Re: number of patients to be seen/ Ideal insurance mix

[Guest guest]

Thanks for your point of view, . I certainly think that I can do all the MA work, but I would feel terrible firing them. I started with one of them because when I opened my practice I receive the recommendation of having someone elso to call patients and give vaccines so that parents feel that the "doctor's work was more important than that", when I hired the other doctor I also hired the other MA. Currently at the rhythm I'm working I need them, because I don't have time to do things like checking the refrigerator's temp, checking the supply and vaccines inventory, writing down all vaccine logs and lab logs. If I cut to 10 patients a day I could do those things (maybe even take a bathroom break), but I don't feel strong enough to fire them.

Re: [Practiceimprovemen t1] number of patients to be seen/ Ideal insurance mix

What's wrong with this ....Say you dropped down to 10 patients per day and lost all your staff.You now have 2/3 of the day to do the stuff they did.10 x $80 = $800 per day * 5 * 4.33 = $17320 per monthLess 8% for billing company = $15934Less rental of $3200 = $12734Equipment rental $300 = $12434Licenses of $400 = $12034Less malpractice of ?? $2000 = $10,000Vaccines are fully reimbursedSo, that $10k per month with payment for utilities and taxes to come off that.On Sat, Aug 9, 2008 at 12:01 PM, Fierro <vhfierroyahoo (DOT) com> wrote:> Equipment rental ( a CBC machine that gives me nightmares every time I have> to pay for the CLIA permits): 300>> Insurances (malpractice, liability, health for employees): 4000>> Billing company: 8% of

collected: 3000-4500>> Licenses and permits: 400>> Rent: 3200>> Salaries: excluding the doctors: 16178>> Vaccines 14000>> Payroll taxes: 1370>-- Graham Chiuhttp://www.synapsed irect.comSynapse - the use from anywhere EMR.

[Guest guest]

What is IMP?

Re: number of patients to be seen/ Ideal insurance mix

Hi ,

Welcome.

I'm a new IMP. Started July 15th.

I am doing solo-solo without staff.

I hear you about the secretary. How else to manage 50 calls and still see patients? Since I don't have a full panel like you do I'm not entirely sure. Some of it is training patients. Some of those 50 calls were people who weren't used to the answering machine as the previous doc had a secretary and so some of them were repeats. Some of those calls were sales pitches, etc. etc. But for what it's worth I'm using a digital phone that I set to "Do Not Disturb" while with patients. Fifteen minutes of every hour is to return calls. One thing the answering machine does -- makes some people come to the point. My fax is on the same line and if a fax tone is heard the fax machine will pick it up instead of that answering machine. And it's saving it digitally so I can import it to my computer. Others in the IMP Community are using internet faxing or services like One Box and Up Dox. I am using Amazing Charts and find

it much easier to use than eCW and certainly love the price. I will be doing in house billing. The folks on this list serve have been giving feedback to help me with that. I agree with Tim that I work just as hard and maybe longer hours ( to be expected as a newbie) but it is not as stressful as working at seeing more and more patients to pay for overhead. (Some of the reason it's not as stressful is my daughter can be with me when we are printing up business cards or new patient packets, etc. So spending time with her makes less stress for me as a mom and makes me a better doctor, mom, person.) But also remember solo-solo is not the only way to go --- lots of folks here are IMP and have support staff. Others here are morphing into IMP by cutting out lowest paying or big hassle factor insurances and/or cutting staff to 3/4 and gradually phasing out. It takes time. I've been following the list serv and

hooking up with mentors for a year. I also took a business course and currently have a friend teaching me billing/coding and another teaching me phlebotomy. I'll be doing my first order of immunizations next week (there goes the rest of the start up money). It's a very steep learning curve for doing all the stuff I had support staff doing for me all these years. It takes big energy and committment to do this but clearly it's doable with lots of individuals making it work "their way" from cash only to specialty care (endo, neuro, optho and I think we have an ortho IMP too), to adding asthetics from city to rural with some working part time and others full time. Were you comfortable that first year when you were seeing 10-12 patients a day during your first year? Were you stable financially? Were you happy? What would have been your salary if you weren't paying the front desk person? Was Medicaid the tipping point

