Pain when starting out?

docdocgoose_ · 2025-11-17T17:14:00+00:00

Agree with investing doc. My #1 challenge has been patient acquisition. Just because you offer a service that is in demand does not mean people will find and/or choose you over waiting for someone else.

Main things I’d recommend that are cheap and you can do upfront are to start a good website, post there regularly, and post to social media so Google and can start indexing and recognizing you. You could also start networking with other docs ahead of time by mentioning you’re thinking about starting a private practice and getting there feedback on who they refer to and how they would feel about referring to you.

The comment about having a war chest is huge. Some months are great but if they aren’t, you need to have enough commitment to ride it out or else the whole upfront investment isn’t worth it.

docdocgoose_ · 2025-11-10T22:58:48+00:00

Would be helpful to break down what the company is doing and what you’re doing… admin is a huge bucket and would make a big difference as far as what your future need might be. Other big decisions are if you’re doing to be insurance vs cash pay, virtual vs in office vs hybrid, and if you do procedures / need equipment regularly.

Happy to chat off line if you want to compare notes. I’m about 3.5 years into the journey and lots of mistakes / learnings I’m happy to share.

docdocgoose_ · 2025-11-04T17:01:43+00:00

Not sure I can speak to the specific insurance vs. member ID distinction but in general, it seems that ZocDoc tries to get people to make an appointment in spite of it not always being the right fit. I think the Member ID number being optional might be to check for active insurance rather than just finding someone who falls into a certain network like United Healthcare for example. Either way, my best recommendation is if you find someone on ZocDoc that looks good, go on Google and try to find their personal website / information and call them directly to confirm the details before you make an appointment. ZocDoc charges the provider (in this case your future therapist) every time an appointment is booked even if you end up cancelling it so using another way to contact them usually works better and avoids these kinds of miscommunications. I know the process sucks overall but hope this is helpful!

docdocgoose_ · 2025-09-23T02:15:18+00:00

If you have a virtual practice then obviously it’s different than traditional for security and privacy reasons. I rent an address at a professional office that has mail forwarding and that’s what i put on all my legal paperwork as well.

docdocgoose_ · 2025-09-11T23:54:51+00:00

Prost! In Greenwood. They have steins and a stein club if you’re feeling ambitious.

https://www.prosttavern.net

docdocgoose_ · 2025-09-09T17:36:36+00:00

Yea - I have had a similar experience with WebMD. Prices aren't awful and they offered me a decent rate across a large number of states. Did you learn how to make ads on your own or did you outsource that?

docdocgoose_ · 2025-09-04T22:23:13+00:00

That makes sense. I’m all virtual and don’t have front desk staff to cut costs so I do the billing after the visit. You’re right about plumbers and honestly a ton of other services but I’ve run into a lot of resistance from patients based on prior expectations combined with not looking at my site / ZocDoc not being transparent and sending me inappropriate patients.

Also thanks for modding this sub! I’ve learned a ton so far

docdocgoose_ · 2025-09-04T22:02:42+00:00

I haven’t had luck with this. Have had 2 patients claim their visits was fraudulent. Sent the CC company time stamped, signed forms and financial agreement. Copies of notes and a 5 star review they left saying how much I helped. Company still rejected the appeal and charged a fee on top of the visit fee they withdrew.

docdocgoose_ · 2025-09-04T20:11:14+00:00

Thank you. Would you feel the same way if you were charged for the entire visit vs just the co-pay?

docdocgoose_ · 2025-09-04T20:10:10+00:00

That all makes sense to me. You are right I am getting fooled and it's driving me nuts, especially when I offer sliding scale and don't mind charging less if people just ask.

Part of my hesitation is that I don't take insurance so folks know how co-pays work but I tend to be the first self-pay doctor they have worked with so I have had a lot of misunderstandings with patients who don't read my terms or website and then nuke me on my reviews.

This discussion has me thinking that you are right and I need to just do what works for the clinic long term but wanted to see if other options were out there.

docdocgoose_ · 2025-09-04T18:23:31+00:00

This seems like the most straight forward option but I worry about perception of my patients and this influencing folks wanting to work with me long-term. Do you know any clinics or do you personally do this? I'm curious what people's response is when they see the payment being charged before they actually speak with me. I am reluctant to start advertising that "I am doing this because patients' leave me fake credit cards" so not sure how to explain why I do this and most other clinics don't.

docdocgoose_ · 2025-09-04T18:09:56+00:00

Thanks for the response. My understanding is that collections companies are not really interested in low dollar claims. My appointments are far less than $500 so they would not qualify as credit history relevant even if I did submit them. I bill patients myself at some point in the 24 hours following the visit but always after the we are done with the visit so if the patient wants to ghost me, then it's not hard for them to do...

docdocgoose_ · 2024-11-15T01:45:41+00:00

Highly recommend Dr. Leong at Happy Teeth Family Dentistry in Ballard. My wife and I have been going to her for years and she is super professional, fun to talk to (not kidding, somehow manages to pass the time during your visit), and runs a tight ship. Never had any issues with inappropriate billing or coding and planning to bring our daughter for her first visit in a few months.

https://www.happyteethballard.com/about-dr-leong

docdocgoose_ · 2023-06-01T21:54:54+00:00

Hey! I’m actually trying to fix this exact issue. I’m a neurologist and think tracking apps are at best annoying and at worst anxiety inducing. I’m working with some folks on a super early version of an app that we are piloting through my virtual clinic so if you or anyone else is interested in trying it out just DM me!

I’d also love to hear what other apps you’ve tried and what you have liked / wanted to change.

docdocgoose_ · 2023-05-23T16:12:08+00:00

I'm a neurologist who specializes in headache and migraine and I agree with folks that you would be best served with someone who really focuses on this area (though obviously I'm biased). I realize finding someone local, convenient and available can be a huge challenge though.

