Sunday, January 04, 2004

A new beginning

Happy New Year! Holidays and viruses (*cough cough*) have distracted me from updating this blog for the past 2 weeks. Okay, and inertia, too. Tomorrow was supposed to be my target start date, set about 3 months ago, but it has been clear to me for the past month that I would not be able to meet that deadline.

I originally chose January 5th because it will be my official resignation date from Kaiser. I finally managed to clean out my office on New Year's Day, and get all my abnormal labs and phone messages taken care of. A nice feeling, to have all my work caught up, with nothing hanging over me. But the funny thing is that my first day as a solo family doctor will be spent . . . working at Kaiser! I have signed up to work as a per diem or fill-in doctor for the next several months whenever there is a need for one. Since I don't have any patient in my own practice yet, it will be a way for me to earn some income as I get my new practice off the ground. In essence, I will be doing what I have been doing for the past 13 years still, but I will be getting paid less for it, since the perdiem rate is less than the rate I was paid as a partner physician.

My own practice? Well, I had new tile installed in the exam room where there was carpeting before. My sister and brother-in-law helped me paint my tiny 8 x 8 ft office two days ago. I picked up my office furniture from Plummer's today, and will be assembling it throughout the week. They are delivering my vaccine mini-refrigerator/freezer next week.

I have to decide on a logo this week so that I can get my business cards and stationary made. When I asked for their opinions, my various relatives preferred a different logo than the one my wife and I liked best, so we're going to have to think about it. Part of the problem is that they chose the one that "looked the best" while my wife and I chose one that matched "the image we wanted the practice to project."

I have my applications for Aetna and Blue Cross but still have not finished filling them out. Since I've heard that it takes up to 3-6 months to be accepted as a provider, I plan to test how much of an interest there is from cash-paying patients for an open-access doctor in this area. I heard on the radio today that California has as many as 200 "boutique medicine" practices, where patients get 24 hour access, longer appointment times, easy to make appointments in exchange for extra fees. That sounds like a high number to me, but I believe that it will get more and more popular among physicians.

But what if you could get boutique medicine service without the boutique medicine price? That's what I'm going to be trying to offer. I've heard that there are at least 2 local physicians in the Pasadena area who do not accept any insurance, but do cash-only business, and supposedly they have very successful practices. While tantalizing, I'm sure they built up their practices over a long period of time. I plan to allow myself two years to build up my practice, with a goal of 1000 patients in my panel and $100,000/year income. We'll see how close I get.

People have been asking me when I will open my practice. I used to say, "Sometime in January." Now I say, "As soon as I can." All I need to open my practice is:
1) to get my furniture assembled (this week)
2) stock my exam room with medical supplies, vaccines, medications, etc. (2-4 weeks)
3) get inspected by the city fire department so they can issue me a business license (?)
4) get approval for my fictitious name permit from the California Medical Board (supposedly 8-10 weeks from the day I mailed it in in October)
5) get business cards and stationary printed (2 weeks)
6) place ads in local newspaper

So my new target start date will be Feb. 2nd, just because I like to set definite targets. I have about a month of vacation time saved up which will be paid in a lump sum upon my resignation, so I will not be struggling financially yet. I have some time to relax a little before my solo practice begins. Hopefully, I'll use the time wisely.

Countdown until *new* target start date: 29 days