that started making the need for more and more visits? Is it time to say good by to Medicaid? As to Open Access I've lost track of the original formula but I plan on capping my panel at 800 because the figures seem to indicate that will be about 8 calls per day for same day access and my schedule allows for 12 visit per day at full capacity. I hope the sharing of my new practice gives you encouragement to find what will work for you to get off the hamster wheel that only leads to burnout and frustration. Pick one change at a time -- eliminate an insurance, start using EMR, cross train staff and don't replace if one leaves, etc. etc. I have never been happier. Myria (family practice, upstate new york, Amazing Charts)> Equipment rental ( a CBC machine that gives me nightmares every time I have> to pay for the CLIA permits): 300>> Insurances (malpractice, liability, health for employees): 4000>> Billing company: 8%

of collected: 3000-4500>> Licenses and permits: 400>> Rent: 3200>> Salaries: excluding the doctors: 16178>> Vaccines 14000>> Payroll taxes: 1370>-- Graham Chiuhttp://www.synapsed irect.comSynapse - the use from anywhere EMR.

[Guest guest]

So , pumpkin , IMP is ideal medical practices How did you find this list serv anyway?we are a bunch of folks moslty primary care not all , moslty outpaitent only not all ,who run mostly small practices not all ,and the motto is something like superb patietn experience of care for every patient every time ,in an environment that is vital and sustainable for the physcian

we do a bunch of " best practices " work We do not incrementally touch up this or that in practice but radically transform our way of practicing to .... lower overhead so much so that we have....'breathing room "

which allows for time to think , solve processes, connect with people, and oh uh recognize your spouse if they walk in off the street...then we measure it Measure our outcomes In a painless way An internet program called HowsYourHellth.org

Just stay on the list serv and keep reading things will begin to click and we will help youIt doesn't sound like you c an go on like you are so there will need to be some comfort level with change -not easy

jean in MAineWatch for announcement for next summer for the annual conference called CAmp (you will NOT have to hike or pitch tents) and come to it --It will be in seattle go to impcenter.org and look around also there is a wealth of information

i think it is toooo sweet you do not have the strength to lay off staff but you have the strenght to go without bathroom breaks food or money. we in the IMP project believe in frequent bathroom breaks

What is IMP?

Re: number of patients to be seen/ Ideal insurance mix

Hi ,

Welcome.

I'm a new IMP. Started July 15th.

I am doing solo-solo without staff.

I hear you about the secretary. How else to manage 50 calls and still see patients? Since I don't have a full panel like you do I'm not entirely sure. Some of it is training patients. Some of those 50 calls were people who weren't used to the answering machine as the previous doc had a secretary and so some of them were repeats. Some of those calls were sales pitches, etc. etc. But for what it's worth I'm using a digital phone that I set to " Do Not Disturb " while with patients. Fifteen minutes of every hour is to return calls. One thing the answering machine does -- makes some people come to the point. My fax is on the same line and if a fax tone is heard the fax machine will pick it up instead of that answering machine. And it's saving it digitally so I can import it to my computer. Others in the IMP Community are using internet faxing or services like One Box and Up Dox. I am using Amazing Charts and find

it much easier to use than eCW and certainly love the price. I will be doing in house billing. The folks on this list serve have been giving feedback to help me with that. I agree with Tim that I work just as hard and maybe longer hours ( to be expected as a newbie) but it is not as stressful as working at seeing more and more patients to pay for overhead. (Some of the reason it's not as stressful is my daughter can be with me when we are printing up business cards or new patient packets, etc. So spending time with her makes less stress for me as a mom and makes me a better doctor, mom, person.) But also remember solo-solo is not the only way to go --- lots of folks here are IMP and have support staff. Others here are morphing into IMP by cutting out lowest paying or big hassle factor insurances and/or cutting staff to 3/4 and gradually phasing out. It takes time. I've been following the list serv and

hooking up with mentors for a year. I also took a business course and currently have a friend teaching me billing/coding and another teaching me phlebotomy. I'll be doing my first order of immunizations next week (there goes the rest of the start up money). It's a very steep learning curve for doing all the stuff I had support staff doing for me all these years. It takes big energy and committment to do this but clearly it's doable with lots of individuals making it work " their way " from cash only to specialty care (endo, neuro, optho and I think we have an ortho IMP too), to adding asthetics from city to rural with some working part time and others full time. Were you comfortable that first year when you were seeing 10-12 patients a day during your first year? Were you stable financially? Were you happy? What would have been your salary if you weren't paying the front desk person? Was Medicaid the tipping point

