Murphy’s Law (1) When Starting a Practice


“Murphy’s Law” is an old adage that is typically stated as: “Anything that can go wrong will go wrong”. When you start a new practice you’ll experience many examples of Murphy’s law. I’ve opened over 3,000 new practices. Just when I think I’ve heard them all, a new twist on Murphy’s Law comes along. Here are a few of my favorites. I offer them with the hope that they just might help you avoid getting “Murphied”.

Everything takes twice as long as you think it will – then double it.


ook at your projections … then double the length of time you’ll need to open your new practice. You’ll find that whenever you set out to do a task, something else must be done first. And if you think you don’t have time to do something right, you’ll always find time to do it over again. I’ve had many clients who tried to rush into practice. The day they arrived in town they put up their “open” sign. Unfortunately, the city noticed that they didn’t purchase their city and county licenses and closed them down. Then when they solved this problem they rushed into practice… forgetting to apply to and sign up with Medicare, HMOs & PPOs. Therefore they didn’t get paid. All that work and stress resulted in extremely little income and more stress. Trying to speed up the process doesn’t work. Unfortunately, you’ll find that out when you skip a step, it will take longer because every shortcut breeds new problems. This results in the saying, “A shortcut is the longest distance between two points”.

Don’t try to establish an opening date for your practice. You’ll never open on that date. Your opening date will occur when everything that needs to be done is completed…not until then. Remember, everything takes twice as long as you anticipate. And if you pressure yourself to open on a certain date, all you’ll accomplish is greatly increasing your stress…unnecessarily.

Nothing is as easy as it looks… nothing. EVER!

The best made plans usually go from bad to worse. Most of the time when you apply for a remodeling permit the city won’t approve it. When they do approve it they will usually change their mind. When you are ready to sign your office lease, the landlord will lease your office space to someone else. That’s Murphy’s Law.

When you cheat… you’ll get caught… KARMA

When a doctor tries to remodel his/her office without a permit, he/she will usuallly get caught. Too many times a doctor will try to save money by not paying for an architect to design his/her office to city specifications, not paying for building permits, etc. He/she is trying to outsmart the system. This doesn’t work. City codes are made to protect you and your patients. The city building inspectors and fire inspectors will notice construction going on at your office site and close your office. At this point the city will be furious at you and will make you tear out your drywall to make you re-do the electrical, plumbing, spacing of studs and fire protection. I’ve actually seen cities make doctors tear out all the walls and re-do the process (i.e.: architect, permits, inspections, etc.). Because the city is furious at the doctor for cheating, they will be twice as stringent on their codes and inspections… and take their time approving anything the doctor does. I’ve seen cities take 1 ½ years to approve the remodeling. Imagine the loss of income you’ll suffer by delaying your opening by 1 ½ years, e.g.: $250,000 – $400,000 all because you cheated. Cheaters get caught. Every shortcut breeds new problems.

Anything that can go wrong… will go wrong.

ifitcanitwillgowrongIf there is a possibility of several things going wrong, the one that will cause the most damage will be the first one to go wrong. And, if there is a worst time for something to go wrong, that’s when it will happen. It’s amazing how contractors, subcontractors and suppliers can screw up your plans (e.g.: they will have a $3,000 X-ray tube protecting a 10 cent fuse… the x-ray tube will blow first).

If your X-ray equipment is to be installed on a certain date, it will be late. If it is on time, the floor will be uneven. If it is delivered on time and the floor is even, they will forget the lead for the walls. If it arrives on time and the floor is even and they have the lead for the walls, then the electrician has installed the wrong wiring. Does it sound like I’m being cynical? I’m not. One of my clients purchased her used X-ray machine against my advice. She had it installed and then had a contractor build the walls around it. You guessed it. The machine didn’t work and it couldn’t be fixed or disassembled in order to be removed from the room. Therefore the doctor had to have her contractor tear out the door and the walls to remove the old unit, and then place a new X-ray in the room and then replace the walls. By trying to save a few thousand dollars on a used X-ray machine, it cost her over $20,000 for the contractor to tear out and reconstruct the room. And, she still had to purchase a new X-ray unit.

Lastly, all equipment you purchase will break down after the last payment or when the warranty expires… whichever comes first.

Everything will cost you twice as much as you think it will – then double it.

Trying to save money will usually cost you more money. You’ll find that the few pennies you save will not be worth very much… considering the money you’ll lose trying to save a few pennies.

Unfortunately, the temporary joy of a lower price will soon be replaced by the sorrow of poor quality. I’ve always instructed my Practice Starters® Program clients on the brands of equipment they should buy… or should not buy. Naturally some of my clients didn’t like my advice and bought equipment that was of inferior quality, or had a history of breaking down. I remember being berated by a doctor because I told him not to buy a certain brand of adjusting table… he bought three. After a few years, I asked him how his tables were working. He got red in the face and said all three of his tables had broken down… and the company had gone out of business.

Lastly, no matter how good of a deal you get on your equipment, it will be put on sale later. Count on it.

Did you encounter a different Murphy’s Law when starting your practice? If so, I’d like to hear about it. Send it my way at [email protected] . I’ll see that it gets published along with your name. For more information on starting a new practice go to

Dr. Peter G. Fernandez is the world’s leading authority on starting a practice. He has 30 years’ experience in starting new practices, has written four books and over 100 articles on the subject, and has consulted in the opening of over 3,000 new practices. Please contact Dr. Fernandez at 10733 57th Avenue North, Seminole, Florida, 33772; 1-800-882-4476; [email protected], or visit

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