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Early Career IssuesFull Access

“So Now What?”

Published Online:https://doi.org/10.1176/pn.38.3.0019

David Lipsig, M.D.

So you have made it through your psychiatry residency and chosen to start a private practice.

Matthew Norman, M.D.

You felt that you were well liked and respected by the faculty and other residents in your program. You have a few patients who stayed with you from your residency, and the phone rings a few times in the first week or two. It wasn’t the “ringing off the hook,” however, that you hoped for, but you figure that the number of calls will increase.

You are now a month into your practice and have gotten some new patients. Then the phone stops ringing! You check your voicemail/answering service and cringe at the familiar voice at the other end saying, “You have no new messages.” You tell yourself that new patients don’t like to call on the week around a holiday weekend, Mondays, or Fridays.

Another week or two go by. You begin to check your messages obsessively. The perceived response is an almost mocking, “You have no new messages!”

Denial sets in. Perhaps new patients don’t like to call during the first two weeks of the month of August? Or maybe on cloudy days? You wait. The phone doesn’t ring. Now what do you do?

The first thing to do is to panic. Perhaps you are not as good a psychiatrist as you thought. You should probably rethink your profession and the rest of your life. Of course, this is a joke, and if you didn’t realize that, you should go on vacation. Now!

In all seriousness, however, the answer is don’t panic. You need to realize that primary care physicians, psychiatrists, and other possible referral sources are perhaps not aware of your new practice. This is a sign that you need to market your practice.

Wait a minute. Marketing is what all those other people in college studied while you were toiling away in organic chemistry. Since you probably never learned marketing techniques in college, medical school, or residency, the next question is how best to do this.

The most important marketing rule in terms of developing new referral sources is “face time.” First, don’t feel reluctant to let physicians with whom you have worked know that you have opened your practice. You need to stop staring at the phone and make a list of those resources. The list should include present and possible future referral sources. For example, you could stop by a group primary care office. When you go, look professional, shake a lot of hands, and give out your business cards. Emphasize that it is your policy to do everything you can to see new patients within 24 to 48 hours (after all, what else to you have to do at the moment—stare at the phone?). You need to be on the minds of the primary care physician, psychiatrist, or psychologist for you to defeat the mocking banter of “You have no new messages!”

Other ways to increase the amount of face time is to have periodic office receptions. Such receptions provide a reason to contact potential referral sources and give them an opportunity to see where you work. The more they are thinking of you and your practice, the greater chance that they will start referring patients to you.

Believe it or not, a short time later you will hear, “You have new messages.” Great! So your efforts were successful. You’re done. Time to go out and buy a new convertible roadster.

No. No. No!

An important lesson is not to rest once the phone starts ringing. Even though you are now busy, the phone may not continue to ring at that pace. Private practice ebbs and flows. Therefore, you should view the marketing of your practice as an ongoing process—in fact, a full-time job. There should be no or minimal days spent staring at the phone—those slow days can be used to meet and make new contacts. Get active by going to other receptions, giving presentations, and joining committees in your community. Try to think of other offices you can visit and whom to invite to your next reception (make it inclusive, not exclusive). When you do get referrals, you should thank each referral source individually.

Remember that building a private practice is like a marathon. You have to prepare adequately. You have to pace yourself. Most importantly, enjoy the race. When your practice is going well, you can look back and ask, “So now what?” ▪

Drs. Lipsig and Norman recently established a private group practice in Atlanta after completing their training in general and forensic psychiatry at Emory University.