Many doctors struggle with starting their practice. They do not know where to start, how to get the capital, how to do the legal and financial paperwork, the structural needs, the marketing and human resource management aspect of business. You do not need to do a full MBA to start your practice – just a lot of guts, diskarte, and hunger for knowledge.
1. Get your SSS, PhilHealth, GSIS and Pag-ibig, TIN, PRC, and specialty license if you haven’t already. Make sure all your previous liabilities are accounted for. A clean slate will always be good prior to starting your practice. Here is a list of registration requirements that you might want to go through.
2. Find a prime location. The location of your practice is crucial. Your location should not be saturated with other doctors of the same specialty. You don’t want to fight a long and difficult price war. Your location should also be accessible. Are you near a grocery store, a school, a business center (such as call centers), or in a mall? Do people pass by your area everyday? Do you want to start practice in a hospital? Ask how many time slots and clinic spaces are available. Check the costs for rights to practice. Take note that some residency programs, especially those in private hospitals, will allow you to have rights to practice and be decked with patients after graduation from residency. Other hospitals will require a certain fee called “hospital stocks” to allow you to practice. Make sure that you check the competition in that location to ensure that you thrive. Entrepreneur.com makes an more detailed list here.
3. Determine your budget. Visualize your end goal, then find the means to create your budget. It may be very limited after graduating from residency or from medical school. This can be rectified with a loan, if your credit line has been good over the past few years. For this reason, building a good credit line and a backup fund is important. Also be realistic with your income potential over the next few months.
4. Find reliable business partners. If you cannot afford an entire clinic to yourself, another option is to share your clinic with other doctors. This will allow you to cut your overhead costs as well as to find sources for referrals. For example, your pediatrician partner sees that his or her patient’s parent has an illness. If you are an Internal Medicine specialist, you will easily get that referral because you have a partner. If you want to go solo, on the other hand, you will have full control of the clinic. This allows you to hire doctors instead of share with them. All the extra income goes to you, because you pay your doctors by the hour. Be warned, however, that finding reliable doctors are a hit or miss.
5. Start a sole proprietorship or a corporation. In the Philippine setting, it is financially safer to start a corporation than a single proprietorship. In a corporation, your personal assets are not at risk in the event of liabilities. You will need five people to start a corporation with, with any amount of stocks distributed amongst the five. For more information, check out the following articles: “How to register a corporation“, “How to register a sole proprietor business” and “How to start a small business in the Philippines.”
6. Find a reliable accountant, but be well versed in accounting as well. A reliable accountant is one that minimizes your costs but does not get you into trouble. Still, make sure that all your taxes are paid well, and that your clinic does not fall into jeopardy due to penalties. Be as honest as you can about receipts.
7. Secure your lease. Read your lease contract thoroughly for possible price increases (and possible locking in of prices for a certain period of time). If you have a lawyer, have him read over your lease contract to ensure that your terms are fair. If you don’t have a lawyer, ask more experienced tenants in the area of how the terms are to them, and compare them to yours.
8. Find an architect and an engineer. These two people will be able to build your clinic from your ideas and cash to the place you will be working in several years. Coordinate with them as you tell them clearly what you need in your clinic. Do you need a sink? Do you need a space for a bed or recliner? How big is your reception? Will you be placing additional equipment?
9. Canvass, canvass, canvass. Buying your raw materials or equipment at the most expensive mall in the business district is not the wisest thing to do. Make sure to get the most value for money when it comes to buying your equipment. Check out Quiapo, Bambang, Recto and other nearby places for medical supplies. Also making a direct purchase from the manufacturer is always better than buying it in retail stores. Remember, you want to minimize costs, and maximize profit.
10. Build your clinic slowly. Buy the materials that you need considering that you will be using these for many years, but also remembering that you will need to create a return on investment. If you wanted to buy that Femtosecond laser machine but still don’t have the very basics, defer the expensive equipment for the very basic equipment you need to start your practice with, then go from there after you have safely earned back your initial investment. This is called Lean Startup Method. This helps you avoid debt and keeps your assets liquid and easily manipulated. If you see a demand for a particular service, you can focus on procuring materials for that service instead of buying raw materials or equipment prior to the demand.
11. Check the prices of other consultants. Charge slightly lower than the other consultants are charging. As a beginning doctor, you will still be proving yourself in the market and the greatest way to do that is to remove the barrier of a high price, allowing a greater influx of patients.
12. Hire honest, hardworking and friendly staff. Your receptionist is the front face of your clinic. Hire someone who wants to help your practice, with a cheerful and open disposition. If you are hiring an auxillary team of assistants, it is important to know their skills as well. Hiring is tricky, so make sure to do a background check (apart from their resume, ask for an NBI clearance, references, and transcripts). For some tips on hiring, check out this article.
13. Create an online presence. You can now post your clinic hours online at filipinodoctor.com. It is a huge database of doctors with their clinic spaces and hours, which allows other patients to find them at their convenience. The creation of promotions are a gray area, as can be seen in our laws on Medical Jurisprudence. Keep your advertising enticingly subtle and classy.
14. Get accredited by insurance. As a starting doctor, it may be beneficial to get recognized by the leading health insurance organizations such as PhilHealth, Medicard, Maxicare, Intellicare, Blue Cross, Cocolife, Valuecare and many others. While they may not offer you absolute control of your prices, and will entail waiting for payments after some grueling paperwork, they allow you to gain momentum in your business. Not all practices will thrive on insurance, however, especially if you are a cosmetic surgeon, but for others, it can truly help you create a steady source of referrals.
15. Brand your practice. This marketing concept entails projecting to the public what value you deliver to them. What makes you and your practice better than all the other medical practices out there? Will you provide cheaper costs? Are you more pragmatic or more approachable than the next doctor? Will you provide exceptional first class service? Will you provide convenience and efficiency? This will set you apart from the rest, and will carry you throughout the rest of your medical practice. More specific examples could be found here.
16. Be patient. There will be days when you have absolutely no patients, but there will be days when patients will come to you when you least expect it. Do not give up simply because the wait in building your practice is too long. Be productive while waiting, think of ways to let people know that you are there and to improve the way you interact and manage your patients.
Beginning your dream medical practice is a large endeavor that starts on day 1 of medical school. It is important to do what you can today as well as to think ahead.
If you have insights on starting your own practice, experiences to share, or questions, comment below!