Q:

Hi Dr. M,

It's me again!  About 8 months ago I wrote you about leasing space 
from another doc and we discussed the pros and cons.  Please read 
all of me:)



Let me tell you my original objectives:



    After having been in an IC situation from hell, my confidence 
was stripped, so I wanted to rebuild my confidence in terms of 
patient interaction and adjusting.

    I wanted to have CA support as a resource for first situations 
encountered.

    I knew this would not be a long term relationship as I know my 
personality and I need to be in my own place, but I wanted to get off 
to a running start.  I set certain goals in terms of     



    -collections

    -services

    -patient visits/week

    - new patients



Well I got off to a rough start in the beginning.  The CA is there to 
answer my Q's, but other than that, I do all my own billing, 
paperwork, stats, patient mailings.  I even designed my own forms.  I 
had some trouble getting NP in the beginning but my retention and 
compliance is over 90%.



Our agreement was verbal - a flat rent with use of everything 
unless there was an excess, which she never defined and told me not 
to worry about it.  Well last month, I got a PI patient and all of a 
sudden the doc said it was time to raise the rent plus take a percent 
of collections.  The rent was quadrupled.  I said no to opening my 
books and giving a % because I had waited 12 weeks and the 
insurance checks were finally coming in and I needed to catch up on 
my bills.  I then took a proactive approach and laid out a schedule of 
gradual rent increases over the next year which would eventually get 
her to where she wanted to be.  This was approved and signed by both 
of us.  



Now I believe another 'tenant' is interested in my room ( a 11' x 10" 
square) who is not a chiropractor, but can pay more rent.  This doc 
called me at home on my day off to tell me that on Monday, we 
needed to have a conversation.  I asked jokingly, if I am being kicked 
out and the response was, 'you and I will have a conversation on 
Monday.'



I have not been wholly happy there in a while.  I feel that my 
responsibilities as a contractor are emphasized to the exclusion of 
my rights and her rights are exercised to the exclusion of her 
responsibilities.  Because of this I have started looking around for 
space quietly.  Unfortunately, I have not done a whole lot of 
promoting lately because of this unhappiness with the situation. 



 It seems that on a weekly basis, I am being hassled or 'spoken' to 
about something.  All I want to do is pay my rent, see my patients 
and live my life.  I have stopped scheduling patients on Saturday 
because the small office is overcrowded and I feel like I am in the 
way.  There is not a lot of consideration for the fact that there is 
another doc there sharing things like x-ray, etc.



Anyway, back to the objectives and my question.



My confidence about talking chiropractic and adjusting is back. I 
have long surpassed my services goal.  I am a little behind in my NP 
goal(but I haven't really been promoting much lately), I am about 75% 
of my PV goal and a little behind in collections, though I have about 
$3700 in insurance receivables, including the first month of the PI 
at around 1200.  



I'm trying not to look at the situation as negative, but more like 
the mother chick scooting the baby chick out of the nest to test her 
wings and fly solo.  Where do I go now? Financially am I ready?  I 
know my patients are really pleased with their care and I am getting 
results and referrals!!!



Strip malls are expensive and there are the CAM's - about 
1600+/month total.  what do you think about a professional office 
bldg, like a dentist or MD?  Business park?



I need about 800 s/f, correct?  and at 14/sf, I maybe can afford 
that before utilities.  Personal expenses are mostly covered by my 
fiance and I still keep a night job, but we bought a house about 3 
weeks ago and this office issue is just something I didn't need right 
now.  When are you ready? Am I off to a decent start in that I have a 
patient base.



Please help

Thank you for your time!!


A:

Thanks for your e-mail and question. Remember .. being an IC is just 
like being a renter in an apartment complex. Problem is .. many DC's 
go into an IC situation without legal documents being signed or a 
lease with clear wording of everyone's responsibilities. We often 
hope that a fellow DC will be honorable but just as often find this 
isn't the case. 

I recommend you not get too negative over your present situation. 
Look upon it as an opportunity or at least a kick in your pants to get 
you off your ass and move on. Your confidence is increasing .. your 
ability to discuss the big picture to new patients and your previous 
negative experince along with your living through .. means you have 
staying power and each episode makes you grow stronger. 

So .. what to do???

If it was me .. I'd begin to look at new locations. Don't be too stuck in 
the city where you presently are .. if you were to move to another 
town .. even if you have to start over .. but found a decent place for a 
reasonable rental fee .. and most important began a strategic plan 
towards building a practice .. you may find this clear air with a new 
found determination to succeed. 

This is what I would do. If you find a location that is too expensive 
you will chock yourself before growth develops. If you can create a 
finance package for balloon rental payments .. paying more later 
giving some breathing room in the beginning .. it may be easier to get 
going.

As far as finances .. you need to budget your personal and 
professional life. If you can find a location that has enough room to 
grow and leave enough money for creative promotions .. cheaply but 
on going .. and find the time per day to dedicate the nuturing of a new 
practice .. you will succeed. When it is your place and all the funds 
are yours ..  the survival factors to succeed will make you work 
hardre and you will find the going easier. You can also invite 
someone to be your IC .. this time with the proper contracts and no 
hidden pending problems.

Ok .. maybe I didn't answer your question as you like .. or .. possibly I 
still don't understand what you wanted me to write .. but the 
common thread for all questions are the same .. what can I .. can I 
and will I .. answer this yourself then go and do it.

Have a Great Day

Dr. M