Planning, research, caring are keys to cultivating patients,referrals

Editor's note: Every month in Residents' Forum, a dermatologist in practice or academia discusses clinical and practice management issues affecting residents. If you're a resident and would like to see specific issues covered in this column, please e-mail the editor at mhrehocik@advanstar.com
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Especially for doctors starting their own practices - although less so for those joining a large group or academic setting - one crucial question must be asked and answered: Where will I get my patients?

For Brett M. Coldiron, M.D., the answer to that question can only be found by asking and answering a lot of others. Dr. Coldiron, director of the Skin Cancer Center in Cincinnati, urges new doctors starting out - and veterans starting over - to spend some time pondering the following:

Questions such as: Do you specialize in skin-cancer surgery or cosmetic surgery?

"The answers can also help you decide on where you'll locate - or conversely, where you want to locate can help you decide what to specialize in," Dr. Coldiron says. "If it's skin cancer surgery, it's best to look at the southwest or Florida, where there are plenty of retirees and blue collar workers who develop skin problems from exposure to the sun. If you're looking at cosmetic surgery, you're looking at the East and West Coasts, or pockets in Colorado, Arizona or Nevada, or where there's a younger, urban population."

Wherever the answers to those questions lead, Dr. Coldiron - again, from a business perspective - says it's important to consider the competition.

"Obviously, it's easier to develop a thriving practice where there's less competition, and I advise checking out the databases of the American Medical Association and the American Academy of Dermatology to research that," he says. "A few rules of thumb to remember: There is greater income where there is less managed care; consider the cost of living when calculating potential income and costs; and find out what percentage of Medicare private insurance pays."

Other rules

Whether starting a new practice or buying an existing one, doctors should also remember other rules of thumb, Dr. Coldiron says.

"Medicine is a service industry, and, like any industry, a key factor is to make your customers happy, whether it's your patients or referring physicians," he says. "And like any industry, ours is sales - and that includes selling yourself as well as your services. The best way to begin doing that is to create a mission statement. You should tailor it carefully - by the way, I always advise including the staff in this - and try to live up to it. An example I use is, 'We strive to provide the highest-quality skin cancer treatment in the world, in a fun, efficient manner.' Also remember that your mission statement can be amended as needed."