that started making the need for more and more visits? Is it time to say good by to Medicaid? As to Open Access I've lost track of the original formula but I plan on capping my panel at 800 because the figures seem to indicate that will be about 8 calls per day for same day access and my schedule allows for 12 visit per day at full capacity. I hope the sharing of my new practice gives you encouragement to find what will work for you to get off the hamster wheel that only leads to burnout and frustration. Pick one change at a time -- eliminate an insurance, start using EMR, cross train staff and don't replace if one leaves, etc. etc. I have never been happier. Myria (family practice, upstate new york, Amazing Charts)

> Equipment rental ( a CBC machine that gives me nightmares every time I have

> to pay for the CLIA permits): 300>> Insurances (malpractice, liability, health for employees): 4000>> Billing company: 8%

of collected: 3000-4500>> Licenses and permits: 400>> Rent: 3200>> Salaries: excluding the doctors: 16178>> Vaccines 14000>> Payroll taxes: 1370>

-- Graham Chiuhttp://www.synapsed irect.comSynapse - the use from anywhere EMR.

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

Take a look at our IMP center for more information:http://www.impcenter.org/impcenter_knowledgebase.htmNOn Aug 9, 2008, at 3:17 PM, Fierro wrote:What is IMP?  Re: [Practiceimprovemen t1] number of patients to be seen/ Ideal insurance mixWhat's wrong with this ....Say you dropped down to 10 patients per day and lost all your staff.You now have 2/3 of the day to do the stuff they did.10 x $80 = $800 per day * 5 * 4.33 = $17320 per monthLess 8% for billing company = $15934Less rental of $3200 = $12734Equipment rental $300 = $12434Licenses of $400 = $12034Less malpractice of ?? $2000 = $10,000Vaccines are fully reimbursedSo, that $10k per month with payment for utilities and taxes to come off that.On Sat, Aug 9, 2008 at 12:01 PM, Fierro <vhfierroyahoo (DOT) com> wrote:> Equipment rental ( a CBC machine that gives me nightmares every time I have> to pay for the CLIA permits): 300>> Insurances (malpractice, liability, health for employees): 4000>> Billing company: 8% of collected: 3000-4500>> Licenses and permits: 400>> Rent: 3200>> Salaries: excluding the doctors: 16178>> Vaccines 14000>> Payroll taxes: 1370>-- Graham Chiuhttp://www.synapsed irect.comSynapse - the use from anywhere EMR.

[Guest guest]

> down all vaccine logs and lab logs. If I cut to 10 patients a day I could

> do those things (maybe even take a bathroom break), but I don't feel strong

> enough to fire them.

Sounds as though all your staff are well paid, and you're getting the scraps.

This happens in many small businesses that are not successful.

If you want to continue working as a business owner, you have to make

the hard choices.

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

[Guest guest]

I read an article in America Airlines magazine about a doctor that changed her life thanks to this group's help. That's how I found you.

Re: [Practiceimprovemen t1] number of patients to be seen/ Ideal insurance mix

Hi ,

Welcome.

I'm a new IMP. Started July 15th.

I am doing solo-solo without staff.

I hear you about the secretary. How else to manage 50 calls and still see patients? Since I don't have a full panel like you do I'm not entirely sure. Some of it is training patients. Some of those 50 calls were people who weren't used to the answering machine as the previous doc had a secretary and so some of them were repeats. Some of those calls were sales pitches, etc. etc. But for what it's worth I'm using a digital phone that I set to "Do Not Disturb" while with patients. Fifteen minutes of every hour is to return calls. One thing the answering machine does -- makes some people come to the point. My fax is on the same line and if a fax tone is heard the fax machine will pick it up instead of that answering machine. And it's saving it digitally so I can import it to my computer. Others in the IMP Community are using internet faxing or services like One Box and Up Dox. I am using Amazing

