In today’s show, Chris Cox Au.D., and Riley Bass Au.D., transition from being a student to provider and detail your options for starting your own business as a professional Au.D.
Did you miss our series on Transitioning from Student to Provider? Catch up on what you missed by visiting our special series page.
Listen to the Episode Below
Read the transcript:
CHRIS COX: [SHOUTING] Who wants to be a millionaire?
RILEY BASS: And by that I mean, who wants to own your own practice?
CHRIS COX: Oh.
RILEY BASS: Oh. Do you want to own your own practice?
CHRIS COX: I do. I want to own my own practice.
RILEY BASS: I think it’s definitely a good opportunity to be autonomous in your career.
CHRIS COX: So you’re saying that if I own my own practice, I can be a millionaire?
RILEY BASS: You definitely can. There’s lots of opportunity out there. And we work with practices that range from one audiologist and one front office person in a small location to practices that have 23 locations in four states and over 100 audiologists working with them.
CHRIS COX: [WHISTLES]
RILEY BASS: Pretty impressive. Almost as impressive as that whistle, actually. I’m kind of impressed that you just did that.
CHRIS COX: Oh, thank you.
RILEY BASS: [LAUGHS]
What we’re trying to say is that the sky’s the limit when you own your own practice and nobody can dictate and tell you what the limit is and what you have to stop at. You can continue growing and continue building until you’re satisfied. Some people are never satisfied.
CHRIS COX: The cool part about it is if you like to build things, if you like to have things on your own terms, it’s one of the best places to do that. And we’ve talked about private practice a little bit in the past. But today we wanted to talk to you about how to actually get into being an owner of your own practice and the different pathways to that.
RILEY BASS: The first way is what most people would associate as the way that you start your own practice, the organic way. And we don’t mean granola and–
CHRIS COX: Mmm, no pesticides?
RILEY BASS: No pesticides.
CHRIS COX: Is it gluten free too?
RILEY BASS: Yes, it is. Actually, it’s the gluten free audiology practice. You go out and you find a storefront that you say, this looks like a good place. And you rent it and you get some furniture in there and then you go out and build a patient database.
CHRIS COX: Whole Foods and hearing aids.
RILEY BASS: That’s right. Number two, partnering with somebody. Finding someone else that’s interested in opening a practice– or maybe one that already does– and joining forces with them to take over the world together.
CHRIS COX: Hmm. Like Pinky and the Brain?
RILEY BASS: Yes. Number three, retirement or an exit strategy. There’s a lot of audiologists out there that are looking to retire in the next five or 10 years. And they want somebody to continue on their legacy that they built over the last 20, 30, 40 years. So they’re looking to find a bright young talent to take over their practice.
CHRIS COX: Let’s look into these a little bit more. Let’s look at number one. This is the one that most people think about whenever they’re thinking about building their own business or starting their own business. And that’s the organic way.
Starting with that first brick, looking for the location yourself, and then hiring on that front office person. You may not even be able to do that at the very beginning. But looking at sound booths, looking at all the equipment that goes into it. That’s not to mention setting up your business type, whether it’s an S Corp or an LLC or whatever it is.
So there’s a lot that goes into it. But if you’re a builder type, you may like doing that. You may like just getting everything customized just as you wanted, just as you see it, and starting your business off in that manner.
RILEY BASS: And a lot of people do like that, and they like that aspect of building. But I have the opportunity to talk to students almost every day, and one of the things I always hear is, I’m scared. I don’t even know where to start. I have no idea how I go about starting a practice. It can be a little bit scary and it can be a little bit intimidating.
CHRIS COX: Sure can. And it’s not like opening up a lemonade stand, like back whenever you were a kid and you’re selling lemonade to–
RILEY BASS: Right.
CHRIS COX: Kids on the street.
RILEY BASS: You don’t usually have to take out a bank loan to have a lemonade stand.
CHRIS COX: No. With the lemonade stand that I had when I was a kid, we also sold gum and other candy. So we kind of diversified a little bit. I ended up eating most of the candy though.
RILEY BASS: I’m not surprised. [LAUGHS]
CHRIS COX: [LAUGHS]
RILEY BASS: It was a failed business venture?
