Launching a second office: Is it time to branch out?

Opening a new practice location can be a great opportunity -- or a great drain. Here's how to ensure that you make the right decision.

By Larry Stevens, AMNews correspondent. May 28, 2007.

About 10 years ago, Carolina Ear Nose and Throat Associates found itself in what it believed to be a dangerous strategic position, one getting more perilous by the month.

The six-doctor group is based in Gastonia, N.C., a suburb of Charlotte. While most of its patients were from the Charlotte area, a growing number -- at least 200 a month -- were coming from neighboring Cleveland County. The county, which has grown to about 100,000 people, at the time had only one otolaryngologist: a solo doctor getting close to retirement.

Indirectly, this doctor's situation created a serious threat to Carolina Ear Nose and Throat, said Frederic Levy, MD, one of the physicians in the group. "We knew as soon as that doctor retired, and possibly before he retired, another ENT group was going to move in and fill the vacuum." Not only could another group take most of the patients who travel eastward from Cleveland County to Gastonia, but it also could make some inroads with the Carolina group's in-county patients who live near the county line.

So the group decided to protect its flank: It opened a second office in Shelby, a city in Cleveland County. Initially, group members were planning a small satellite office staffed a few days a week. But they quickly discovered that referrers there did not take kindly to people they considered interlopers.

So the group hired a new doctor who would live in Cleveland County and made its two offices co-equals instead of primary and satellite. "We had to give the [Cleveland County] hospital and referrers a comfort level with us by demonstrating that we were really committed to practicing there," Dr. Levy says.