Moving Your Wound Care Practice When Opportunity Knocks

To move or not to move

  Carefully weigh your options before you decide to relocate. Many reasons exist to change the location of your practice and the decision must be based on one’s head and not their heart. Is the reason for the move because of personal/family reasons? Is another hospital or professional association doing the recruiting? It is also important to consider if one is leaving a thriving practice for future possibilities? Evaluate the new position thoroughly and understand that it may take several months, if not longer, to get established and rebuild the practice at the new location.   If the hospital or catchment area is larger, it could increase your patient load and expand the practice. Also, larger hospitals tend to have more resources, more sub-specialists, and more access to marketing. Enticing opportunities may be available such as teaching, or the possibility of starting a fellowship or training program. On the other hand, larger hospitals may have more competition among physicians.   Another catalyst for change could be for more call coverage or less of a time commitment in the clinic. However, this can be a double-edged sword. One could have more administrative responsibilities, but the less time one is in the clinic, the fewer patients they can see and bill. Achieving this balancing act takes a significant amount of effort.   Increased benefits represent another reason to move. Anyone who is self-employed understands the added cost of benefits for their family and any employees they may have. If the new position offers an upgrade in health/dental insurance, malpractice insurance, life/disability insurance and/or a 401K, it should strongly be considered.   The future goals of the center or hospital can also encourage a move. Expansion plans or the potential to open satellite clinics could significantly increase the number of patients that one can serve.   Understand the reasons to move the practice, weigh the pros and cons regarding important long-term goals, and if the situation best suits one’s needs, then move forward.

Before the move

  Once the decision to move has been made, a number of issues must be addressed prior to the actual move date. This is very important, to maximize efforts and not have a significant delay in treating patients or reimbursement.   Inform the billing and collections company preferably 60 days in advance of the actual move. If this is impossible, than at least 30 days notice. This will allow them to inform the necessary insurance companies, Medicare and Medicaid, to the new location. Failure to do this could seriously delay of the clinic’s revenue stream.   Also, one must inform the state board and the FDA of the new location. If the move is to a new state, it may take up to 6 months to obtain a new state license, so do not plan the official move until you are sure that everything is in place and one is eligible to practice in that state.   The current practice location must also be informed of the decision. The current practice may need time to find a replacement. Try not to burn bridges during this process, explain the reasons for moving, and assist in any way to make the transition as smooth as possible. It is also important to provide them with address forwarding labels (which can be done easily on a computer printer).   Next, about 4-6 weeks prior to your move, start informing the patients. A general moving letter given to them at their next appointment is the most efficient way. Only a minimal amount of information is required in this letter (when is the move, where will their medical records be, and, if known, who a replacement in that location will be). If the patient asks directly, one may want to elaborate about where they are going and their reasons you are moving.

Moving and packing

  The physical aspect of moving presents its own challenges, especially if one waits until the last minute. Starting several weeks in advance and slowly pack books, belongings, and papers a little at a time, creates less of an ordeal. Throw away un-used or out-dated material and organize along the way. Make sure to keep important papers and files easily accessible and label each box carefully. It is shocking at how much trash one can accumulate over the course of several years. Above all else, keep it simple.   In addition, try to be as un-obtrusive as possible. There will be enough distractions with the staff and patients during the transition. If possible, packing is best completed after hours or during weekends.

Marketing

  One of the most important things to do before, during, and after the move is to market the change of locations of one’s practice. After practicing at one location for a number of years, chances are the only marketing that has been occurring is simply reminding the referral sources of the clinic’s services. Moving to a completely different market requires quite a bit more effort. This may be extremely time consuming, but the efforts are well worth the investment.   First, identify the referral sources. These can include, but are not limited to, primary care physicians, podiatrists, vascular surgeons, plastic surgeons, hospitalists, general surgeons, endocrinologists, and oncologists. Send each group an announcement card or packet, informing them of the re-location or arrival. Some groups have weekly or monthly meetings, try to get on the agenda. The hospital or wound center may assist with this and use it as an advertising opportunity.   If the wound center is already established, identify the existing referral patterns, ie the location of the catchment area for the wound center and/or the hospital. This may provide additional physicians to contact. Home healthcare agencies, long-term acute hospitals, and nursing homes that serve those areas are other sources where marketing efforts should be focused. Referral pads and educational material that define the services provided should be included in the marketing material to these sources.   It is also important to always carry business cards. Pass these out to anyone; potential referral sources are everywhere. Never be afraid to think outside of the box, using newspaper ads, sponsorship for charity events, or volunteering for health/diabetic fairs are all potential ways of getting the practice established.   The most important marketing tool one has is their networking skills. Nothing can replace the face-to-face meeting with another physician. Take the time to go to different physician’s offices and meet peers, explain the clinic’s services and how it may be able to help their patients. Answer their questions, but be aware of their time constraints and understand if they can only spare a minute or two between patients.   Any time a move occurs, the experience can be daunting and even intimidating. If the right opportunity knocks, take the time, prepare thoroughly, invest time to market, and enjoy the new practice. Remember, truly great opportunities do not come very often. Andrew J. Applewhite, MD, CWS, UHM is Medical Director for the Baylor University Medical Center’s Comprehensive Wound Care and Hyperbaric Center in Dallas, Texas. Dr. Applewhite can be contacted via email at Andrew.appleewhite@BaylorHealth.com.