CHRIS COX: Yep. But it was a fun time hanging out on the street with my friend.
So when we talk about getting your own business started, there’s a lot of aspects to it. And it can be a little bit scary. But it can also be very rewarding once you get that business off the ground and you know you’ve done it on your own, under your own rules and with your own vision in sight.
And the thing with that– and one of the cons probably– is the amount of start up costs or capital that you’re going to need to get going with that. And some of us may have a rich uncle somewhere. Some of us may have pretty good credit and be able to get a nice loan from the bank. But it does take a little bit of start up costs on that.
And depending on where you are and what the location is and so forth, you may be looking at quite a bit. There’s definitely ways to be able to get some of that capital, getting some investors or whatever it is to get you going. So it’s absolutely doable. And people do it all the time, and it’s not impossible.
RILEY BASS: Right.
CHRIS COX: You just have to know what you’re getting into.
RILEY BASS: If people didn’t start those practices, there wouldn’t be any of them out there now. So it is definitely possible. It’s a challenge, but it’s something that you can step back from when all’s said and done and say, wow, I did this. And I started this from scratch, and this is my baby.
CHRIS COX: Yeah, very satisfying. Very satisfying. The next one we can talk about is partnership.
RILEY BASS: Maybe you like the idea of owning a practice, but you feel like you would be a little bit better off with a comrade, somebody to work alongside you.
CHRIS COX: This one is probably one that some people have thought of, but may not be thought right off the bat whenever you think of, I’m starting my own practice. But getting in with a partnership with somebody– either someone who both of you are going to build it together or you get in a partnership with somebody who’s already established– that’s another common way of doing it.
It could be somebody who has been established for some time. You come in as say, an extern or a new graduate, and you guys just hit it off. And you have the same direction and vision and your goals for life, and you decide that hey, you know what? After a couple years and you proving yourself, that they can make you a partner.
And that can look like many different things. It’s not that you both get a corner office or you both get the cool parking spot at the front of the parking lot. What that can look like is really part of expansion. So if you’re looking to grow the business and you can take one location and that other person can take the other location and you work together, everything is under one roof, but–
RILEY BASS: But separate roofs.
CHRIS COX: But separate roofs. Two different roofs.
RILEY BASS: A metaphorical roof over both practices, but separate locations.
CHRIS COX: Mm hmm. And you can continue to grow that way. And it’s a little bit lower cost initially for you. And maybe a little bit lower risk seemingly at first. But when you look at it from the long term perspective, it can be very, very satisfying as well.
RILEY BASS: Right. It can have a huge return. And you have that advantage of having somebody else to hold you accountable and for you to hold accountable to make sure that you guys are both really putting what you need to into the practice and making sure that it’s growing and you’re moving in the right direction.
CHRIS COX: For sure. But there is one thing to say about that is this is a business partnership, and I’ve heard it said that you’re basically getting married to this person. So make sure that before you go down this road that they’re the person that you’re going to be willing to spend–
RILEY BASS: That you want to spend your life with?
CHRIS COX: Spend your life with. Basically you’re building something together. It is a business relationship and it’s huge. And if you have any doubts in your mind about getting into business with that person, it’s probably best to move on or do something on your own than to get in that relationship.
But you can be really successful with it. And if you do it with somebody that you know you can depend on, it can be amazing.
RILEY BASS: One of the things we’re seeing a lot of right now is our third category, which is that exit strategy. As young graduating audiologists, you guys are really at an advantageous position because there’s more audiologists retiring than there are graduating every year. And a lot of these people that own these practices that they’ve had since the ’70s are looking at saying, I’m ready to go and travel the country in my RR and hang out my grandkids and do these things.
CHRIS COX: Wait, hold on. The ’70s? You mean they opened their practice when–
RILEY BASS: The ’70s.
CHRIS COX: Disco was in?
RILEY BASS: Yes. It was a disco and audiology clinic. All the booths had disco balls in them.[DISCO MUSIC PLAYING]
CHRIS COX: That’s cool.
RILEY BASS: And the audiologists wore bell bottoms.
CHRIS COX: Why did we move away from that? That sounds amazing.
