Starting my own practice

Hello All,

I’ve been following these forums for some time and it seems like some of you know quite a bit about the business side. I am in the process of opening my own practice in the SW (USA) and I was wondering if any of you had any advice for me or if you would be willing to answer a few questions? I am mainly concerned about the financials. How much does it cost to open an office between 1000-1500 sq feet and is this size adequate? I’ve seen estimates online anywhere from $50-$200 a sq foot but I know my current employer pays about 400g’s to open a office…which is insane. What should I spend on marketing? I believe direct marketing works best in my area. It’s kind of hard to write up a business plan without any knowledge of the prices and I’ve got a feeling nobody in my area would be willing to share such info.
Thank you much

I got only one advice to you… buy a verifit…

Read Audiology practice management, as it seems you are very far from starting up and this was a great introduction for me. The more you spend on EFFECTIVE marketing the better. You will find that most of your clients are actually internet savvy, contrary to popular belief so make sure you have a decent internet presence.You might also be surprised to find that some of the providers in your area will be too happy to help. Competition is good for a practice, it help stimulate the market.

Do you find that a verifit helps with fittings?

I retired from my first business in communications technology about five years ago and am now an IT professional (contracted IT management/admin) as well as a Real Estate Broker. Both took considerable effort, time and money to get running and so will an audiology practice.

I would suggest that you begin by taking some business courses if you want your own business… and I cannot overemphasize this. Also, expect and be prepared and willing to HIRE and PAY FOR the best help you can get wherever you are ignorant (no insult intented of course). It took me ten years to figure that out and it was ten years wasted in terms of building a business.

Where does one start? One starts with a very thorough, well thought out, detailed business plan. If you don’t know what a business plan is or how to create one take a night school course or go to the library and get a few books. It is not a one day job. Expect to spend considerable time researching your market, your suppliers, your budget, your marketing, etc. And then take that business plan to a business oriented banker and ask for a whole bunch of money; part in the way of capital equipment loan and part in the way of operating and inventory loan. Tell them you are willing to put your home up as collateral??? NO!! Tell them that you would like them to loan you the money based on your business plan and see what the reaction is. You need to get a professional to read and examine your business plan and point out errors and ommissions, etc. This is a great way to do it. YOU have legwork to do BEFORE you even think about opening up. You need to scout locations. Your business may benefit from being located on a busy thoroughfare where you can put up a large sign or buy billboard space. You need folks to know you are there! We were in a large mall with a national brand on the sign above and ten years later they still get folks calling other stores and asking if there is a store in XXX mall. Incredible. And think carefully about newspaper and radio advertising unless you are prepared to keep at it for a couple of times a week and forever. We ran the FRONT page basebar on our local newspaper for several years and I always said that it was a waste but they would not let us run a coupon to test the ad. Anyway, one day they approved a coupon ad on the front page (they don’t like the front page of the paper being chopped up)… we went out and bought 1,000 Black and Decker tool kits and offerred them FREE to anyone who came in and said hello with the coupon. No purchase necessary. Figured the 1,000 would last a week and that would be sufficient… so how many did we give away? A grant total of about TEN. And that was the last ad we ran on the front page of the newspaper.
My friend, running a business is not just wanting to help folks out, liking a particular line of products, etc. BUSINESS IS BUSINESS and you need to make a profit in order to stick around for 30+ years like I did. I can tell you there were days that we didn’t know if we could meet payroll… and bought groceries at the only store in town that would take a credit card for food at the time (they all do now).
So, my most profound and sincere advice to you is this… know what you are getting into by studying and creating an extensive business plan and see if it flies with a banker (even if they say not without signing over your home… at least you will get feedback on the business plan, especially if it is asking for more money than your home is worth, right?). Do not skimp and get yourself the best bookeeper and accountant you can afford. Have a lawyer draw up incorporated papers to limit your liability and take the best insurance you can afford because folks that seem like your momma are going to sue the pants off you for everything under the sun.
And when the time comes to actually open the doors remember this one thing. THE CUSTOMER IS ALWAYS RIGHT. Your food on the table and your roof over your head are paid for by your customers no matter how big you get. The bigger you are the more you need to pay attention to this detail. My deal was that my store managers were empowered to make EVERY customer happy regardless of cost as long as it was legitimate (and I could tell you of a ton of humdinger scams tried on us for size… a store manager that could not tell an honest customer from a scammer got their final paycheck on the spot with two weeks paid in lieu of notice and were handed a box or bag to put their personal items into for inspection and shown the door. Right then and there.) Also be prepared to install a top notch alarm system answered by an armed guard service. Be prepared to decorate in keeping with good taste and the price of the product you are selling. Be prepared to keep the place SPOTLESS. No dust anywhere for sure. And on and on the list goes.

So, if you are ready to go, you now have a smidgen of an idea as to what it takes to do so. Sure, you can pick up a line, rent a space and start selling, but I am here to tell you that asides from pure dumb luck hitting you like a lightening bolt your business will not last long. And it won’t be from lack of effort but rather from lack of organization and knowledge.