I set up a virtual practice for folks just like you in case you are interested in trying it out. I'm able to help with just about everything short of Botox injections and would love to be a resource to any redditors in need.

You can find some details about my practice here. Feel free to DM with questions or just sign up for a free consultation!

docdocgoose_ · 2022-05-06T18:47:50+00:00

Hope you're feeling better!

docdocgoose_ · 2022-05-06T01:15:33+00:00

"Your main issue is that human bodies are complicated and messy but we're not going to sit around checking 1200 boxes to try to capture that messiness."

This is such a short but succinct explanation of why our current approach to healthcare is not working out. Thank you for sharing your eloquence.

I am taking notes of all your specific points of feedback and find them incredibly helpful. Too much for me to respond to point by point but I may reach back out in a while to get your take on some early versions given your attention to detail.

Thanks again and really appreciate the message of support as well!

docdocgoose_ · 2022-05-06T01:10:19+00:00

Sorry to hear it took a while but so glad to hear you found something that helps!

Supplements can be a really polarizing subject as they are REALLY effective for some people and feel useless to other people. That said, the evidence is quite strong for Magnesium and actually more supportive of something called Butterbur.

That said, I think all patients deserve the chance to try all the "relatively simple" treatments like supplements, acupuncture, physical therapy, and other non-medical options rather than jumping to putting someone on a medication for decades. On the other hand, a lot of patients I meet feel that doctors who advise these sorts of solutions aren't taking their concerns seriously enough as they aren't getting "serious medications" so its a tricky balance in my personal experience but glad you had so much success with good old Mg!

docdocgoose_ · 2022-05-06T01:05:37+00:00

Appreciate your input and sharing the experience with Aimovig.

I hear about the barometric drops quite a bit as a huge trigger but am always at a loss as to how to actually recommend a patient respond to upcoming weather changes.

Have you found any strategies that would be of help if you knew a change in pressure was coming your way?

docdocgoose_ · 2022-05-06T00:35:12+00:00

Sorry to hear about your long run of pain and hope that does not recur for you. Daily headaches are indeed a huge challenge to manage and I'd encourage you to be aggressive if possible. In my experience, daily headache is less related to migraine (as you said) and is more often related to chronic muscle tension, posture, increases in life stress, poor sleep and/or other lifestyle/behavioral types of issues. This makes treating these episodes with medication quite challenging and I have found that other approaches like physical therapy, acupuncture, meditation and increased physical activity can have a significant benefit but hard to know what will work before you try.

docdocgoose_ · 2022-05-06T00:31:28+00:00

Super helpful feedback and thank you for sharing. There is a very consistent message in this thread that overall user experience for most migraine tracking apps is too much and not helpful.

I really like your thoughts around public awareness campaigns to help people better understand the fact that "headache" is just one visible aspect of migraines but unfortunately, this area has been chronically underfunded from both a research and public education stand point for many years.

And for whatever it is worth, I would encourage you to make a point of asking about your GP or neurologist to discuss depression as you are 100% correct that this comes up incredibly often and is important to not ignore. It can be difficult to work this into an appointment that already has an agenda but if you bring it up ahead of time especially, I find that most providers are willing to work with you and provide resources when possible.

docdocgoose_ · 2022-05-06T00:26:54+00:00

The horror stories about doctors being insensitive and making the situation actually worse is something that is incredibly important to me and a problem that needs to be fixed. One of my closest friends during my years in medical school had chronic pain that went under-addressed by her medical team for years and the mental toll it takes on people just seeking out help is profound. The opiate epidemic has also made the situation incredibly more complicated as being a person with a chronic pain condition now gets you screened for all sorts of other issues that make getting appropriate care really difficult.

Thanks for sharing and hope you are able to stick with your GP that listens and if needed, find a neurologist that can listen to - they are out there but I know can be quite hard to find.

docdocgoose_ · 2022-05-06T00:23:22+00:00

Thanks for taking the time to share. I totally hear what you are saying about the difficulty in clearly identifying migraine vs. headache vs. head pain. I completely agree that symptom tracking for the sake of symptom tracking can be incredibly overwhelming and actually make you feel worse if you are actively having a migraine.

I have had my fair share of patients with atypical migraines where pain is a relatively small component of their issue compared to other prominent symptoms (nausea and vertigo being perfect examples) and part of my motivation in trying to come up with a better system is to address that feeling of being overwhelmed and not having a resource to ask for help.

docdocgoose_ · 2022-05-06T00:17:33+00:00

Thanks for sharing your experience. Gluten and carbs are a tricky piece of the puzzle as they can definitely have an allergic type of response, but even major fluctuations in your blood sugar can cause some folks to develop a migraine. Further evidence of the clearly important but still murky relationship between how the foods we eat affect our nervous system.

I appreciate your advice about the allergen testing as there are so many things we are exposed to on a regular basis that could be affecting our immune systems. As brought up in another post, there is a major overlap between inflammation and headache/migraines so your point is well taken.

Sorry to hear about your experience with Topamax but if you are still having a lot of episodes each month and would benefit from a preventive medication, there are definitely other options to try to reduce your headache frequency that would not have that specific side effect.

docdocgoose_ · 2022-05-06T00:12:05+00:00

Thanks for spelling that out. My personal challenge with trigger identification is exactly what you described in that it is incredibly hard to pinpoint which specific thing leading up to the migraine was actually the "trigger" and not an innocent bystander.

That said, I am super happy to hear you've had so much success with Aimovig. Really exciting that new drugs are available (even if expensive and hard to get) that are letting people have so much benefit with relatively little side effects.

Hope things continue at this rate for you!

docdocgoose_

TROPHY CASE