Ebb and flow of demand by season

[Guest guest]

From the old doc in Drain, Oregon, About the problems breaking even, and having a variation of the number of patients you see by hour, day, week and season: Remember, most of our practices are new. There is a several year start up curve, that takes between two and five years to get your practice to the point it will grow to. You will grow quickly to start with, assuming you started in the right place and have something people want. Then at maybe six months, the curve slows down but contiinues to go up over the next two to four years. You practice the way you want to, and the practice itself "calls out" the kind of patient that likes that practice style. If you change systems, you will "call out" a different type of patient and some of the ones that liked it the way it was will leave. It is asking a lot to have a solo practice make us the entire amount we would want to have in the long run, after a few weeks or months of work. This is small business, and by definition that makes it risky. If you want total security, you have to work for someone else and take their systems. The low overhead thing is what this group is doing different, that makes solo practice possible. The massive delay in insurance and medicare payments makes it much more difficult. Skip this if you don't like to see someone on a soap box: Most small businesses have immediate feedback: I buy shoes and I pay for them or go barefoot until I do. If I want medical treatment and have no insurance, I have to balance my need against my other priorities

(like shoes), remembering that the costs are enough to make most people gasp. If I want medical treatment and have insurance, I get the treatment and it may be six months before the last dollar comes to the "provider", and the payment may not have much to do with the charge. We have turned our health care over to the hands of money managers: people with training and mandates to make as much money as possible. Of course this is an insane system. Joanne Holland DVM/MD

Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

RE startup growth and curves.

I like the analysis.. 17 months in, just about expense break-even; second phase of growth starting now-- just about time!!

Sweating it....

Dr Matt Levin

east of Pittsburgh

Goal of 30-40 pts a week, getting there.

Solo since Dec 2004

In hospital practice from June 1996-July 2004

Residency completed in 1988

Re: Ebb and flow of demand by season

From the old doc in Drain, Oregon,

About the problems breaking even, and having a variation of the number of patients you see by hour, day, week and season:

Remember, most of our practices are new. There is a several year start up curve, that takes between two and five years to get your practice to the point it will grow to. You will grow quickly to start with, assuming you started in the right place and have something people want. Then at maybe six months, the curve slows down but contiinues to go up over the next two to four years. You practice the way you want to, and the practice itself "calls out" the kind of patient that likes that practice style. If you change systems, you will "call out" a different type of patient and some of the ones that liked it the way it was will leave.

It is asking a lot to have a solo practice make us the entire amount we would want to have in the long run, after a few weeks or months of work. This is small business, and by definition that makes it risky. If you want total security, you have to work for someone else and take their systems. The low overhead thing is what this group is doing different, that makes solo practice possible. The massive delay in insurance and medicare payments makes it much more difficult.

Skip this if you don't like to see someone on a soap box:

Most small businesses have immediate feedback: I buy shoes and I pay for them or go barefoot until I do. If I want medical treatment and have no insurance, I have to balance my need against my other priorities (like shoes), remembering that the costs are enough to make most people gasp. If I want medical treatment and have insurance, I get the treatment and it may be six months before the last dollar comes to the "provider", and the payment may not have much to do with the charge. We have turned our health care over to the hands of money managers: people with training and mandates to make as much money as possible. Of course this is an insane system.

Joanne Holland DVM/MD

Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

Just when I was getting restless (after 6 months ) you give me hope !

I cover about 50% from overhead from patient billing and the rest

from locum tenens work.

> RE startup growth and curves.

>  

> I like the analysis.. 17 months in, just about expense break-even;

> second phase of growth starting now-- just about time!!

>  

> Sweating it....

>  

> Dr Matt Levin

> east of Pittsburgh

> Goal of 30-40 pts a week, getting there.

> Solo since Dec 2004

> In hospital practice from June 1996-July 2004

> Residency completed in 1988

>> Re: Ebb and flow of demand by season

>>

>>

>> From the old doc in Drain, Oregon,

>>    

>>        About the problems breaking even, and having a variation of

>> the number of patients you see by hour, day, week and season:

>>        Remember, most of our practices are new.  There is a several

>> year start up curve, that takes between two and five years to get

>> your practice to the point it will grow to.  You will grow quickly to

>> start with, assuming you started in the right place and have

>> something people want.  Then at maybe six months, the curve slows

>> down but contiinues to go up over the next two to four years.  You

>> practice the way you want to, and the practice itself " calls out " the

>> kind of patient that likes that practice style.  If you change

>> systems, you will " call out " a different type of patient and some of

>> the ones that liked it the way it was will leave. 

>>  

>>    It is asking a lot to have a solo practice make us the entire

>> amount we would want to have in the long run,  after a few weeks or

>> months of work.  This is small business, and by definition that makes

>> it risky.  If you want total security, you have to work for

>> someone else and take their systems.  The low overhead thing is

>> what this group is doing different,  that makes solo

>> practice possible.  The massive delay in insurance and medicare

>> payments makes it much more difficult. 

>>      

>>   Skip this if you don't like to see someone on a soap box:

>>  

>>     Most small businesses have immediate feedback:  I buy shoes and I

>> pay for them or go barefoot until I do.  If I want medical treatment

>> and have no insurance, I have to balance my need against my other

>> priorities (like shoes),  remembering that the costs are enough to

>> make most people gasp.  If I want medical treatment and have

>> insurance, I get the treatment and it may be six months before the

>> last dollar comes to the " provider " , and the payment may not have

>> much to do with the charge.  We have turned our health care over to

>> the hands of money managers:  people with training and mandates to

>> make as much money as possible.  Of course this is an  insane system.

