Intro

[Guest guest]

Hello to everyone in this group; I am a new member of it. I expect to be pestering everyone with a bunch of questions over the next several months so I figured I'd do a little introduction.

I am 5+ years out of a primary care IM residency, living and working in Denver, Colorado. I had the great pleasure of starting my own practice up anew 5 years ago as an employee of a large hospital corp that is prominent in Denver. My original plan was to build up to 3-4 physicians then divest from the hospital as a group, which actually I think would have worked well. Unfortunately, the hospital essentially refused to add anything more than a part-time physician and for a variety of reasons that I'm sure many of you are familiar, working for a corporation clearly isn't something I can do for my career.

Over the last couple months, I've decided I need to just go off on my own to have the type of practice and career that my patients and I deserve. I was referred to this group by an endocrinology colleague that started up last year via the IMP model.

I certainly have some things in my favor as far as going off on my own. Foremost is I have a pretty strong patient base after starting with nothing 5 years ago. I've seen in total about 2400 unique patients in the 5+ years and about 1000-1200 in the last 24 months and see on average 14-16 patients daily. I've generated on average about $270,000 in yearly revenue. Additionally, I have an EMR (Allscripts) in which I'm fully embedded and have been using for 4 years.

Despite the positives above, I still feel I need to move on. I cannot work with my current company any longer; they are just way to malignant and have such little interest in either physician or patient satisfaction. While I have an already low volume practice, I feel the need to cut my patient volume back to provide the level of service I want.

I am in the process now of exploring different practice models and am hoping to finalize my blueprint over the next 2-3 months. I can then start looking for specific space in my area and planning the definitive transition.

I plan to continue traditional insurance billing

I plan to use a 3rd party billing service that already uses Allscripts so they essentially would use my own software to do our billing and charge about 6.5%

I'd like to additional have a very low cost retainer/yearly fee for patients. I was think of about $100. I was hoping this would add back some of the revenue I would lose by decreasing patient volume. Additionally, I'm hoping this helps to wean my patient base only to those patients that really want to be with ME as opposed to any doc. I feel that 1) the quality of care I provide is worth that yearly retainer, and 2) its small enough that it should be a financial restriction to probably 95% of my patients. I would likely allow my current medicare patients to come over though I assume I cannot charge them the retainer (is that correct?)

With the Allscripts software there is an online patient portal that allows scheduling, physician correspondence and lab/study result viewing by patients that I plan to use (we're not currently using it).

I don't foresee myself trying to do this with a partner though I wouldn't mind renting some space from another physician office as opposed to just finding a small space myself. I do have a colleague that does acupuncture and chiropractic work that I was considering sharing space with as that fits with my practice where I utilize a lot of non-traditional treatment modalities.

Those are some of the specifics that I've formulated most in my head at this point. Of course, none of those are mandatory if another model seems as if it will work best. As above, I'll likely be asking a slew of more specific questions but thought I've give this little intro. If anyone has some general thoughts or specific black holes to avoid, it is much appreciated. I've already enjoyed reading the board over the last week. Thank you all.

Dave Gordon

Denver, CO