Being in business for oneself is the most satisfying means of making a living that there is and I don’t care WHAT the business actually happens to be. It is just great fun and a wonderful learning experience… so I wish you all the luch and good fortune in the world. Just go in ‘eyes wide open’ and not blindly into the fog. Do this and you WILL succeed beyond your wildest dreams and build something for the generations. Go in blindly and you will most likely become a statistic through no fault of your own.

Oh, one last thing. If you need bank financing? Regardless of what the bank says they want (usually it is exclusivity) make sure that you have at least two banks online and a backup plan for financing. I have had banks pull the plug on me more times than I care to count because the new manager did not feel we fit into their portfolio nicely. His/her whim just about killed us a couple of times until I got the picture in my head and never again put all of my confidence into one lender or banker. And never had that issue again although we did have banks pull the plug over the years. We even had banks change their location on us while we continued to make daily deposits and write checks to suppliers based on those deposits… only to discover that the bank had messed up the account change and our money had all gone into “limbo” somewhere and all of our checks bounced until a supplier finally called us to let us know. It was a Friday afternoon and the bank manager said to call him back on Monday and he would see what he could find out at that time. I suggested that he stick around for ten minutes as I would be over with the police fraud squad by then since he had little interest… and oh, by the way, can I please have the number for the President of the bank? I’d like him to know that the police will be paying him a visit as well to investigate along with the local papers and news media. I got some attention and letters of apology to each supplier (actually phone calls). And then they, too, dumped us for being poop disturbers. But, that’s business and that’s what you are going to have to put up with without losing your marbles or having a coronary. Remember, it’s business and needs to be run like a business.

Think a franchise, a chain, or similar with and out in the contract in a certain amount of time if you really want to go on your own. Franchisor has the experience, the plan, etc. The good ones will be there to help you get started. Yes, you pay them in some way, but it’s the experience of their knowledge you want, plus their bookkeeping plan. With experience under your belt you’ll know what you need to do.

Hello,
I began my practice last year also. My first fitting was in October. I provide a mobile service, meaning that I do house calls-all the time. My audiometer is pc operated, My service kit is a wheeled tool box and spare parts are in plastic boxes in the car. My overhead is low and I am already making a living-in a small town of 2500 souls. I serve an area that is within an hour’s drive. Sure beats waiting for calls in a leased office!

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Dana,
I think your idea is great! By going on the road you can offer your clients the ultimate fitting experience. If the timing is right you can fit them in all situations: noisy situations, tv, car, telephone use, etc. This could limit the number of times you see them drastically and you are offering what is the closest to self programming with a professional at your side. Too bad you don’t live in a larger area I think once the word got out the phone would be ringing off the hook! Good luck!

I have a daughter that will be finishing her audiology masters and is wanting have her own private practice. Is it wise to jump in right away or would it make more sense to work for a practice to build some experience first. Any thoughts??

IMHO, she’s going to get exposure to better practice, different ways of working and more brands by starting out (at least for a little while) working for somebody else. It’s a big step to go it alone without a bit of experience elsewhere first.

It’s not really the kind of industry you can just get going with straight-away unless you either buy yourself into an existing business or are extremely lucky.

I’ve done a zero start-up, but I’d been working elsewhere first - years 1-3 can be a really slow burn and cost you a pile of cash reserves.

Sometimes it is best to just jump in.

In 1978 I bought a small HA office in San Clemente. ( My ex ran it ). In 1981 I became partners with an audiologist who had started an office from scratch a couple of years earlier. In 1986 I opened an office from scratch in Irvine Calif. In 1990 I bought a well established office in Anaheim.

I had several different partners and employees in these ventures.

I have been in a single office, no partners, one office mgr/secretary since 1999.

After 30 years of experience, if I had to do it again I would buy an established practice with a consistent cash flow. Having on going business makes all the differenc ein the world.

The last thing I would do is to open an office from scratch ( unless I had a GUARANTEED stream of patients ).

I recently opened my own Audiology practice.

Allow me to offer her a strong word of advice - DO NOT go into business for herself without gaining experience first!! Audiology academic programs DO NOTHING to prepare an Audiologist for owning and running a business. Add this to the fact that she is wet behind the ears, it can be a recipe for disaster. After completing a Audiology program, there is TONS to learn about patient care and only experience can provide this for her. If she is acquiring clinical experience and simultaneously trying to learn to run and manage a practice, it can be extremely overwhelming. I literally learned more in the first year of clinical practice, than I did in 8 years of college completing my degree. Trying to learn to run a practice, will inevitably hinder her refining her clinical skills.

My advice would be to work clinically for at least a couple years. It would be best if she worked at a private practice (Audiology or ENT) so that she can understand how it works. During those years, she should read and study all she can in her spare time about running and owning a medical practice. There are unique aspects of a medical practice that she will need to understand, like coding and billing for insurance, licensing and accreditation, liability insurance, along with all the traditional aspects of owning any kind of business.

Can it be done straight out of college - yes. But she will greatly increase her chances of being successful if she waits - I did.

Good luck to her!

dr.amy

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First of all I’m not an audiologist but I am a contractor. If I were doing it again I would go into business with a partner to help even out the load. For an audiologist the learning curve continues after school and continues though out her career and although she has the degree and license she is as dr. amy says " still wet behind the ears." So, I would steer her toward working for an established practice and get as much experience as she can over the next several years and then perhaps go out on her own.