Starting a Medical Practice

florida healthcare attorneyBy: Jeff Cohen

Medical school may teach you all you need to know about how to care for people medically, but it won’t teach you how to package that into a sustainable business.  Here are some of things you’ll need to tackle when you do move into practicing medicine:

Licensure.  The first step of course is to be licensed to practice medicine in Florida.  Make sure you allow more than enough time to go through the process, especially if there are any holidays during the application period.  And if the application gets slowed down for some reason, reach out to an attorney who deals directly with the Board of Medicine to see what can be done to expedite the process.  If you’re expecting to start employment with an employer, make sure the start date is flexible to bend with the unforeseeable licensure delays.

Become an Employee or an Employer.  Nearly every physician starts out as an employee because they are still honing their skills and don’t want or need the distraction of business issues early on.  Things like HR, IT, billing and collection are overwhelming at first, and most younger physicians don’t have access to loans necessary to get started.  This means most will start out as an employee of a medical practice, a hospital or a university.  As such, getting legal counsel on board to help navigate the contract is essential.  And the one thing to find out is what sort of experience the lawyer has in such matters. 

That said, for the physician who wants to jump into the fire and open his/her own practice, one common thing to look into is whether a hospital in the area is willing to recruit the doctor and give them a “recruitment package.”  Such packages usually consist of an income guarantee and a variety of other financial support, all of which usually burns off (is forgiven) over a period of a several years.

Finally keep in mind that it often takes several months to go through the process of contracting, and that the time period is even longer when a hospital is involved.

Location, Location, Location.  For the adventurous physicians, finding a location to get into practice is the first step.  Being close to a hospital is a nice idea for those with busy surgical practices; and many hospitals own medical office buildings and can offer very nice incentives to lease the space.  For the even more adventurous, finding a medical office condo is an option.  In either event, use a real estate lawyer to help with that and the lease agreement.  Finally, when looking for a space, remember that it may need buildout, and that can take many months.  You may need to find a temporary home till the space is built out.

Notices.  Medicare (and the Board of Medicine) need to be informed of your practice location.  And of course if there is more than one physician working in the practice location, a Medicare group number may be required (if the practice provides ancillary services).  So make sure you allot enough time to that process, or there will be a cash disruption in the practice (since it doesn’t have the requisite provider number(s)).

Getting on Managed Care Plans.  Don’t approach this on an “if we build it, they will come basis.”  Make sure the marketplace is open to new provider enrollment.  You’ll need to know the largest plans in the area you’re locating to, and whether those provider panels are open.  Do not put yourself in a position to have a big surprise that leaves you out of network when every competitor around you is in network.  Patients faced with bigger out of network financial responsibility are going to generally prefer physicians who are in network.  And also keep in mind that getting on a plan can take many months.

Take the time to assess the market you are going to.  And make sure you give yourself enough time to face the normal challenges to getting into practice.  It always takes longer and costs more than you think!

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