I began my solo ophthalmology practice journey not too long after the 2008 financial crisis. Obtaining financing for my new practice was nearly impossible. After being rejected by over ten financial institutions, my credit score dropped from 800+ to the mid 500s. I ultimately was able to get equipment only financing at a high interest rate, which was still a godsend for me at that point. Since the rest of the practice startup lied solely upon my personal savings, I had no choice but to open the practice on an extremely tight budget.
Everything up to opening day was essentially DIY. After finishing residency, I was unable to secure a locums or part-time position in my area. I used my free time to learn how to do everything from filling out credentialing applications on paper to patching drywall. I lived off $5 to $10 a day for food, rented a small one bedroom apartment in a not-so-great part of town, used free internet at the library or a coffee shop, and did everything I could to minimize the cash burn from my personal expenses.
I slept a total of 10 hours and lost 10 lbs in the week prior to opening day. There were so many tasks that needed to be done. I could not afford to have any delays because I had maxed out all of my credit cards and had only one month’s worth of operating expenses remaining in both my business and personal checking accounts. Essentially, if I saw zero patients in my first month, I would be going into default.
I started out with one full time employee, which in retrospect was actually one too many employees for me at the time. She answered the phones, checked in patients, and collected copays. I did everything else. Because I couldn’t afford any professional help, I had no choice but to learn how to do my own billing, my own surgery scheduling, my own bookkeeping, my own taxes, my own IT, etc. In addition, my employee had no experience in a medical office. I also had to learn how to perform all of her tasks so that I could train her.
Little did I know back then that a minimalist approach to running a medical practice is actually the superior way to operate a clinic. Less is truly more. Through technology and automation, I have been able to grow and expand my practice while maintaining the ethos of my modest beginnings.
None of my employees knows how to perform his or her job better than me. No one can hold me hostage to any position. I know what it takes to do every task properly. Thanks to my initial struggles, I have become a jack of all trades when it comes to starting and running an efficient and profitable practice with high patient satisfaction rates and minimal wait times.
