I’ll be honest: I built my allergy practice by stumbling first. 

I overpaid hospitals, underpriced visits, and clung to old protocols long after the data moved on. 

Here is the short version so you can skip the bruises—what I did wrong, what I do now, and the simple steps to copy this week.

1. I Underestimated How Successful I Could Be

When I started in Great Bend, Kansas, I thought I needed the “security” of being tied to a hospital system. 

I didn’t think I could run a practice on my own. That fear cost me 15–20% of my income every year in hospital administrative cuts.

If I had believed in myself sooner, I would have gone independent earlier, kept more revenue, and had full control over my schedule and care decisions.

If you’re fresh out of med school, don’t assume you need to be employed. 

Look seriously at private practice from day one. If you go independent, you keep control and more of your money. 

Run the numbers. You may be far more capable than you think.

2. I Ignored the Business Side for Too Long

Medical school trains you to diagnose and treat disease, not to run a business. 

Early on, I didn’t understand payroll, cash flow, real estate, or even how to negotiate contracts. I learned everything the hard way (which was expensive).

The biggest miss? I undercharged for my services and let insurance dictate my value. I also sold a clinic building I wish I’d kept because real estate rarely makes you say, “I wish I sold sooner.”

From the start, you need to learn the business side. 

Hire a practice management group if you need to. Keep a close eye on your numbers. 

And if you buy real estate for your clinic, think twice before selling.

3. I Didn’t Stay Current Enough in the Beginning

When I finished my training, I practiced medicine exactly like I’d been taught because I thought that’s what “good” doctors did. 

But my mentor taught me to think outside the box. He challenged standard asthma care, introducing oral steroids immediately instead of hours later. It was controversial 30 years ago; now it’s the standard of care.

No matter your speciality, never stop learning. 

Read journals. Attend conferences. Ask researchers why they did what they did. 

The best doctors evolve constantly. The worst stay stuck in the year they finish school.

Medicine changes fast. If you fall behind, you’ll be treating patients with yesterday’s best guesses.

4. I Didn’t Use My Whole-Body Approach Soon Enough

Early in my career, I treated asthma like it was separate from hay fever or eczema. 

Over time, I realized it’s all connected: respiratory inflammation drives multiple allergic conditions. If you treat one aggressively, you improve the others.

For asthma and allergy specifically, think systemically. 

Test IgE and eosinophil counts to see the bigger picture. Focus on treatments—like biologics—that reduce overall inflammation and simplify patient care. 

One biologic often replaces five different medications.

5. I Avoided Risk When I Should Have Leaned In

Risk scared me at first.

Buying a practice, trying new treatment protocols, and making bold clinical calls, all have weighty pros and cons. But every big leap I eventually took paid off, from rapid immunotherapy protocols to business decisions.

Take calculated risks. 

Buying an existing practice gives you a patient base overnight. Innovating in patient care can set you apart. 

Yes, risk is uncomfortable, but comfort rarely leads to breakthroughs.

If you’re still uncertain, get some advice from a seasoned doctor like I did in med school.

6. I Waited Too Long to Get Legal Savvy

Doctors eventually cross paths with the legal system, whether as expert witnesses, in depositions, or lawsuits. 

I didn’t seek out legal knowledge early, which meant more stress than necessary when those moments came.

If you want to keep those cortisol levels down, get to know attorneys now before you need them. Learn how depositions work, how to answer questions, and what your rights are. 

Legal confidence keeps you calm under pressure, and a calm doctor is a better doctor.

7. I Underused Technology (Until Recently)

For decades, I charted and documented the “old” way. 

Then AI charting tools like Open Evidence came along. They were game changers. My notes became sharper, faster, and more complete. 

Honestly, I wish I’d embraced tools like this sooner. I would have made more money a lot faster.

With AI exploding right now, you should adopt new tech early. Use AI for charting, research, and patient education. 

The right tools free up hours of your week and can improve the quality of your documentation.

Final Advice If You’re Starting an Allergy Practice Today

If I could go back and talk to a younger me, here’s what I’d say:

1. Audit options—do not default to employment.

Map MD/PhD (research), private practice, hybrid, employed. Call two people in each. Score Income/Autonomy/Risk/Lifestyle 1–5. If private wins, buy a retiring allergist’s panel or sublease 2–3 days/week. Set a 90-day go/no-go.

2. Build thick skin and systems.

Expect upset patients and missed calls. Institute same-day voicemail returns, a weekly 15-minute “what slipped/what changes” huddle, and an escalation ladder (MA → RN → you) with time targets. Use: Trigger → Owner → Time limit → Next step.

3. Get legally literate.

Book a 60-minute consult. Learn deposition basics. Write a one-page SOP: answer only the question, pause, “I don’t recall” is acceptable, never speculate. Have counsel review messaging and records policies.

Bonus: Use AI for charting.

Adopt Open Evidence/AI notes; create templates (new asthma, food-allergy follow-up, immunotherapy build-up). Track time saved for 10 charts; keep the winners.

Running an allergy practice is equal parts medicine, business, and adaptability. I wouldn’t trade my journey for anything, but I’d sure do some of it faster, smarter, and with more confidence.

And if you take these lessons to heart, you can.