Building a private practice requires exacting standards, attention to detail

Chicago - Running a successful private practice demands that dermatologists give their patients the best of everything, from pre- and postoperative care to drug samples and waiting-room décor, says Haines Ely, M.D., a Grass Valley, Calif.-based private practitioner and clinical professor of dermatology, University of California, Davis. Dr. Ely's office logs at least 50 patient visits daily.

"Office efficiency is intelligent laziness. And complacency stalks success as shadows stalk the sunlight. So, no matter how long we've been practicing, we need to renew ourselves and become new doctors every day," Dr. Ely says.

"Some people think one should work like a bee," he adds. "I believe one should work like a dog."

"One spends a third of one's life asleep, one-third with one's family and personal life, and one-third at work. One wouldn't sleep in a bed that had lumps in it, so one's work should be just as nice as one's bed is - it should be a beautiful location, and everything about one's office and practice should be as good as one can make it," Dr. Ely says.

Care for practice

In keeping with this philosophy, he explains, "fixed overhead is the least of one's practice expenses. So always buy the best surgical tools and everything else. Never skimp on your practice - many practices that I see have shabby offices that look like the janitor hasn't been on the job, and there are old magazines in the waiting room."

"These offices look like the practitioners don't care," Dr. Ely says. "One never wants to give patients that impression."

Rather, he says, a dermatologist's office should show patients at every opportunity that the doctor is the best at what he or she does.

"One's whole practice depends on first impressions," he says. "The person who answers one's phone is the first impression. One wants patients to say, 'I can hear the smile at the other end of the phone.'"

He adds, "People have trouble believing that I only have two employees (he recently hired a third), and I run a very busy practice. The ideal is to keep the number of employees to a minimum, and to select employees with the best personalities, highest intelligence and most radiant smiles. One doesn't usually find these people in nursing schools. Usually, one finds them running banks or restaurants or in professions where there's a lot of contact with the public."

Such people, he says, can be trained to do whatever is required in one's office. Dr. Ely's employees are all cross-trained and do every job in the practice.

Care for employees

When it comes to pay and perks, Dr. Ely says, "treat your employees better than you treat your patients. One spends a third of one's life with those employees, so one must make sure they're always happy."

One way to do this involves finding new and unusual ways to reward employees.

"Let's say a patient comes in who does massages for a living and wants to trade a massage for an office visit," he says. "One can say to them, 'how about giving each of my employees a 20-minute neck and shoulder massage, then I'll see you as a patient?'"

A patient's first in-person impression is the waiting room.