Charts and find it much easier to use than eCW and certainly love the price. I will be doing in house billing. The folks on this list serve have been giving feedback to help me with that. I agree with Tim that I work just as hard and maybe longer hours ( to be expected as a newbie) but it is not as stressful as working at seeing more and more patients to pay for overhead. (Some of the reason it's not as stressful is my daughter can be with me when we are printing up business cards or new patient packets, etc. So spending time with her makes less stress for me as a mom and makes me a better doctor, mom, person.) But also remember solo-solo is not the only way to go --- lots of folks here are IMP and have support staff. Others here are morphing into IMP by cutting out lowest paying or big hassle factor insurances and/or cutting staff to 3/4 and gradually phasing out. It takes time. I've been following the

list serv and hooking up with mentors for a year. I also took a business course and currently have a friend teaching me billing/coding and another teaching me phlebotomy. I'll be doing my first order of immunizations next week (there goes the rest of the start up money). It's a very steep learning curve for doing all the stuff I had support staff doing for me all these years. It takes big energy and committment to do this but clearly it's doable with lots of individuals making it work "their way" from cash only to specialty care (endo, neuro, optho and I think we have an ortho IMP too), to adding asthetics from city to rural with some working part time and others full time. Were you comfortable that first year when you were seeing 10-12 patients a day during your first year? Were you stable financially? Were you happy? What would have been your salary if you weren't paying the front desk person? Was Medicaid the

tipping point that started making the need for more and more visits? Is it time to say good by to Medicaid? As to Open Access I've lost track of the original formula but I plan on capping my panel at 800 because the figures seem to indicate that will be about 8 calls per day for same day access and my schedule allows for 12 visit per day at full capacity. I hope the sharing of my new practice gives you encouragement to find what will work for you to get off the hamster wheel that only leads to burnout and frustration. Pick one change at a time -- eliminate an insurance, start using EMR, cross train staff and don't replace if one leaves, etc. etc. I have never been happier. Myria (family practice, upstate new york, Amazing Charts)

> Equipment rental ( a CBC machine that gives me nightmares every time I have> to pay for the CLIA permits): 300>> Insurances (malpractice, liability, health for employees): 4000>> Billing company: 8%

of collected: 3000-4500>> Licenses and permits: 400>> Rent: 3200>> Salaries: excluding the doctors: 16178>> Vaccines 14000>> Payroll taxes: 1370>-- Graham Chiuhttp://www.synapsed irect.comSynapse - the use from anywhere EMR.-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax

[Guest guest]

Graham gives a great analysis. Only thing I notice is that while vaccines should be fully reimbursable, the revenues were included in collections, therefore the expense must be taken out. Still, reducing vaccine costs by 2/3 gets it from 14,000 to 4,667. Take $4,667 from the bottom line of $10,000 and that still leaves $5,333 per month net v. the $140 original take-home pay for an illustrative month. Subletting space or moving to a smaller space could cut the $3,200 rent cost.

It might be difficult to fire staff, but it would be more difficult to me to pay them at my personal sacrifice. Don't you and your family deserve reward for your work more than your staff? You should pay them fairly for the time they do work for you. You should not expect service from them when you are not paying them. Neither of you owes more to the other than this.

Best of luck to you. I am sure things will get better as you are addressing these problems now.Sincerely,Jacques L. Guillot, MD, FACP, FAAP

What's wrong with this ....

Say you dropped down to 10 patients per day and lost all your staff.

You now have 2/3 of the day to do the stuff they did.

10 x $80 = $800 per day * 5 * 4.33 = $17320 per month

Less 8% for billing company = $15934

Less rental of $3200 = $12734

Equipment rental $300 = $12434

Licenses of $400 = $12034

Less malpractice of ?? $2000 = $10,000

Vaccines are fully reimbursed

So, that $10k per month with payment for utilities and taxes to come off that.

> Equipment rental ( a CBC machine that gives me nightmares every time I have

> to pay for the CLIA permits): 300

>

> Insurances (malpractice, liability, health for employees): 4000

>

> Billing company: 8% of collected: 3000-4500

>

> Licenses and permits: 400

>

> Rent: 3200

>

> Salaries: excluding the doctors: 16178

>

> Vaccines 14000

>

> Payroll taxes: 1370

>

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

[Guest guest]

Well now you really need to read the materials, understand the concepts, re-read the advice we have all been tpying away at here and start to put together an action plan to get you and your practice healthy. Welcome aboard...

