An Open Letter to a Young Client

We can go back and forth time and again but the results are going to be the same. I do not believe that you will ever find a location that will be so good (“Perfect”) that it will overcome your shortfalls in production, business experience, and an empty patient roster. Let me put it another way:

There are many wonderful places to practice that will have low overhead. By definition, these places won’t be perfect. As a young professional wanting to build a long-term practice, you have to keep overhead in mind. A reasonable location (not Perfect) will help mitigate some of the risks you face with having a large debt service when you start practice. Remember, the lease will be only a fraction of your operating costs. You still have to hire a competent and experienced staff. Does it mean that you may want to change locations as the practice grows and you have beaten the wolf back from the door a little ways? Absolutely! The problem with coming directly out of school and wanting to open a “Taj Mahal” practice is really found in the risks you undertake when opening as a scratch practice.

I am sure you have had friends who claim to have left school and opening a practice on a shoestring and NOW they are rich beyond belief. Experience tells me that there is always part of the equation that is missing. They may not be lying (many are) but there is something you don’t know. Certainly a reasonable location will be important (a good demographic character + favorable competition ratio + growth + luck) but there are other factors that will matter far more in determining your success. One of those factors is how quickly you can treat patients without (them or you) feeling too rushed. Experience can be gained only with time. It will make the practice more profitable. Further, having some time in a practice and seeing the various staff “types” will also give you insights that cannot be purchased. As many experienced hands in the professional will tell you, the most expensive mistake you can make is hiring the wrong person.

Please do not think that I am trying to talk you out of opening a practice nor should you think that I am trying to tell you that a particular location you have fallen in love with won’t support a successful office. What I am trying to say is that there are risks and issues associated with an office that is frankly larger than you will need for five years in a retail environment that will place you deeply in risk of failure for two years even if everything goes reasonably well. In short, don’t make things harder on your self that you must.

Yes, I know your supply representative has sworn that with the right kind of equipment, you cannot fail. He may actually believe it with all his heart. It does not mean that he is right. Listening to sales people rather than those who have been through “the mill” will probably get you into trouble. Do all the furnishing REALLY need to be new? Can you get along with a smaller staff (but one with experience)? The questions are not inconsequential. Let’s find a location you can afford, that will lower your risk and help you to stay in practice for the long-run.