Medical Practice Startup

Professional Management and Marketing is one of the few consulting firms in the nation that have been cumulatively accepted by all of the following into their consultant panels for a medical practice start up consult to their physician-members on starting and running medical practices:
American Medical Association
American Academy of Family Physicians
American Academy of Ophthalmology
American College of Physicians
We also teach medical practice start-up for the AAD Resident Program, AAAAI, and the California Academy of Family Physicians.
We have given numerous seminars on the topic at national, state and local conferences, and have authored many articles on this and related topics.
Hundreds of references are available, and we have worked successfully with many specialties to start practices.

Our consultants authored two national-standards-setting books published by McGraw Hill; The Medical Practice Forms Book; and the Medical Practice Pre-Employment Tests Book, both important to start-up practices. Keith Borglum has also authored a book on practice valuation for purchases and buy-ins, available at PRS.

We also provide consultation on most of the problems and issues faced by physicians in private practice, excluding tax, law and financial planning. We also do not do coding and fee-setting, but refer those topics to very efficient lower-cost consultants that specialize in those areas.

Medical Practice Startup One Day Consult

A medical practice startup consult is ideally performed at least four months in advance of the start date, and the earlier the better (even though some practices come to us months after starting up!).
It involves an intensive full-day meeting with the doctor(s) making as many decisions as possible regarding practice start-up and operations.
Templates are customized for a business plan; an employee handbook; staffing and hiring: billing and collections; office brochure; general ledger/accounting; and most forms needed to run the practice.
Preliminary marketing strategies are discussed and planned.
A checklist and calendar of pre-start-up activities are prepared and reviewed in detail.
The doctor is referred to pre-screened specialists for business loans (easy-qualifying loans available to $200,000), fee-setting, superbill creation, tax and legal requirements.
A practice budget is established using specialty reference data; financial policies determined; often a computer or billing service selected; and all physician-questions answered.

The one-day consult on practice start-up can be at your location or ours. Solo or two-physician practices usually come to us, but have us come to them if three or more physicians are involved.

We budget all day for the consult, but only bill you for the time used (if at our offices). If you have zero private-practice experience and are starting from scratch, plan on 8-10 hours in consult. If you have some private practice experience, or have a lot of preparation already completed, it could take as little as 4 hours in consult. Every consult is customized to the needs of the client.

Physicians fly in from all over the country to meet with us for our one-day consult.
You will leave the consult with far greater confidence in the process of opening your practice, with a detailed plan of execution.
Past clients tell us that the consult reduced their startup workload to under 100 hours.

We recommend doing little-to-no advance preparation. Many clients tell us they wasted a lot of time studying the wrong things in advance. For example, you could easily spend hundreds of hours researching EMRs, when we might be able to reduce your choices to 1-3 within minutes! (our opinions on EMRs are published nationally in medical journals)

We are available thereafter anytime by phone, email, or visit for further support.

Lots of reference quotes are at the Client Comments section.

Travel

United Airlines flies into San Francisco and Oakland airports nearby, and there are hourly shuttles to Santa Rosa, a 2 hour trip. Driving a rental car takes about 75-100 minutes depending on traffic.
Alaska/Horizon airlines have direct flights into Santa Rosa twice daily from Los Angeles, Seattle, Portland and Las Vegas.
Santa Rosa is in the heart of the Sonoma Wine Country, and one hour north of San Francisco.
Many clients book a consult on Friday and spend the weekend in the wine country or San Francisco "studying notes about practice start up", making much of the visit tax deductible, as activities in planning to open a business are generally tax-deductible (ask your CPA - or read the book Small Time Operator, an item on the recommended reading list for startups).

Other related consults available:

PRACTICE START-UP OR TAKE-OVER IMPLEMENTATION SUPPORT, occurs after the Start-Up Consult or Practice Purchase and includes weekly meetings with doctor and/or staff to make sure the practice is started and run correctly. Meetings can be in person or by phone. Meetings continue until two clean month-end financial reports are generated, greatly reducing chances of failure. This also provides insurance to the seller of a practice that the new doctor will continue to be successful until pay-off of the seller financing. Retainer agreements also include all support activities by the consultant when not in meetings, such as research or staff-hiring.
By retainer for 2-3 months, or hourly, depending on need.

PRACTICE PURCHASE or BUY-IN APPRAISAL Buying a practice is very cost-effective if the price is right. We do appraisals, second opinions, and expert-witness testimony for purchases and court-cases. We participate in the National Goodwill Registry and are members of the Institute of Business Appraisers and National Association of Certified Valuation Analysts. More info is available on our valuation website. Appraisals typically take 10-20 hours, excluding travel, which often can be avoided.

PRACTICE SALE SUPPORT, meeting with both the buyer and seller together to facilitate decision-making on all the details of transitioning the practice from one to the other, including the terms of sale for the agreement to be finalized and drawn by an attorney. This reduces misunderstandings, unresolved issues and attorney fees.
Typical Time: 2-4 hours on site or by conference call

MERGERS AND GROUP FORMATIONS: We offer a one-day intensive session with the merging parties to structure the transaction and how operations will function post-merger. This can be combined with a Practice Startup Consult if appropriate. Pre-merger practice evaluations & valuations are another option.
Fees are hourly, typically taking 5-8 hours, plus travel if required.

FEES
Fees are typically $300 per hour, but discounted for the Start-Up Day, or by project retainer. We have chosen to keep our rates modest and charge for all activities, including travel, rather than have higher fees and not charge for travel. Since we work on a national basis, we feel this is fairer to the individual client as local clients do not subsidize the costs of remote clients. Clients are usually given the opportunity to meet at our offices rather than theirs to avoid our hourly travel costs. Our location in the Sonoma Wine Country one hour north of San Francisco lends itself well to mixed business/pleasure trips for consults at our offices. The money saved by not having us travel to you will pay for a nice weekend here!