Re: [Practiceimprovemen t1] number of patients to be seen/ Ideal insurance mix

Hi ,

Welcome.

I'm a new IMP. Started July 15th.

I am doing solo-solo without staff.

I hear you about the secretary. How else to manage 50 calls and still see patients? Since I don't have a full panel like you do I'm not entirely sure. Some of it is training patients. Some of those 50 calls were people who weren't used to the answering machine as the previous doc had a secretary and so some of them were repeats. Some of those calls were sales pitches, etc. etc. But for what it's worth I'm using a digital phone that I set to "Do Not Disturb" while with patients. Fifteen minutes of every hour is to return calls. One thing the answering machine does -- makes some people come to the point. My fax is on the same line and if a fax tone is heard the fax machine will pick it up instead of that answering machine. And it's saving it digitally so I can import it to my computer. Others in the IMP Community are using internet faxing or services like One Box and Up Dox. I am using Amazing

Charts and find it much easier to use than eCW and certainly love the price. I will be doing in house billing. The folks on this list serve have been giving feedback to help me with that. I agree with Tim that I work just as hard and maybe longer hours ( to be expected as a newbie) but it is not as stressful as working at seeing more and more patients to pay for overhead. (Some of the reason it's not as stressful is my daughter can be with me when we are printing up business cards or new patient packets, etc. So spending time with her makes less stress for me as a mom and makes me a better doctor, mom, person.) But also remember solo-solo is not the only way to go --- lots of folks here are IMP and have support staff. Others here are morphing into IMP by cutting out lowest paying or big hassle factor insurances and/or cutting staff to 3/4 and gradually phasing out. It takes time. I've been following the

list serv and hooking up with mentors for a year. I also took a business course and currently have a friend teaching me billing/coding and another teaching me phlebotomy. I'll be doing my first order of immunizations next week (there goes the rest of the start up money). It's a very steep learning curve for doing all the stuff I had support staff doing for me all these years. It takes big energy and committment to do this but clearly it's doable with lots of individuals making it work "their way" from cash only to specialty care (endo, neuro, optho and I think we have an ortho IMP too), to adding asthetics from city to rural with some working part time and others full time. Were you comfortable that first year when you were seeing 10-12 patients a day during your first year? Were you stable financially? Were you happy? What would have been your salary if you weren't paying the front desk person? Was Medicaid the

tipping point that started making the need for more and more visits? Is it time to say good by to Medicaid? As to Open Access I've lost track of the original formula but I plan on capping my panel at 800 because the figures seem to indicate that will be about 8 calls per day for same day access and my schedule allows for 12 visit per day at full capacity. I hope the sharing of my new practice gives you encouragement to find what will work for you to get off the hamster wheel that only leads to burnout and frustration. Pick one change at a time -- eliminate an insurance, start using EMR, cross train staff and don't replace if one leaves, etc. etc. I have never been happier. Myria (family practice, upstate new york, Amazing Charts)

> Equipment rental ( a CBC machine that gives me nightmares every time I have> to pay for the CLIA permits): 300>> Insurances (malpractice, liability, health for employees): 4000>> Billing company: 8%

of collected: 3000-4500>> Licenses and permits: 400>> Rent: 3200>> Salaries: excluding the doctors: 16178>> Vaccines 14000>> Payroll taxes: 1370>-- Graham Chiuhttp://www.synapsed irect.comSynapse - the use from anywhere EMR.-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax 207 778

3544

[Guest guest]

I agree with about the savings with eMD's. I have no staff and the program

saves me the staff costs of 60K ayear and allows me to see 11-12 patients a day

without any effort so to speak.

________________________________

From: on behalf of Graham Chiu

Sent: Fri 8/8/2008 7:44 PM

To:

Subject: Re: number of patients to be seen/ Ideal

insurance mix

What's wrong with this ....

Say you dropped down to 10 patients per day and lost all your staff.

You now have 2/3 of the day to do the stuff they did.

10 x $80 = $800 per day * 5 * 4.33 = $17320 per month

Less 8% for billing company = $15934

Less rental of $3200 = $12734

Equipment rental $300 = $12434

Licenses of $400 = $12034

Less malpractice of ?? $2000 = $10,000

Vaccines are fully reimbursed

So, that $10k per month with payment for utilities and taxes to come off that.

