Eyeworld

22 Ophthalmology Business • September 2018 While the decision to join Eye Physicians of Florida took care of a couple of major hurdles of starting her own practice, Dr. Loh said there was still anxiety. "Prior to opening my practice, I didn't have a business background, I had never hired an employee. There's that doubt 'Am I actually going to get patients?' Will I be able to pay all my expenses before I'm bringing in revenue? On top of that you have to actually practice medicine still," she said. Completing the Physician CEO program at the Kellogg School of Management helped Dr. Loh receive some business acumen. In terms of building her practice, once the doors were opened, she said it's been a lot of networking. Dr. Loh personally visits optometrists and primary care doctors, passing out business cards, providing her cell phone number should they ever have a question, hosting small gatherings at her expense to get to know possible refer- ring providers. Dr. Loh said she has done a little advertising and social media and encourages her patients to leave her reviews online. When she was just opening, Dr. Loh said she performed all the tasks a tech would usually do as well. "You have to be ready to roll up your sleeves," she said. Dr. Loh feels like she has really built something and that she loves seeing growth on a daily basis. She also likes setting her own schedule and being the doctor patients come to see. Despite being established for a couple of years, there is still stress. "It's a little like a roller coaster ride. Every day there is something that pops up, business or HR related, … having to deal with all of those things and at the same time wanting to be a good doctor and a good sur- geon, some days it can be draining," she said, adding that the challenge of it, however, can be fun as well. For those who might be interest- ed in setting out on their own, Dr. Loh's advice is to do your research, create a business plan, talk to as many people as you can about how to run a practice, and "the last piece of advice I have is just be prepared for anything." John Parker, MD, and Jack Parker, MD Parker Cornea, Birmingham, Alabama Small practice for 21 years and 1 year, respectively When Dr. John Parker first entered medicine out of training, he worked for 5.5 years at the institution where he had held his cornea fellowship. When that institution changed ownership, he decided to go out on his own. He said the new owners were accommodating, selling him used equipment, leasing him space, and allowing him to see patients he had accumulated. A technician and receptionist also came with him to his then-solo practice. Initially, a sticking point was the billing service he had hired. It was a problem from the beginning, Dr. John Parker said, but despite having five young children at home, his wife took on the practice's billing in the earlier years. Now, Parker Cornea employs 10 full-time, non-physician staff members. For his part, Dr. John Parker said he's never been tempted to join an- other practice since starting his own. "Being my own boss wasn't always easy, but it has been very re- warding," he said. "We've been able to treat our patients and employees the way we think they should be treated. We get to go to the meetings and buy the equipment we think would be most helpful." Disadvantages of being in a small practice, Dr. John Parker continued, are having to be a jack-of-all-trades and needing to comply with a myri- ad of changing rules and regulations. When his practice was solo, prior to his son, Dr. Jack Parker, joining, every time Dr. John Parker went to meetings or took vacations, the office had to close. Dr. Jack Parker said one of the pros is that Parker Cornea is not just a small practice, but a family prac- tice. "My father and I see the pa- tients, and my mother and sisters run the office. It's an arrangement whose benefits are impossible to overstate," he said. "The office feels like home and the patients feel like family." On the flip side, Dr. Jack Parker said the blending of work and family means "all we talk about is work," even outside the office. While this is OK with them, "we're not as fun at parties," he quipped. At a time when the pressures of practice management might have smaller and solo practices thinking of joining a larger group, Dr. Jack Parker said they remain competitive by cul- tivating strong relationships with pa- tients and referring doctors. He also said they have been early adopters of some services, giving them an edge. "For example, we [were] the first in the state to offer DSEK, DMEK, corneal crosslinking, and Bowman layer transplantation," he said. OB Reference 1. Khullar D, et al. Can small practices survive? Sharing services as a path to viability. JAMA. 2018;319:1321–1322. Editors' note: The physicians have no financial interests related to their comments. Contact information Loh: jenniferlohmd@gmail.com John Parker: melissa@heremollygirl.com Jack Parker: melissa@heremollygirl.com Patel: DrPatel@WichitaEyeDoc.com continued from page 21

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