"Are you crazy?"... If so, opening cold may be for you
The first thing I heard from colleagues when I mentioned opening cold so soon out of school was, "you're brave," and from reps, "you're crazy." I just might be. At one point in optometry school, every student has considered opening cold. It's what we do. Very few are "crazy" or "brave" enough to follow through.
How do you know if opening your own practice is for you?
1. You want to be your own boss
Being your own boss is the best thing about owning your own business. No one tells you which days to work or when you can take time off. No one makes you stay late to see that last patient or decides how many patients per hour you are going to see. I love everything about being my own boss.
As the boss, every difficult problem will come back to you. You can empower staff to help, but ultimately if something is not working, you must be the one to fix it. Especially with a start-up, you are the one to wear many hats. You must be the technology officer, insurance coordinator, and the optician. You must trouble-shoot everything. Why aren't the phones working? What's wrong with the AC unit? Is the patient having trouble with their new glasses because the base curve is different? Or is it the difference in eye size? How do I heat this frame without melting it? I'll be the first to admit, I hate this part of the job.
3. You enjoy building things from "the ground up"
Opening a practice is about taking a concept in your mind and building it. If you aren't a fan of the process, purchasing an existing practice may be better. I love the idea of creating something completely mine. I took this into consideration before I opened. Many times, ODs buy existing practices and have to scrap them. It makes more sense to start from scratch, and do things your way.
4. You think creatively and/or are innovative
Doctors in general are probably not creative people, but you must be when dealing with staff, product or patient encounters. There is a huge push in healthcare to create an experience. It's how you approach that experience that matters.
5. You are prepared to work HARD
Most new practice owners must work an associateship in order to fund their new practices. In the beginning, you must have resources from another source. New practice owners should count on working at least 3 days elsewhere in addition to the days spent at their own practice. Plan on working at least 6 days a week. On the days I work for someone else, I still end up seeing a patient at my practice before I go in for the day, and a patient after my second job ends. No one tells you when to work, but if you don't, you're not paid. Be prepared to live and breathe work.
6. You can see the big picture and the details
When it comes to things like frame lines to planning an office, you must be involved in both the big picture and the details. It's very easy to come up with a floor plan, but you must consider things like traffic flow and patient management. You want to plan ahead because small forgotten details can add up to costly mistakes. If you aren't involved in the accounts receivable, you may be too late in filling for insurance claims. If you aren't involved in frame buying, you may end up with frame line overlap or money-held up in merchandise you cannot sell.
7. You are a planner
Not only is it necessary to plan for long-term success, you must be able to manage the day-to-day. It would be extremely difficult to open a practice, and not have your life scheduled. I try to map time out for the necessary day-to-day administrative activities such as posting payments, calling insurances companies about accounts receivable, and sales-rep visits.
8. You are willing to sacrifice
It's extremely difficult to sacrifice after you've lived like a student for 4 years, and upon graduation are making the big bucks. It's natural to want to make extravagant purchases and take much needed vacations. As a student, you had this idea of what life would be like upon graduation, and now you are working 6 days a week including Saturdays. It's difficult to swallow the idea that even with a doctorate, you have to be willing to put in the work. You must be willing to live like a student for the next 3-5 years when you open cold.
9. You have a support team
I am blessed to have an extremely supportive family that has always made me believe that I could accomplish anything. I'm not sure if it's even possible to open cold without friends and family willing to contribute their time, talent, and support. It's vital to have a team to support you on the entrepreneurial roller coaster and to affirm you are making the right decisions.
10. You aren't afraid of change
I've only been out in the "real world" optometry-wise for about 3 years now, and have only been a practice-owner for about 1.5 years. In that short time, there have been changes in lens technology, changes in healthcare regulation, and changes in contact lens pricing. I now expect to find out something has changed regarding either insurances I take or product I sell, on a daily basis. At first, it seems overwhelming - how can anyone stay on top of everything? You can't, it's impossible, but you have to be flexible to make those changes.
11. You like to be responsible for your own destiny
Like Spiderman said, "With great power, comes great responsibility." It's great to have your success in your own hands. How many times have you worked for someone else and thought if we just changed "x, y" would be so much better for the staff and patients? I love to be able to make those changes. I love that I can influence how the patient perceives both me, as a doctor, and optometry. If you work hard, you prosper. If you treat your patients well, your practice should flourish.