On Sat, Aug 9, 2008 at 12:01 PM, Fierro <vhfierro@...

<mailto:vhfierro%40yahoo.com> > wrote:

> Equipment rental ( a CBC machine that gives me nightmares every time I have

> to pay for the CLIA permits): 300

>

> Insurances (malpractice, liability, health for employees): 4000

>

> Billing company: 8% of collected: 3000-4500

>

> Licenses and permits: 400

>

> Rent: 3200

>

> Salaries: excluding the doctors: 16178

>

> Vaccines 14000

>

> Payroll taxes: 1370

>

--

Graham Chiu

http://www.synapsedirect.com <http://www.synapsedirect.com/>

Synapse - the use from anywhere EMR.

[Guest guest]

Been on vacation, so sorry to jump in

late, but I have to agree with on eMDs. We financed it over 5 years

at $900/month which paid for the software licensing plus all of the hardware (1

laptop, 1 tablet, faxserver, main server, 2 desktops, insurance card scanner, 2

laser printers, and document scanner) and the installation and upgrades for the

first year. You can do the billing yourself at the end of the day with a

$99/month Gateway EDI account in about 20 minutes (or less) and have one of

your staff members do your postings. I do postings 2-3 times per week for

Steve (my husband) and it takes me about 30-45 minutes each time. I take

one Friday afternoon per month and work collections – about 2

hours. Alternately, see if you can find a less expensive biller.

But the EMR really will do 90% of the work for you. We have a PT doc in

our office that I can’t get away from his paper billing company. He

pays her 4% of collections, and I can do it for less than 1%, with him paying

me a fair hourly wage.

We’re also Internal Medicine, so we

don’t do any lab draws here. The PT doc has a subspecialty in

Infectious Disease, so we do quite a few immunizations for him. We have 1

FTE MA for 1.5 FTE doctors plus myself (office manager/IT/biller/front

desk). We will expand to 1.5 FTE MA’s soon (both doc’s are

still building their practices). I can’t speak for the PT doc, but

Steve and I are taking home $10K/month combined right now. When our EMR

lease goes away in Feb 2010 and our Tenant Improvement lease go away in March

2010, our salaries stand to increase about $3K/month

Good luck!

Pratt

Office Manager

Oak Tree Internal Medicine P.C.

From:

[mailto: ] On

Behalf Of Egly

Sent: Saturday, August 09, 2008

4:50 AM

To:

Subject: Re:

number of patients to be seen/ Ideal insurance mix

:

eMDs has won pediatric documentation awards several

years running. I believe it can help you. For cost, it is comparable to

3 telephone lines and minimal yellowbook each year. Averaged over the

first 5 years. Less for you if you practice solo MD. I am an internist,

but am very familiar with eMDs.

Again, it decreases your workload at every

point. Workflows would change and only you can create the vision.

For $3-4,000 per month I would really considerbringing billing back in

house. Even if you didn't change your practice, but employed someone in

your office, I think you would come out ahead. That is $36-48,000 per

year. $360,000 to $500,000 over 10 years.

That is 3-4 years of my salary. I would look

to keep it somehow.

I'm a pediatrician in

Miami.

I started my office 4 years ago, and I haven't been able to be

productive. Currently I'm practicing solo, I see patients from

private insurances and from medicaid. In the last month I'm seeing

about 30 patients a day (working 9 to 7 with only one hour break for lunch

and answering messages). Before that I had hired another physician

but we never got enough earnings to get a salary larger than 8000 a month

for both of us (we divided that between the two). I'm going crazy,

and I'm not hiring anyone else because I don't think that I can afford it.

Can someone give me

an orientation in this regards? Is this the way a pediatrician' s

life should be or there is a way of being productive seeing less patients?

What is the average

number of patients a pediatrician should see to be productive? How do

I calculate and get the ideal insurance mix to have a healthy practice and

a healthy life?

Fierro

--

If you are a patient please allow up to 12 hours for a reply by email/

please note the new email address.

