My 2 cents for 2 years.

Its been 2 years since we established our humble clinic. It has by far reached 2400 patients in records. It was a slow 2 years but the clinic survived the economical turmoil. There were some learning points which we have acquired during these past 2 years. As a clinic in an area with other clinics within close proximity, there are certain strategies to be taken into consideration to ensure that it survives. Don't take our word for it 100%, we are still a growing establishment and trying more ways to make the clinic successful.

1. If there are other clinics nearby (theres 3 near mine), consider applying for panels. Although cash paying patient is more gratifying, panels in a way, attract more patients as they may not need to have cash on hand. However, payments to you from the panel might be in the span of 2-4 months. I usually get patients who come to me for 2nd opinion as the first GP failed to treat them. Then they would politely say that they prefer our clinic, but is pressured to go to the first clinic as their panel is catered there. Many of these patients gave similar sentiments to me. Our clinic have limited panels, therefore, it is in our future consideration.

2. Credit card and debit card. Most merchant terminal provide Visa/Mastercard and debit card payments. Some can be obtained from banks or 3rd party companies. Their terminals can be with cord or cordless. I find it essential to have the device in this day and age, as many prefer to use their credit cards for payment. It prevents them from carrying too much cash and useful during emergencies. Card terminals is an important consideration.

3. Extra medical devices. Apart from the usual ultrasound and ECG, other medical device services may attract more clients. For example, we are keen for an FBC machine as our area is plentiful with dengue cases. However, it's a steep investment as the machine costs from RM25-40k. The benefits and costs must be weighed in your area. Our competitors here have Jaundice machines, Phototherapy services, FBC machines, 3D ultrasounds and xrays. Hence study the crowd and your competitors. Future investment in these equipments may make or break your clinic.

4. Service with a smile. I noticed that throughout these 2 years, I've had loyal clients who come to us and eventually bringing all their relatives to our care, just because we treat them with kindness, compassion and a beaming smile. From my nurses to myself, we pledged to ensure that all our clients are treated with respect and empathy. Despite them being celebrities or even illegal foreigner, we will treat them all the same. And we noticed, that although they have panels in our neighboring clinics, they prefer to come here for the comfort in care. That stands out. But to others, if finance is an issue, despite their fondness for our service, they will resort to their panel eventually. Therefore, point number 1 must be taken into consideration.

5. Go the extra mile. We have made practices to call back our clients/patients, to ask about their progress and wellbeing. Mainly those who came to us quite ill and even those who are referred to a hospital. Our nurses would give them a ring and ask their condition and update me. Even I would call them myself just to learn on their road to recovery. This add to the personal factor to our care. Many clients appreciate it.

6. Consider it free for emergency cases. It other terms, "sedekah". Most emergency cases that lands on our doorstep required immediate management and ambulance call. Most of the time, they are cashless and upon leaving the clinic to the hospital, payments are not made, records are lost, or patient does not respond to our calls later for claims. Hence, consider it as a volunteer practice. Although there were many stories about clinics "closing" their doors to emergency cases, question your ethics and conscious as a doctor and human being; we should help.

7. Weather influences business. I think this is self explanatory, if it rains, heavy, your clinic would be quiet. Nuff said.

8. Watch the expiry dates. Medications will expire. If your staff arranges the drugs without rotating the old meds, your might overlook some drugs which has expired. Always bring forward your old stock during arrangement to prescribe them first.

9. Paper or paperless. I chose paperless, there are many international and local electronic health records (EHR) in the market, but most of them costs a bomb. Some range from RM 200 to RM 6000. And some require monthly or annual renewal fees. It depends on your capitol and IT savviness. I looked around for free EHRs with no string attached. The one I'm using is PracticeFusion. A cloud based EHR. Works like an email but with all the necessary medical notes you need. Internet connection is required. Hence on days when the system is down for updates, pen and paper is used first then later typed into the EHR. The notes are signed, can be printed and used as medicolegal documents. And its totally FREE.

10. Treat your staff well. If you are nice to them, they would be nice to you and eventually, carry out many of your orders and plan. It takes a team to run the clinic, and both nurses/care assistants and doctors should work together hand in hand to ensure the management runs smoothly.

11. Keep your clinic clean and organized. At times, I do my own sweeping, mopping and clearing of the utensils. Just to ensure that its done right. However, the staff would also rotate jobs in maintaining the upkeep of the clinic. The bathroom is most important to keep clean.

12. Try not to overcharge. Pricing is always adjustable by you. If you notice that they come from a poor family, or brought the whole family for treatment, consider discounts here and there. This small gesture would make them be grateful.

13. Get to know your clients/patients. We know most of the patients by name, including their family members. We remember their problems and treatments. It gives a whole new meaning to personal care to our clients/patients. They appreciate it much.

14. Hire reliable, legal and authorized locum doctors with valid APCs and permission from their superiors. This rule was postulated by MOH. However, if all the paperwork is good but the doctor is lazy, your clinic image might be jeopardized. Make sure they are nice with good patient-doctor relationship. Of course, competency is also a major factor.

15. Managing accounts. I have NO EXPERIENCE in business or accounting, hence this I'm still learning at a snail pace. But the usual debit credit comes in and my efforts to balance the sheet is still a headache. Hiring an accountant might help but prepare the paycheck.

Okay, this as much as I could churn out for now. But for those who are embarking in this path of establishing your own clinic, these experiences I share might differ to yours, but I believe that its not about destination, but more of  the journey. I hope my 2 cents would help. Please share any experiences of your own to guide others in this daring endeavor. Its tough, but resilience would bear fruit and satisfaction one day.

Good Luck Doctors.