RILEY BASS: And I’m sure the ruffly sleeves sometimes got caught on the knobs of the audiometer. [LAUGHS]
CHRIS COX: [LAUGHS] They had vacuum tubes in the audiometers back then, right?
RILEY BASS: That’s true, yeah. And I remember when I was in my acoustics class, he was talking about the piezoelectric style hearing aids, and they used the crystals in them. And he showed the clip from Napoleon Dynamite where he puts the crystals in the time machine. So that’s what I just imagine ’50s, ’60s, ’70s hearing aids was the time machine in Napoleon Dynamite. [LAUGHS]
CHRIS COX: [LAUGHS] Yes. I’m sure if there’s anybody that was around back then that is listening to this right now, they’re probably really mad at you for making fun of their time machine.
RILEY BASS: From Napoleon Dynamite’s time machine? [LAUGHS]
CHRIS COX: [LAUGHS]
RILEY BASS: We digress.
CHRIS COX: We digress. But you’re right. Some of these people– some of these people– some of these audiologists have been around for a really long time and they’re ready to retire. And they want to be able to leave their legacy, that business that they’ve built over the last 20, 30 years to someone who’s going to take care of it just as well as they are so they know that their legacy lives on.
RILEY BASS: Right. When we were talking about the organic start ups and that moment where you can step back and look at your practice from the outside and say, wow, I did all of this, that’s where they are. And they don’t want to see that go by the wayside. And they don’t want to see that practice fall apart as they retire. They want somebody that’s going to love it as much as they did to take over.
CHRIS COX: Only about 20% to 25% of us really think about private practice as a viable career option. And once we get out into practice, it maybe goes up to about 25% to 30% are actually in private practice. And actually, we need more. We need more than that.
RILEY BASS: The demand for audiologists is rising every year. And there’s not been an incredible amount of growth in audiology as far as new graduates every year. So the demand is there and the patients are there, and they’re waiting for you guys to treat them and to help change their life.
CHRIS COX: And the best way to do that and the most autonomous way we can do that is going into private practice. And we’ve talked about this a couple times before and I’m very passionate about it. But private practice is really the place where we as audiologists who have been fighting for autonomy and for that right to see patients on our own terms, this is really where this happens is in private practice.
Not saying that you can’t any other place. But this is really the place where you can see it the most.
And so whether you go into it from the organic or into a partnership or into that exit strategy or someone who’s taking over for someone retiring, either one of those is great. ‘Cause we need more of you. We need more people out there in the private practice world. When you look at that hand off from someone who’s about to retire to someone who’s just new in the field, in the profession, how does that happen?
RILEY BASS: That’s a great question. We have a lot of examples of this. But one that’s pretty easy to relate to is one of our practice owners that we work with out in Ohio, he was getting ready to retire in a couple years and said, I really want to hand this practice off. He hired a young lady to come in and she worked with him. She had expressed interest in I want to own a practice someday. I want to make something my legacy as well.
They worked out a sweat equity agreement where she would work for him for a certain amount of time and then was given that portion of the practice with the buyout option. And after those couple of years when she fulfilled her requirement, she was able to purchase that practice outright. And before she was 30 years old, she owned that practice.
CHRIS COX: And now she’s able to take the baton from the person that was there before and carry that forward into her own practice and doing what she feels is best for her patients. And it’s hard work. And I’ve talked to her after that and it’s hard work. She said that there’s a lot of long days and there is a challenge there.
But at the end of the day, it is about it being hers and it is about her being able to make those decisions as she sees fit. And she’s overall very happy with the position that she’s put herself in at this point. Because she owns a practice and she’s getting started here a lot earlier than some of the rest of us are able to.
You do have to think of one thing. Well, you do have to think of a couple things when you’re looking at this option. It can take a little bit longer to actually acquire that practice, depending on what you’ve set up and what you’ve negotiated with that owner. So it could take a little longer.
It could be something that’s not even guaranteed. You may be working for four or five years and at the end of it, that person can change their mind. And all the sudden, they’re going to sell it off to somebody else.
And so it’s not necessarily guaranteed every single time. But that’s really about you and setting up the relationship with that owner and knowing that you’re both in it together and this is where you want to go with it. So there’s good and bad to each one of these things.
RILEY BASS: Right. One of the definite pros over that organic start up and taking into or coming into a practice that’s already existing, is the patients are already there.
