Tips on Starting a Successful Otolaryngology Practice

Defining scope of service is another challenge to starting a practice. Michael Setzen, MD, who opened his own private practice in Long Island, N.Y., in 2008 after 26 years in an academic setting, said otolaryngologists looking to set up shop first need to determine whether they will be fully aligned with an academic institution, independent, or part of a hybrid approach that affiliates a practice with an academic entity but is not formally dependent on the school.

Dr. Setzen, chief of the rhinology section at North Shore University Hospital in Manhasset, N.Y., said that alignment with a school involves specific details that require attention. “You do need to think about publishing, presenting,” he said. “Try to make an impact even though you are a private practitioner.”

Once the type of practice is determined, the next major decision is determining what services will be offered. Brinson said that understanding the market is key to making that choice. A geographic area saturated with audiologists or speech pathologists may mean that offering those services up front is an unnecessary cost. If those services aren’t easily available to a nascent practice’s potential patient base, then adding them might be a revenue driver.

Dr. Setzen said that when he opened his practice, equipment was a top concern. He decided that video, photo, and recording equipment would differentiate him from other otolaryngologists in his area. “I felt it was important to be able to show my patient, ‘This is what your deviated septum is and looks like,’” Dr. Setzen said. “Many patients would say, ‘Hey, doc, everybody has a deviated septum.’ And I could say, ‘Yes, but this is what you have. Do you see how deviated your septum is?’ A picture is worth a thousand words.”

Pictures aren’t cheap, though. Dr. Setzen’s video equipment cost roughly $75,000. He bought it on a five-year lease, a plan he suggests might be worthwhile to others looking to take advantage of expensive equipment without having to pay for it all up front. Other expensive equipment he leased that way included a computed tomography (CT) scanner. He noted that spending that money is a choice each otolaryngologist has to make.

Staffing Concerns

Another major challenge for any practice is staffing. Is an on-staff audiologist necessary? Should a speech pathologist be on site? What about a swallowing expert? Allergist? Dr. Merati believes that there is value in “lowering the barrier to access, letting the patients get to you as the expert, and then you can offer the services.”