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Solo practitioners like Douglas Stevens are becoming a rarity in medicine.
Stevens says he's just one of two ear-nose-throat specialists in Fort Myers who isn't part of a larger group of doctors or a hospital. But the story of how he stays in business as a sole practitioner shows that entrepreneurial doctors can remain independent and even thrive in business if they're willing to make adjustments and devote time to promoting their business.
As his business grew, Stevens diversified into plastic surgery, a more profitable practice that allows him to continue to see ear-nose-throat patients without feeling rushed or pressured by falling insurance reimbursement rates.
Most people pay cash for plastic surgery, usually an elective procedure to make them look younger. Insurance companies and Medicare won't pay for most plastic surgery, which can cost from about $7,800 to $11,000. By comparison, Stevens charges between $81 and $266 for a patient visit for an ear-nose-throat visit.
As his ear-nose-throat practice grew after he acquired it in 1997, Stevens says he would see as many as 300 patients a week and had a staff of 10 people to manage the workflow. After work at 6 p.m., Stevens would go home and dictate patient cases until 11 p.m.
So Stevens started doing more plastic surgery until it became 90% of his business by 2005. Now, Stevens sees 80 patients a week with a staff of three people. “That's a big difference,” he says.
Stevens says his own daily life is more manageable now, too. “If you don't make a life for yourself, it gets counterproductive,” he says.
Because he was a solo practitioner, Stevens was among the first doctors to adopt electronic medical records for his office about 10 years ago. While the system cost $80,000 and one nurse quit because she couldn't adapt, Stevens says it helped streamline his business.
Of course, the recession hurt plastic surgeons and Stevens says cosmetic surgery is now 75% of his business. But he has adapted by shifting procedures to his office, which is more affordable than using an outpatient center or even a hospital.
And, unlike many doctors, Stevens spends time marketing his business writing blogs and scheduling marketing meetings twice a week with staff and consultants at Pushing the Envelope in Fort Myers. For example, he trademarked a facelift procedure he calls Active Lift, a procedure he performs in the office.
While the operating procedure isn't new, Active Lift is Stevens' own way of providing pre- and post-operative care, including the schedule of consultations and non-allergenic products he gives to patients. Doing the procedure in Stevens' office saves the patient about $3,000 on the operating room and anesthesia.
Stevens says he started doing the Active Lift procedure in the office in 2005 because that's what patients preferred. “It wasn't something I did for the recession,” he says. But the timing proved to be good because he says several plastic surgeons left the area as business shrank from lower spending.
Stevens brainstormed the name with his staff, encouraging them to help with the marketing. The front-desk receptionist, Amy Miller, came up with the name Active Lift. “When you spend a lot of money marketing something, you want to trademark it,” he says.
But when Stevens asked attorneys in the area how much it would cost to trademark Active Lift, they told him to expect to pay $5,000 for a state trademark. A national trademark would cost more, they told him.
So one of his office staff researched on the Internet and used LegalZoom.com to trademark the name nationally. Of course, the U.S. Patent and Trademark Office took its time. Stevens received the trademark on Active Lift on May 10, 2011. “It cost all of $500,” Stevens chuckles.
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