CHRIS COX: That’s true.
RILEY BASS: You may come into a practice that’s been there for 20, 30 years and they’ve got 7,000 or 8,000 patients that they’ve seen over the years that are already existing patients that are going to be returning to you for services. Whereas if you’re starting a practice from ground zero, you have to go out and get those patients and you have to really build that brand and build your practice up from scratch literally. Which some people absolutely love doing that, and some people say I would rather focus more on that patient care and actually seeing those patients than going out and doing consumer education seminars and going to health fairs and things like that.
So it’s really personal preference. It’s your personality, what you most feel comfortable doing and what you like to do the most.
CHRIS COX: That’s a big one, having that database.
RILEY BASS: The good news is you have the autonomy to make that decision, because nobody’s telling you what you have to do or what you need to do at that time.
CHRIS COX: So what should we be thinking then? If say I’m a student or a new graduate looking to go into private practice, where should I really start?
Should I start with my own organic practice? Should I go ahead and try to find somebody who’s trying to retire? Do I just get in a partnership with somebody? Do I just work somewhere else before I go into it? What do you think?
RILEY BASS: I think you have to go back and look at a few different things that we’ve talked about over the last several podcasts. Who do you know? What are your options? Do you know somebody that’s looking to retire in a few years? Do you feel confident to take over a practice that somebody else has done?
CHRIS COX: Well, hold on. So you just go knocking on doors and asking hey, [KNOCKING] are you going to be retiring any time soon?
RILEY BASS: No, of course not. But the more people that you know and the more people that you’ve met in the industry, you might hear from a friend of a friend or something that says I heard that this audiologist in this town that you really want to live in is getting ready to retire. They’re looking to sell their practice, or they’re looking for a partner or something like that. The more people you know, the more you’re going to find out about what’s going on with your peers.
CHRIS COX: So networking, is that what you’re saying?
RILEY BASS: Weird. Isn’t that crazy that we just talked about that a few weeks ago and here we are circling back around?
CHRIS COX: It’s like it’s all connected somehow.
RILEY BASS: It’s weird. It’s like a spider web.
CHRIS COX: [LAUGHS] The other thing really goes back to those goals. We’ve talked about that as well.
What are your goals? Where you want to go? Where do you want to be in 10, 15, 20 years? What do you want to look back on when you look at your career as an audiologist? Where do you want to be? And that is probably going to be the one of the number one things that’s going to drive the decisions that you make.
So if we look at the organic practice, we’ve talked about the good and the bad with that. To be able to build your own practice and your own business is going to take a lot of hard work, as we’ve talked about. Does that align with where you wanted to be and what you wanted to do from a goals standpoint?
Or is going to be easier to do the retirement or exit strategy succession where you get to go in and take over for somebody who’s about to retire? So it all really comes back to what you’re setting yourself up for, what you see as your future.
Of course, there is way more information under each one of these categories, and probably another couple models out there that we haven’t even talked about. There are whole degrees on building businesses and starting your own business. So there’s no way we could get into everything here. But we wanted to touch on a little bit of each one of these three major models of acquiring a practice or becoming an owner of a business.
RILEY BASS: Right. These are definitely questions that we are being asked frequently. And all of our topics for these podcasts are questions that were asked by students like you. So we want to give you, from an audiologist’s perspective, what we know about getting into that private practice ownership and how to do it.
There are many different routes you can take. Not every single route is right for every single person. But there is a good option out there for every person.
CHRIS COX: So with that, we’re going to go get some lemonade now.
RILEY BASS: Sounds great. I’m going to head down to Chris’s lemonade stand and get a tasty lemonade drink on this warm afternoon.
CHRIS COX: There’s no candy left though. I already ate it.
RILEY BASS: But he already ate all the candy. So I guess no candy for me. As always, my name is Riley Bass.
CHRIS COX: And I am Chris Cox.
RILEY BASS: Thank you so much for listening to the podcast. Make sure you like us on iTunes, subscribe, leave us some feedback. If you would like to tweet at us, please feel free to @rileyb659.
CHRIS COX: And @coxchriscox.
RILEY BASS: And we will talk to you next week. Thanks, guys.