Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Tuesday, October 02, 2007

Eighteen Years

Eighteen years ago today, I hung out my shingle and began the practice of family medicine, solo.

I had graduated from residency and worked for a few months for a pair of other docs who, much to my surprise, indicated that they did not intend to hire me to join their practice on a permanent basis. Their practice was full, though, and they had no objection to my setting up shop in the same town. At the time, it actually seemed like a lot less work to open up on my own instead of seeking out employment somewhere else.

I sat down with paper, pencil, medical and office supply catalogues, mentally reviewing everything in the "office" at my residency program. I priced everything out, generated a shopping list, and wrote out projections for growth and revenue. Then I found a little two-exam room basement office, and went looking for financing. It took four banks, but I finally found one that gave me the $25,000 credit line I was looking for. On October 2, 1989 I opened for business.

I saw three patients that day, but none for the rest of the week. Still, the practice grew slowly but surely. After two years I moved out of the basement office into an old surgeon's office building. Two years after that, when we couldn't negotiate a sale, I moved to my present location.

A lot has happened over those eighteen years. I've been through an embarrassing number of staffers, learning hard new lessons every step of the way. I look back at a 1989 H&P with more than a little embarrassment; they really do call it practicing for a very good reason.

I've been through a divorce, the hell of dating, and found my way into a wonderful second marriage. And my children have gone all the way from infancy and toddlerhood, through elementary, middle and high school, morphing into three sturdy college students who still light up my life.

On the flip side, my income peaked in 1996. It's been a slow but steady slide downward since then. That trend may actually be reversing itself over the last year or so; can't tell if it's just a temporary plateau on the way down, or things are really turning around. I'm trying to remain optimistic.

I'm not at all certain what the next eighteen years will bring, but I can still honestly say that I'm looking forward to it. And -- bottom line -- isn't that what life is all about?

16 Comments:

At Tue Oct 02, 09:30:00 PM, Anonymous Kensington MD said...

Happy Anniversary, Dr. Dino!! (When you say your income peaked in 1996, I trust you're not counting the psychic income of working at something you love.)

 
At Tue Oct 02, 10:40:00 PM, Anonymous Pine Baroness said...

Congratulations Dr Dino!
18 years in business is quite an achievement, even more so in solo practice.

 
At Wed Oct 03, 07:49:00 AM, Blogger rlbates said...

Good for you! Hope you have many more wonderful years!

 
At Wed Oct 03, 08:24:00 AM, Blogger Rob said...

Congrats Dino. There is no way I could have made it solo. My income has gone up only when I started sharing overhead with other Docs. Very impressive that you have done it alone. Even more impressive that you are still "trying to remain optimistic."

 
At Wed Oct 03, 08:25:00 AM, Blogger CrankyProf said...

Wow! Congrats and best wishes for another eighteen -- or twenty-eight, or more -- fruitful and satisfying years!

 
At Wed Oct 03, 08:45:00 AM, Blogger TK said...

Congrats--life is good! And don't forget your writing accomplishments!

 
At Wed Oct 03, 12:15:00 PM, Blogger Dr. Smak said...

Happy anniversary!

It's refreshing to hear from someone who's been at this for a while and is still enjoying it.

 
At Wed Oct 03, 04:08:00 PM, Blogger docbraypa said...

Congratulations on the milestone and may the future also be as inspiring. Just don't forget - everyone is entitled to a spring break from time to time . . .

 
At Wed Oct 03, 04:10:00 PM, Blogger MedStudentGod (MSG) said...

3 patients in a week! That must have been terrifying, but look how well you've done!

Hope that the tide is turning for you and your profession as a whole.

 
At Wed Oct 03, 07:18:00 PM, Blogger Zany Mom said...

Congrats.

Maybe there's hope for a second chance at love for me, too.

For now, I'm happy I have healthy children, which was not always the case.

 
At Wed Oct 03, 10:22:00 PM, Blogger TBTAM said...

Congratulations! I think doing what you did takes SO MUCH COURAGE. And I'll bet the turn around sticks - it's a business that none of us was really trained to manage,and you've managed to raise a family and send 3 kids to college, I'd say that's a huge success!Not to mention THE BOOK you've written and an amazing blog.

Looking foward to seeing what comes of the next 18 yrs....

 
At Wed Oct 03, 11:47:00 PM, Blogger Sid Schwab said...

Many was the time that I wished I'd had the nerve to hang out my own shingle. But I didn't. You have my admiration.

 
At Thu Oct 04, 06:52:00 PM, Blogger Lynn Price said...

Hey, major congrats, Dino. Doing anything solo is not for the weak constitution, and I applaud that you persevered through everything to do things on your own terms. Huzzah!

 
At Sat Oct 06, 11:36:00 PM, Blogger janemarieMD said...

Congratulations--and please keep blogging too when you can!

 
At Wed Oct 10, 03:16:00 PM, Anonymous SusieQ324 said...

As your patient for the last 14 of those 18 years, how glad I am that you continue to hang that shingle. As both of our lives have morphed over these many years, two things remain - your level of commitment and integrity to your craft and my continuing visits to your office, despite it being completely out of my way.

Thank you Dr. Dino for showing me my medical way these last 14 years and I wish you many more years of professional success.

 
At Tue Oct 16, 07:19:00 PM, Anonymous Bosun said...

Dr. Dino,

Quite an accomplishment indeed. Pls accept my belated congratulations. I am delighted to be one of your patients.

 

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