three yr report

[Guest guest]

I may do these yearly reports forever.... Have been open just

over three years Have only recently signed on to my second commercial

insurance(or I think I have, it is complicated)broke even at 2-3 weeks

began to feed self around 6 monthsThings were tight for a long time and while I still sorta live from paycheck to paycheck I live BETTER from paycheck to paycheckActually I have saved money a few times this year I do fear for my car at 268,000 miles and the house should be painted

and I need a new furnace but I think I c an work all that out and

there is some hope we can take a warm winter vacation this year not

having done so for a while

Last summer I did nothing all day it seemed Things were dead I was

very worried This summer much different so I conclude, given that I

have to monitor which insurers I take--I cannot just FILL like a

hospital practice becasue they take all comers and get subsidized by

orhto etc, probably that comment about 2-5 yrs to maturity is dead on.

I am not in a dead zone but I am in an ill zone. Fortunately housing here is affordable and so is malpractice moslty. I

still haven no employees and run exactly the same arrangement as when I

opened- outsource billing ,simple phone, all in one, cellphone

,answering machine, lap top only that I take home on weekends

Lessons learned /things changed-- I no longer order immunizations

form the state I get them transferred from t he pediatric practice

which prevents waste not much other didfference ,but I was wasting so

many it was stupid

had to move a year ago very hard to find space but

otherwise no big deal to move-- becasue uh I did not actually change

addresses .Small town .I moved to a different building in t he office

park. I had been 105 mt blue circle and shared the building so the

post office said I could be suite 2 there. When I moved to 115 mt blue

circle also sharing a previously unshared, building well I called up

the post office and we made another suite 2 , dissolving the first,

using the same mailbox out on a post and I put a differnt sticky

number on it

Had to get a new lap top last fall that was one of the most

painful things I have ever done BEcasue i did not know what I was doing

and lost a few notes So now I know alot more about wher e my data is

and stuff THough I would not wan tto do it again soon....

Still do some outside work for which I am very grateful.Teaching

at the resdiency precepting irregulalry is tres useful -I get

socialization, CME , lunch, contributions to a SEP IRA and they have

had me back now for a second year to teach part of practice management

which lets me prosletyze about iMPS and becasue of which two 3 rd yr

res cam to see my office last yr and both came to CAMp so I hope they

go on to do well

advice/ recommendations: be cheap! ask someone on t he l

ist serv if you need help. the variety of situations we encounter and

the willingness to share is rich and varied

Hospital colleagues have no idea what I do and have shown no interest. When

the hospital's PA teaches Tai chi locally and is in t he paper or some

xray tech gets certified in something it goes on the bulletin board

When I am in t he paper or publish or in medical economics-not.

oh and vacations The most I have been away is a week. I just take

the cellphone and or call my machine twice a d ay-having left the

message I will . If someone need to be seen I scrounge around and find

someone- so far ha s been workable If I can afford three weeks in

Paris I will let you know what I come up with

would I go back to a " job? " nope Do I do a good job?Hope so HYH numbers pretty good -can improve.LAst summer had a clot of people leave mostly the unhappy " Searchers " always looking

Two have come back one I still get the notes for form specialist and she is on no different treatment that I had given.One I see has her home up for sale so has left the areaI get new patient requests more now that a year ago and actually am probably closed or closing

I admit I now cherry pick But not on the basis of money necessarily

.. I saw a new 10 yr old two days ago on mediciad because I see her

parents and I want kids.( in the practice. Wouldn't want the noisy

little things to come home with me)

I turned down a guy with good insurance becasue it was back pain and I was busy. I turned down a family of 4 dual eligbles-all 4- because I thought I could not stand it emotionally the day they called.I

took an insurance well woman because I see grandmother etc PIcking and

choosing case by case is likely how I will slow to a crawl

How much do I make?

Less than Lou Spikol . Hope any of this helps other wise how fun I got to type.My favorite thing.

overhead about 35%

malpractice about 8,000space about 125 sq ft rent about 537.00 a month registered

patients ?who knows? the number is 758 but many were skilled nursing

home patients who rehab'd and went home that work is minimal now due

to difficult changes at the nursing home

Like to see genreally up to 8-10 a day but not quite every day still yet business

model is solid and has held up when like yesterday i saw 9 people

only 1 wiih medicaid, i do very well thank you. The model says if I

fill every day with the right mix I can make about 107,000

EMR-Have welford chart notes outsource billing 8% Jean

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