for the ride.
March 3, 2011: I’m on pace to see zero paying patients today. I do have one patient coming in whom I agreed to see at no charge. (Howie’s note: I strongly advise against seeing patients for free. I collected deductibles, coinsurance and copays at the time of service from day one. The types of patients I want for my practice are those who are responsible and pay their bills, not game the system. If patients can’t afford to pay, it’s the job of politicians to come up with the money, rather than have docs work for free. Sign up for Eye care of America if you want to give something back to the community.) I visited the Korean American Community Services center today to look for volunteer opportunities. Of course, those guys were super excited to see me. We’re going to try to arrange some regular health functions/screenings soon. I’m getting a free dinner out of it too! 😀 While I was there, they told me that one of their employees/volunteers, who’s Medi-Cal application is currently pending, had an eye problem. She’s coming in shortly.
Today, I also met up with 3 more O.D.’s/M.D.’s. Once again, most of them were very friendly and receptive. With me being on all these people’s radars, I’m hoping calls will start coming in toward the end of March. I’m meeting one optom tomorrow and one more PCP on Tuesday. After that, I think I should be close to done with the Korean network.
March 6, 2011: One of my favorite books is Sun Tzu’s “Art of War.” It’s a must read for every poker player. Originally, I read it with the aim of applying its principles to my poker strategy. Interestingly, Sun Tzu’s words have also translated into all other aspects of my life, including my interpersonal relationships and my practice.
I first learned of Sun Tzu in junior high in Korea. There’s a famous saying that most Koreans learn in school:知彼知己 百戰百勝 (this is in Chinese by the way). What it says is: “Know your opponent and know yourself, and of 100 battles fought, you will be victorious 100 times.” This quote goes in conjunction with the well-known verse: “the battle is won before it is even begun.”
I’ve always kept this concept in mind throughout my entire practice startup. I have also tried to apply this same approach to patient care. That’s probably why I’ve had such high patient satisfaction rates. I always make a concerted effort to read into my patients’ minds and body language, and try to react to them promptly and accordingly. The same goes with finding a location for your practice. I can’t emphasize enough how important location is. I probably spent a month and nearly 40+ hours just researching my potential practice location. You MUST know what your target patients want, and who your competition is long before you decide where you set up shop.
Howie’s comments: years later, now every time I speak with Ho Sun he’s complaining about how busy he is and how patients need to wait a month for a new patient appointment.
In fact, many of us now fondly reminisce at the first months of our startup when we weren’t sure if we would make it, and say it was the best part of our startup!
Once again, you should look at the first several months as one long soft opening and not be discouraged if you’re only seeing a few patients every day. I considered January 1 as my “opening” day, but in December saw about 27 patients the whole month (that’s 1.3 patients per day for those of you counting).
During this time, I developed good habits that ensured the success of my practice for many years to come, such as learning the ins and outs of my EHR and PM system, coding and billing, meeting referring docs, etc. If you’re worried about going broke, consider taking ER call, working at the VA or county hospital, or moonlighting at another practice or even optical shop on weekends. I didn’t do any of these things and did just fine.
But you’d be surprised at how quickly you can break even. I had positive cash flow in my first month of January, although this was due to my lease being structured that my first five months were rent free.