Eyeworld

September 2018 • Ophthalmology Business 21 In addition to the expected nerves about all the unknowns of starting a practice, Dr. Loh said she soon realized one of the biggest hur- dles would be getting on the insur- ance panel. "If you are by yourself and you open your practice, to get on an in- surance plan, it's much harder. If you join a practice, you're automatically added within a month or two," Dr. Loh said. That's when she approached Eye Physicians of Florida, a hybrid group, as Dr. Loh put it, of ophthalmologists who came together to centralize ad- ministrative tasks, such as billing, ac- counting, and IT but maintain their own practices. Joining Eye Physicians of Florida made it easy for Dr. Loh to get on the already-agreed-upon insurance panel, plus she got to take advantage of the economies of scale the group provided. "I feel like I have the best of both worlds. In terms of branding, the way my practice looks, my logo, office hours, who I hire, who I fire, that's all up to me. When I take vacations, up to me," Dr. Loh said. "It's my own profit and loss center. All of the money I bring in is mine, all of the expenses are mine, too. All the patients are mine; however, that also means I have the sole responsibility of attracting my own patients. "Legally, I have to have the Eye Physicians of Florida [EPF] logo on all of my paperwork and documen- tation," Dr. Loh continued. "What I have to comply with is there is a per- centage fee of insurance collections that I have to pay to EPF in order to be part of the group; part of the reason you're paying is because they are providing the service of doing the billing and the collection. However, even if I hadn't joined EPF, I would either have to pay an employee to perform these tasks or pay a third- party vendor. So I don't see it as a negative but as a positive since it is still in-house, and it reduces the need for extra employees. Other than that there are not a lot of restrictions." "You have to be self-motivated," Dr. Patel said. "If you're not, I think this is a difficult path. It's not right for everyone, just like group practice is not right for everyone." Jennifer Loh, MD Loh Ophthalmology Associates, Miami Solo practice for 2 years When Dr. Loh told people she was starting her own solo practice 2 years ago, after working as an employee doctor in another solo practice for 2 years followed by a larger practice for 3 years, she said she would often get a look, an 'Are you crazy?' look. There are a lot of naysayers to going out on your own, she said, and may- be not wrongly so. "I probably should have been more cautious than I was. It was one of those situations where you don't know what you don't know," Dr. Loh said. But in her years as an employee doctor, she always felt that she want- ed to be "the creator of a practice." "Whenever you join a practice, my experience was I learned a lot, but I didn't have as much control over the way the practice was man- aged as I wanted," Dr. Loh said. "I thought maybe I could make my own practice culture, create the environ- ment that I wanted to practice in and create the patient base, eye diseases I wanted to treat and take care of. … You can become a partner in a prac- tice, but what I did find in my lim- ited experience was that sometimes finding the right fit can be tough. I realized that I could go out on my own, take a chance, and create the practice that I knew I wanted." paperwork where we say this may take 2–3 hours. They're coming in for a potential surgery, so we're going to take the time to take care of them. Our care is a niche care." Dr. Patel said she learned what she needed to know about starting a practice and its management from resources offered by ASCRS and other ophthalmology organizations. She also said relevant listservs can be helpful sounding boards for ideas and advice. "I found that in the ophthalmol- ogy community … people are more than willing to share," she said. While she doesn't like the government regulations that are impacting practices—Dr. Patel said it distracts from patient care—it keeps things from getting old. "There is always something new and differ- ent," she said, noting that she spends at least 25% of her time on aspects of practice management. Starting your own practice out of training can be daunting, Dr. Patel said. She recommended that those interested in going down this road look into their EMR software early and take coding and billing classes. "Most doctors have no idea about billing and coding," she said, explaining that those in small practices might "need to know that information because you're ultimate- ly responsible for that." She also said those interested in starting their own practice should be prepared for the time it takes to get the doors open. Finding and build- ing out a space can take longer than you think, and you need to have a detailed business plan ready for the loan process, Dr. Patel said. continued on page 22 " You have to be ready to roll up your sleeves. " —Jennifer Loh, MD

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