I decided to start my own practice in March 2006 and officially opened the doors on July 31, 2006. As you can see, I accomplished a lot in a short period of time. I learned a lot about business while interviewing for an associate position and this helped when I started on my own. Of note, there are many similar factors to consider, whether you are starting your own practice or preparing for an associate position.

Starting your own practice is risky and if you decide to take this route, you need to be aware of the risks and be fully committed. It takes several years to build a patient population and you will likely be paying employees before paying yourself for a long time. On the flip side, you are your own boss. You make the decisions, whether good or bad, and in the long run the practice is yours.

So, how do you start your own practice? Below are some of the big steps you need take:

When you start a business, you take a big financial risks. In the event that your business has debt, you need to protect your personal assets from creditors. Therefore, you will likely form either a corporation or a limited liability company. Meet with your lawyer and accountant to determine which entity works best for you. If you are business savvy, you can file the Articles of Incorporation on your own and save some money on attorneys fees.

After discussing my situation with both my attorney and accountant, I decided to form an LLC. My business’s name is Jordan R. Stewart, DPM, LLC and the trade name or “Doing Business As” name is Timonium Foot and Ankle Center. Once incorporated, I acquired a federal tax identification number, a unique 9-digit number that identifies businesses. You will use this number on your professional applications and for business related transactions. Getting this number is simple and it can be done online on the IRS website.

Before setting up your business and getting ID numbers, it is best to have your business address. If you have not established an address, you can still incorporate your business, but in the future you will have to file change of address forms. These forms have associated fees so you may want to delay forming the business until you have your practice location. Remember, every dollar counts, especially in the beginning.

FROM:	Irvin O. Kanat. DPM Director of Podiatric Education Providence Hospital - Southfield, MI, and Genesys Regional Medical Center - Grand Blanc, MI
SUBJECT:	Signing of Residency Contracts following CRIP Interviews

January 5, 2007

Dear Editor,

In a December issue of PRESENT an article was published entitled "Is This the Right Deal?" by Jordan R. Stewart, DPM. The article dealt with the issue of new practitioners who face an opportunity to sign employment contracts, following the period of their resident training, and the concerns that new practitioners should be aware of in such situations.

The opening sentence in the article was misleading, and therefore inappropriate, particularly due to the particular audience to which PRESENT is directed, that being Residents, some Students and Residency Program Directors. The sentence is as follows - "Hopefully by now you have had success with your interviews and a contract has been offered." This gives rise to gross misinterpretation by the reader, particularly now since the annual Centralized Residency Interview Program (CRIP) weekends have just been completed. Although the sentence in question is directed to the period of time following completion of a residency, it may appear to some as though the author is condoning the signing of residency contracts following "success with your interviews." Hopefully, not the CRIP interviews.

For many years the profession has rebelled over the fact that some unethical residency programs have offered employment contracts to students prior to the established Uniform Notification Date, in their selfish efforts to circumvent the established residency matching program and help assure that they sign contracts with the individual resident(s) they may be seeking for their programs. The American Podiatric Medical Association (APMA), the Council on Podiatric Medical Education (CPME), the American Association of Colleges of Podiatric Medicine (AACPM), and the Council on Teaching Hospitals (COTH) have all joined together with efforts to prevent programs from such practices which use students as pawns in their efforts at assuring their selfish choices of resident.

The APMA adopted the following position as early as 1987- "RESOLVED, That the House of Delegates approve the proposed revision in Requirements for Approval of Residencies in Podiatric Medicine (CPME 320), pertaining to the uniform notification date." This Resolution had been submitted by the Council on Podiatric Medical Education.

The CPME adopted the following Standard - "The sponsoring institution shall participate in a national residency matching service. The sponsoring institution shall not obtain binding commitment from the prospective resident prior to the date established by the national resident matching service in which the institution participates."

The Central Application Service for Podiatric Residency (CASPR) Institutional Agreement states that Residency Selection Personnel "shall abide by the official schedule printed in the CASPR application materials…and adhere to the notification date established by the national resident matching service."

Every effort, in the interest of fairness and ethical conduct, must be extended to assure compliance with the residency selection process and the Uniform Reporting Date now in place, and any instance that may detract from that policy must be thwarted.

Thank you for the opportunity to bring this matter to your attention. I welcome responses from our community of interest on this important and timely matter, particularly since this years Uniform Notification Date, March 12, 2007, will soon be upon us.

Fraternally,

Irvin O. Kanat. DPM
Director of Podiatric Education
Providence Hospital - Southfield, MI, and
Genesys Regional Medical Center - Grand Blanc, MI

Editor's Response

Dr. Kanat,

The New Docs on the Block column in PRESENT is intended to share the experience of 2 podiatrists that have taken different career paths following residency. In my case, I started my own practice and Jarrod is working as an associate. Let me clarify that the statement you felt was misleading was referring only to the interview process following residency. That is for a job position independent of any type of residency program. I fully agree that the rules of the residency interview process should be followed so that the match works as designed. I appreciate your concern for the integrity of the match process and apologize for any confusion.

Jordan Stewart, DPM
[email protected]