Making the Leap: Starting our own Family Medicine Clinic
Dr. Lauren LaCute here, proud co-owner of MI Family Medical Center, reflecting on my journey from practicing family medicine in an academic health system to opening my own clinic one year ago. In March 2023, I was about to embark on this new adventure while five months pregnant with twins. It was a rush of a timeline, to say the least. Looking back now, in March 2024, I want to share some insights and lessons learned from my experience, hoping to light the path for others considering a similar leap.
Reflections & Lessons Learned
Longer Transition Period: Once you have decided to make a change, consider negotiating a partial appointment or month-to-month arrangement with your current employer to ease the transition. My partner was able to do this, and you never know unless you ask.
Micro Operations: Keep your clinic operations micro. Instead of hiring your way out of new challenges, be transparent and hire adaptable individuals willing to wear multiple hats and grow with you. Building a team that shares your vision and values is priceless. We’ve found these people and they are gold – treat them accordingly.
Administrative Prep & Resource Management: Start keeping a list of resources you use regularly or will need, and find ways to leverage them without cost or with minimal investment. Observe and understand how common tasks are completed (think: front desk, triage, care management, billing and coding, etc.), and ask questions to anticipate gaps, particularly in your administrative knowledge, to avoid pitfalls. For example, at my previous clinic, I wish I had spent more time understanding global referrals and home health orders – nothing hard, but also not something I knew before, and now do nearly every day.
Financial Preparation: I wish the bar didn’t need to be so high, but ensure you have enough cash flow for at least two years. Even as your clinic opens, anticipate delays in getting paid, and unfortunately, some care that you will provide that may never be paid – Medicaid visits I did starting April/May 2023 with one payer look like they are not ever going to get paid, and it is a tough realization to have worked for the payer for free for nearly a year. Having a financial cushion is crucial. I ended my employment in December 2022 and don’t anticipate a steady paycheck until the end of 2024. Thankfully, my spouse could cover some of our family's cash flow, but we did have to dip into savings quite a bit, especially to cover a brand new expense like daycare.
Navigating Complexities: Understand the complexities of the healthcare system, especially dealing with payers. The credentialing, payment, appeals and reconsiderations process can feel intentionally cumbersome, so meticulous record-keeping and persistence are essential. For instance, a simple inquiry about an error with my previous hospital address kicked me back to the beginning of the credentialing queue, resulting in further delays and frustration.
Leveraging Support: Ask for help. Often. Particularly in family medicine, your colleagues + internet are your friends – we like to help one another succeed, one patient at a time. I am beyond grateful for our administrative friends and fellow physicians who form our wider community of support and that my clinic is proud to be a part of. And, as you can hear more about in this podcast, working with Metis has been invaluable. Their tech-driven coaching can provide tools to maximize your clinic’s impact on patient care and help navigate changes in business, policy, compliance, reimbursement, and regulation.
Ultimately, despite the challenges, I have no regrets. I'm not doing all of this work for someone else—I'm building something for my patients, my community, my family, and myself to be proud of. If you're thinking about making a change, I hope my experience can offer some guidance and inspiration.
