American College of Physicians: Internal Medicine — Doctors for Adults ®

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Want to start a practice? The College has tools to help

From the April ACP Observer, copyright © 2003 by the American College of Physicians.

By Margo Williams

If you've always dreamed of opening your own practice but don't know where to start, a guide from the College's Practice Management Center (PMC) can help. "Starting a Practice" explains how to plan for and build a successful practice, from setting up shop to selecting practice management software and hiring staff. (Members can download the free online guide by clicking here.)

Here's an overview of topics covered in the guide:

  • Buy vs. build. Should you purchase an existing practice with its established patient base or start one from scratch according to your own blueprint? The guide explains some of the pros and cons of each option in terms of investing both time and money.

  • Business model. Do you want to incorporate, form a partnership or go solo? Should you be completely independent—or share expenses? The guide helps you sort through the liability and tax implications of six different business models.

  • Advisors. Who do you need on your team from the start to give you key advice? The guide explains the roles of important players, including an accountant to help with payroll, collections and tax issues; an attorney to assist with contract negotiations and regulatory compliance; and an insurance agent to help arrange the many different types of insurance you'll need. The guide also explores the benefits of hiring a management consultant.

  • Financing. How much start-up capital will you need to cover practice expenses until you're self-supporting? The guide explains how to develop a business plan—including an executive summary, cash flow projections and market analysis—to show lenders when you apply for commercial loans.

  • Staff. What's the minimum staff you'll need to cover essential operations as you get started? Count on at least an office manager to handle billing and reception, as well as a clinical employee to check vital signs and take patient histories. The guide explains all the steps you'll need to take when hiring staff, from writing job descriptions to recruiting.

  • Patient base. How do you attract patients to your new practice? The guide offers helpful tips and marketing strategies to boost your local visibility and forge relationships with people who can refer patients to your practice. (For more on marketing, see the PMC guide, "Marketing Manual for Internal Medicine Practices.")

  • Tools. What licenses and credentials do you need to maintain a practice, and when do you need to get them? The guide includes a checklist and timeline to help you stay on top of essential steps such as obtaining a business license, purchasing insurance and getting credentialed with payers and hospitals—so you can start bringing in revenue.

The guide also contains a special appendix developed by the ACP Young Physicians Subcommittee with a comprehensive "shopping list" to help you equip your practice with everything from wastebaskets to glucometers. The appendix also explains whom you need to contact for help with specific issues like income tax withholding, workplace safety laws, office laboratories, coding and billing and collections.

Margo Williams is a practice management associate in the College's Washington office.

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More help from the College

In addition to the "Starting a Practice" guide, the College's Practice Management Center (PMC) offers a wealth of other resources to help you step out on your own. Visit the PMC Web site for information on hiring staff, purchasing computers, marketing your practice and much more.

ACP members can also call the PMC at 800-338-2746, ext. 4565, for advice and answers to specific questions not covered in PMC guides.

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