> Starting and Running a Practice

Tips for Running Your Own Practice

Upon completing residency training, many newly graduated doctors feel lost as to where to begin if their goal is to open up a new practice. Unfortunately, the business side of the medical field is often glossed over or completely missing from residency programs, leaving doctors in the dark about key elements of practice management.

I recently conducted a survey through LinkedIn, and over 50 dermatology and plastic surgery colleagues expressed that they, too, felt unprepared to run a business right after graduation. They were happy to share a few pieces of advice to help new doctors navigate opening up a practice. Although I could not quote everyone, here are some of the key takeaways.

1. Read Contracts Carefully And Keep Them Current

Plastic surgeon Dr. Tracy McCall, MD FACS learned by experience just how important it is to read your contracts carefully. “There are so many people out there trying to scam you,” she says. “There was a local copier company that didn’t tell you that you had to click the button for black and white when printing or everything counted as color, even if it was just plain text. My printing costs are now a tenth of what they were. ‘Trust but verify’ is a good motto. Even when dealing with physicians groups and negotiating insurance contracts.”

Dr. Roxanne Sylora, MD shares a similar tip for new doctors that are joining someone else’s practice to understand employment contracts before using them. “If you sign a contract, make sure you know the exit if you need it. Find a good attorney to review the contract, preferably someone with experience reviewing these types of documents.”

In my own experience, I learned the hard way that you have to make sure that when the contracts expire or the payment terms change, you must do a new contract.  Every employee must sign a detailed contact that is updated at regular intervals.  We do our annually.

2. Build a System of Checks and Balances

Along the same lines of “trust but verify,” Dr. Robert Tornambe, MD FACS says, “I think one of the most important tips I could give is to build a system of checks and balances within the office staff. Starting out, I only had one employee and trusted her a bit too much. I let her handle all aspects of billing, collections, and bank deposits. I wanted to concentrate on building my practice and taking care of patients. It started out well, and I become very busy very fast. I soon discovered that my office manager/right-hand person was stealing funds at an alarming clip. “

You would be shocked at how many physicians have had an employee steal from them- including myself.  Do not give them the opportunity by having checks and balances in place.

As Dr. Tornambe says, “We need to be doctors and business people as well. Have your accountant oversee all transactions, and meet with staff every week to review cash and money flow. Go to the bank and make deposits yourself when possible.”

3. Collaborate with Others in Your Industry

Just because you are setting up your own practice doesn’t mean you have to go it alone. Plastic surgeon Dr. Kat Gallus, MD understands how overwhelming it can be to manage your own practice and still be a good doctor. “My advice is to self-educate by reading and collaborating with others in your industry. And seriously, we all follow Instagram leaders in aesthetics to see what they are doing. That’s how you know what is trending among potential patients — that and listening to the reps, who all have opinions on skin care and what is trending. You just have to sift through any sales pitch.”

I have found that LinkedIn is a great place to find collaborators and to survey your peers.  Also many conferences have business management sections that are helpful. Ask the Allergan and Galderma sales reps about programs that they have to give you business advice.  I have found Allergan Access to be very helpful. It has job descriptions and information on how to make a budget and many other things that I wish I had found years earlier.

4. Hire a Qualified Patient Care Coordinator

Do not fall into the trap of believing that you must run your business completely on your own. Dr. Laurence Milgrim, MD says, “I think the most important thing for a resident starting out is to hire a qualified patient care coordinator. This will be your most expensive asset, but worth it. The coordinator can then train the staff properly as to what the doctor wants out of them, be it telephone etiquette, how to ask questions, or how to address patients. The coordinator will be your right-hand, and if you only have this person in the beginning, that would be enough.”

For Dr. Patti Flint, MD, getting some outside help was also one of the most important steps she took when starting her own practice. “The best thing I did was to bite the bullet and hire outside consultants,” she says. “They taught me a great deal. Their fees were expensive, but a great investment over the long term.”

5. Hire Staff for Growth Potential, Not Looks

It can be easy to get caught up in trying to hire employees who “look the part,” especially if your focus is in cosmetics. However, Dr. Cynthia Diehl, MD makes a great point that your staff members “don’t need to look like a Barbie doll, but they do need to treat the patients with care and respect.

“What I find,” says Dr. Diehl, “is that when I treat my employees well, they take good care of me, too. It is a win-win. I’ve had my core group of employees since the beginning and hope we all grow old together. They are excellent and are a big part of making my practice what it is. They take ownership and pride in our success.”

Plastic surgeon Dr. Neil Sachanandani, MD emphasizes a focus on hiring employees who will “fit your culture and work ethic expectations. I look for people that show a growth mindset as a marker for being a successful staff member,” he says.

6. Remember That Patients Are Customers

You are running a business, after all, so it is imperative that you view your patients as your customers. Dr. Amita Bagal, MD stresses the importance of valuing patients’ time. “We are a service-based industry and have to remember that our patients are our customers and their time is very important! In traditional academic medicine, doctors tend to finish training with the notion that the whole world will wait for them. In other words, there is not an emphasis during residency to be sensitive to a patient’s time. I think even if you are a world expert in your field, it is important for all practices to respect efficiency and time management as it pertains to the patient.”


Setting up your own practice can seem overwhelming at first, especially if you are like most doctors and do not have a background in business. While there will be plenty of learning to do as you go, taking the time to prepare yourself before you start out on your own can make all the difference. My final piece of advice would be to never be afraid to reach out for help — as you can see, most doctors are more than willing to share their advice!  If you have any questions, feel free to reach out to me on LinkedIn.

Want more articles on running your own practice?  Check them out here!