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MILITARY
facial plastic surgeon. His take home message was -- don’t take
on an unmanageable loan.
Once I chose my path, I researched what I needed to do to open
a practice. First, I talked to colleagues I trusted. One was Dr.
Earl (Ted) Ferguson, a plastic surgeon who was my squadron
commander when I first moved to San Antonio. Ted was always
fair and honest with me when I worked for him. He had retired
from the Air Force and was in private practice. He told me first
I needed an attorney to form a business entity, and also referred
me to a contact at Medical Protective to obtain my own malprac-
tice insurance. Two basic steps were established. My attorney,
Mr. Edgar Duncan, was also very helpful and pointed me to other
contacts.
Though I knew I needed an office, I did not want my own of-
fice while still in the Air Force. Since I would be moonlighting
in my own office, I wanted to sublet a space before I finally re-
tired. But how does one look for space to sublease? Here’s where
I learned the value of connections. I talked to various colleagues,
who suggested various physicians to talk to. But a key connection
came from my wife’s friend, whose husband was a successful po-
diatrist in town. Dr. Russell Stanley referred me to his colleague,
Dr. John Winston, a colorectal surgeon in Stone Oak. Dr. Win-
ston turned out to be a terrific colleague. Though all the other
doctors I talked with were open to meeting me, I felt their priority be treated like a vendor vs. a medical colleague.
was maximizing their profit with me. I was not offended—I un-
derstand that’s business. But Dr. Winston was the only colleague
who truly wanted to help me, and embodied the philosophy of
“paying it forward.” He offered a reasonable lease, but the most
valuable assistance he gave me was his openness to discuss any
business questions I had. Dr. Winston shared his process to meet
referring doctors and strategies to improve referrals. I also appre- never keep the politics straight), had deployed to Afghanistan,
ciated his happiness to recommend various business partners crit-
ical to private practice—from banks to accountants to even
Information Technology (IT) companies. His office manager,
Velma, was also extremely helpful. Velma showed me the basics
of insurance billing, credentialing, and contracting—all com-
pletely foreign concepts to me. In a sense, I received an “intern-
ship” in private practice while working there, and I didn’t need
to hire a consultant to help me start.
With a foundation established, opening my own office was
much easier. I found a real estate broker through another of my
wife’s friend. Carl Salvato was experienced in medical offices, and
he guided me through the process of finding space, negotiating
the lease, and finding a contractor to build out the space. From
MEDICINE
my time at Dr. Winston’s, I met Tom Rosol, the local representa-
tive for Henry Schein. Tom also turned out to be a valuable re-
source since equipping an office is another critical element of
starting a practice. However, I quickly learned the number one
challenge to solo practice is generating patients. All the steps
needed to open a practice involved time, money, and some frus-
trations, but there were always certain promised outcomes. But
just because I have a practice, I learned patients wouldn’t simply
come. As a friend told me, once you get out of the Air Force—
regardless of your reputation—“you don’t exist.” You have to
pound the pavement to get referrals. My case was a bit different
since the predominant patient base I needed was for cosmetic pro-
cedures. I quickly discovered advertising is another important ex-
pense that, unfortunately, is very expensive and whose return on
investment is difficult to judge. With the bombardment from
multiple companies seeking my business (i.e. Search Engine Op-
timizing (SEO), print advertising, TV etc), I felt like throwing
darts and just hoping something will stick. In the cosmetic in-
dustry, I knew effective SEO is the first priority. I’m also trying
print advertising; I’m currently still in the contract period and
will monitor the return. Meeting potential referring providers
also exposed a harsh reality. Not every practice was cordial; I was
surprised to discover many never returned my calls, or promised
their doctors would call but never did. The hardest thing for me
to accept is not to take things personally. Still, it’s frustrating to
I’m still in the early stages of my private practice, and friends
always ask how my experience has been. My answer is the same—
it’s exciting, yet a bit scary at the same time. I had reached the
pinnacle of my Air Force career. I was promoted to colonel, had
served as chief of otolaryngology at SAMMC (or BAMC—I could
and served as a squadron commander. Creating and growing my
own practice is a challenging endeavor that I find very stimulating
and one that motivates me daily. I’ve made my share of mistakes
and believe these will only help me grow. Though the Air Force
didn’t teach me any business principles, I strongly believe its core
values—integrity, leadership, and the essential role of developing
strong teams—are critical to success for any organization.
Dr. Kenneth Yu is a facial plastic & reconstructive
surgeon in private practice in San Antonio and is vice
chairman of the BCMS Publications Committee.
visit us at www.bcms.org 33