Monday, October 19, 2009

Melissa Young, MD: Solo doesn't mean all by myself

I am going to take a break from talking about my EMR choice for now to talk about something I learned along the way about solo practice. See, I had resigned myself to the idea that from now on, it would be all me, all the time. That I would have to plan all the little details of every little thing that went into the practice.

And I supposed I could continue to think that and to act that way. Or I could accept the fact that there are people and organizations that can make things a little easier, or at least a little less expensive.

Read more
For example, I had created and budgeted for a marketing plan. Now, first of all, a mentor from SCORE (an organization of retired business people who counsel entrepreneurs) questioned my need to advertise since most of my patients would come from referrals. And I later realized that the local hospital I was applying for privileges at would be more than happy to arrange ways for me to network. And the physicians who found out that I was coming were eager to ask for and hand out my cards.

I also had planned on coming up with patient education material, completely forgetting that while drug companies cannot spare me a pen or sticky note, they can provide me with ample copies of educational pamphlets, books, and Web sites.

I have found that the hospital has an excellent diabetes education center, so I don’t have to personally teach the patients how to use a glucometer or how to inject insulin (although I will probably continue to show them the basics).

At my old practice, my staff scheduled patients’ radiology tests. I was worried that I would be spending time on this task, but when I called the hospital to find out who the contact person was, I also found out that all I had to do was fax a request with a note saying, “Please contact patient with schedule.”

And thankfully, I have an administrative assistant who is bright and able to work independently. Even when I was still a fellow, I was told that your staff can make you or break you. The office has only been open for two weeks (she’s actually been around for four weeks, helping me get things ready), but she has been able to handle the unexpected tasks that come with starting up a practice.

And lastly, I am blessed with a very supportive husband who has helped with everything from billing to hanging diplomas.

I suppose I could do it all if I had to. And I really thought I did. But now I realize that I don’t have to do it all. Sure, I am still physician/employer/janitor/manager, not to mention wife/mother/friend/daughter/sister. But help is out there — and even better, sometimes it’s free.

Melissa G. Young, MD, FACE, FACP, is an endocrinologist in private practice, an assistant clinical professor at Robert Wood Johnson, and a working suburban mother of two in Freehold, N.J. She is a regular contributor to Practice Notes.


  1. Melissa- You are right on with marketing- it's your patients and physicians that send you new patients. Years ago we spent thousands planning a community open house for our 20 doctor, multi-specialty brand new medical building with ads, balloons, signs on the road and we got 20 people.
    Don't forget to promptly send letters back to your referring physicians; nothing pisses me off more than seeing the patient in the office after a specialist visit with no letter to know what was discussed or ordered.
    I teach my own insulin administration- why delegate what you can do if you have time and patience? When patients see me stick myself with the insulin needle (I am not diabetic so I don't inject insulin) they realize it is not so bad and again it shows my commitment to their health. And you can include teaching time in your billing code and get reimbursed.
    Be wary of your use of drug company literature- there are often hidden marketing messages. Stick with your society's patient education resources.

  2. Melissa, Amen to you sister! Congratulations on the opening of your new solo practice. While many physicians hide from the thought of going solo, you are doing it! Good luck to you.

    For you and others considering the same path, I want to recommend the use of a CPA to assist you with the financial management of your practice. Known as the "most trusted advisor" CPA's can help in both the planning stages of your practice as well as with on going day to day fiscal affairs. We're not just about tax returns and financial statements anymore.

    I wish you well.

    Bill Bloss, CPA

  3. I started my own solo practice this year as well. It has been great, but not without it's challenges. I just discovered a web-based bookkeeping service that is free called It downloads all the transactions for you, generates statements etc.

    I also use a patient protal to help with scheduling and payment. (This has eliminated my need for office staff.)
    Also if your intersted in a free- web based EMR and practice management check out They even have a secure messaging for people within the practice and if you use their biller it's %6 of collected.
    The practice is called Metro Medical Direct in NYC.