Remember that e-mail may not be entirely secure/

MD

ph fax

[Guest guest]

Isn't this kill switch in some way violating HIPPA? Doesn't the pt ultimately own their med records? Does the pt not have rights to those records? Can pt go to AC and request their records (say in the situation dr moves to Fiji or something). Aren't records by law to be kept for 7 years from pts last contact w dr?

Buy AC, it is certainly the best bang for your buck you are ever going to find in an EMR even if Jon has just admitted to having installed a " kill switch " in the program. So we are leasing AC it would seem for semi-reasonable fees every year and not purchasing it... None the less, for $995 for the first doc you can't go wrong. And think of all the money you will save in paper, ink, folders, stickers it addes up fast. None the less that now four people can all be reading the same chart at the same exact time doing different tasks and no more lost paper charts or paying staff time to pull or fill them either... that is certainly worth some money. You almost can't afford to not use an inexpensive system like AC...

Re: [Practiceimprovemen t1] number of patients to be seen/ Ideal insurance mix

Hi As someone else suggested much depends on your overhead- do you want to tell us your rent/malpractice/ utilites/ computer costs etc?did you make a business plan when you started-- doe s it hold up?

MAny times kids are on medicaid and in that case the pay to care for them is so low that it is virtually not feasible to earn a good living without being subsidizedCAn you tell us more about your EMR, does solo mean any staff? and other details?

Some area are just dead zones but some folks on the list may be able to offer suggestions in MAine

On Mon, Jul 21, 2008 at 9:11 PM, Fierro <vhfierroyahoo (DOT) com> wrote:

I'm a pediatrician in Miami. I started my office 4 years ago, and I haven't been able to be productive. Currently I'm practicing solo, I see patients from private insurances and from medicaid. In the last month I'm seeing about 30 patients a day (working 9 to 7 with only one hour break for lunch and answering messages). Before that I had hired another physician but we never got enough earnings to get a salary larger than 8000 a month for both of us (we divided that between the two). I'm going crazy, and I'm not hiring anyone else because I don't think that I can afford it.

Can someone give me an orientation in this regards? Is this the way a pediatrician' s life should be or there is a way of being productive seeing less patients?

What is the average number of patients a pediatrician should see to be productive? How do I calculate and get the ideal insurance mix to have a healthy practice and a healthy life?

Fierro

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.

Remember that e-mail may not be entirely secure/ MD ph fax

-- M.D.www.elainemd.com

You only go through this life but once. Go in the directions of your dreams and live the life you've imagined.

[Guest guest]

Good point. Funny how the software side can get away with this kind of thing, yet we on the provider side of things are none the less held to this much higher standard. Remember most ped's patients we will have to keep their records clear and available for seven years after their 18th birthday... We need the laws on various parts of this industry to catch-up to the technology....

Re: [Practiceimprovemen t1] number of patients to be seen/ Ideal insurance mix

Hi As someone else suggested much depends on your overhead- do you want to tell us your rent/malpractice/ utilites/ computer costs etc?did you make a business plan when you started-- doe s it hold up?MAny times kids are on medicaid and in that case the pay to care for them is so low that it is virtually not feasible to earn a good living without being subsidizedCAn you tell us more about your EMR, does solo mean any staff? and other details?Some area are just dead zones but some folks on the list may be able to offer suggestions in MAine

On Mon, Jul 21, 2008 at 9:11 PM, Fierro <vhfierroyahoo (DOT) com> wrote:

I'm a pediatrician in Miami. I started my office 4 years ago, and I haven't been able to be productive. Currently I'm practicing solo, I see patients from private insurances and from medicaid. In the last month I'm seeing about 30 patients a day (working 9 to 7 with only one hour break for lunch and answering messages). Before that I had hired another physician but we never got enough earnings to get a salary larger than 8000 a month for both of us (we divided that between the two). I'm going crazy, and I'm not hiring anyone else because I don't think that I can afford it.

Can someone give me an orientation in this regards? Is this the way a pediatrician' s life should be or there is a way of being productive seeing less patients?

What is the average number of patients a pediatrician should see to be productive? How do I calculate and get the ideal insurance mix to have a healthy practice and a healthy life?

Fierro

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax

-- M.D.www.elainemd. comYou only go through this life but once. Go in the directions of your dreams and live the life you've imagined.