>>                                 Joanne Holland

DVM/MD

>>

>> Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great

>> rates starting at 1¢/min.

>>

>>

[Guest guest]

I think that I started just about the same time that you did. When you say break even do you mean on current expenses or are you including start up expenses. I have been taking home some salary for about 1 year but I still have a startup loan that its going to take a long time to pay off.Larry Lindeman MDRE startup growth and curves. I like the analysis.. 17 months in, just about expense break-even; second phase of growth starting now-- just about time!! Sweating it.... Dr Matt Levineast of PittsburghGoal of 30-40 pts a week, getting there.Solo since Dec 2004In hospital practice from June 1996-July 2004Residency completed in 1988 Re: Ebb and flow of demand by seasonFrom the old doc in Drain, Oregon,          About the problems breaking even, and having a variation of the number of patients you see by hour, day, week and season:       Remember, most of our practices are new.  There is a several year start up curve, that takes between two and five years to get your practice to the point it will grow to.  You will grow quickly to start with, assuming you started in the right place and have something people want.  Then at maybe six months, the curve slows down but contiinues to go up over the next two to four years.  You practice the way you want to, and the practice itself "calls out" the kind of patient that likes that practice style.  If you change systems, you will "call out" a different type of patient and some of the ones that liked it the way it was will leave.     It is asking a lot to have a solo practice make us the entire amount we would want to have in the long run,  after a few weeks or months of work.  This is small business, and by definition that makes it risky.  If you want total security, you have to work for someone else and take their systems.  The low overhead thing is what this group is doing different,  that makes solo practice possible.  The massive delay in insurance and medicare payments makes it much more difficult.        Skip this if you don't like to see someone on a soap box:     Most small businesses have immediate feedback:  I buy shoes and I pay for them or go barefoot until I do.  If I want medical treatment and have no insurance, I have to balance my need against my other priorities (like shoes),  remembering that the costs are enough to make most people gasp.  If I want medical treatment and have insurance, I get the treatment and it may be six months before the last dollar comes to the "provider", and the payment may not have much to do with the charge.  We have turned our health care over to the hands of money managers:  people with training and mandates to make as much money as possible.  Of course this is an  insane system.                                Joanne Holland DVM/MDTalk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

I think that I started just about the same time that you did. When you say break even do you mean on current expenses or are you including start up expenses. I have been taking home some salary for about 1 year but I still have a startup loan that its going to take a long time to pay off.Larry Lindeman MDRE startup growth and curves. I like the analysis.. 17 months in, just about expense break-even; second phase of growth starting now-- just about time!! Sweating it.... Dr Matt Levineast of PittsburghGoal of 30-40 pts a week, getting there.Solo since Dec 2004In hospital practice from June 1996-July 2004Residency completed in 1988 Re: Ebb and flow of demand by seasonFrom the old doc in Drain, Oregon,          About the problems breaking even, and having a variation of the number of patients you see by hour, day, week and season:       Remember, most of our practices are new.  There is a several year start up curve, that takes between two and five years to get your practice to the point it will grow to.  You will grow quickly to start with, assuming you started in the right place and have something people want.  Then at maybe six months, the curve slows down but contiinues to go up over the next two to four years.  You practice the way you want to, and the practice itself "calls out" the kind of patient that likes that practice style.  If you change systems, you will "call out" a different type of patient and some of the ones that liked it the way it was will leave.     It is asking a lot to have a solo practice make us the entire amount we would want to have in the long run,  after a few weeks or months of work.  This is small business, and by definition that makes it risky.  If you want total security, you have to work for someone else and take their systems.  The low overhead thing is what this group is doing different,  that makes solo practice possible.  The massive delay in insurance and medicare payments makes it much more difficult.        Skip this if you don't like to see someone on a soap box:     Most small businesses have immediate feedback:  I buy shoes and I pay for them or go barefoot until I do.  If I want medical treatment and have no insurance, I have to balance my need against my other priorities (like shoes),  remembering that the costs are enough to make most people gasp.  If I want medical treatment and have insurance, I get the treatment and it may be six months before the last dollar comes to the "provider", and the payment may not have much to do with the charge.  We have turned our health care over to the hands of money managers:  people with training and mandates to make as much money as possible.  Of course this is an  insane system.                                Joanne Holland DVM/MDTalk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

I think that I started just about the same time that you did. When you say break even do you mean on current expenses or are you including start up expenses. I have been taking home some salary for about 1 year but I still have a startup loan that its going to take a long time to pay off.Larry Lindeman MDRE startup growth and curves. I like the analysis.. 17 months in, just about expense break-even; second phase of growth starting now-- just about time!! Sweating it.... Dr Matt Levineast of PittsburghGoal of 30-40 pts a week, getting there.Solo since Dec 2004In hospital practice from June 1996-July 2004Residency completed in 1988 Re: Ebb and flow of demand by seasonFrom the old doc in Drain, Oregon,          About the problems breaking even, and having a variation of the number of patients you see by hour, day, week and season:       Remember, most of our practices are new.  There is a several year start up curve, that takes between two and five years to get your practice to the point it will grow to.  You will grow quickly to start with, assuming you started in the right place and have something people want.  Then at maybe six months, the curve slows down but contiinues to go up over the next two to four years.  You practice the way you want to, and the practice itself "calls out" the kind of patient that likes that practice style.  If you change systems, you will "call out" a different type of patient and some of the ones that liked it the way it was will leave.     It is asking a lot to have a solo practice make us the entire amount we would want to have in the long run,  after a few weeks or months of work.  This is small business, and by definition that makes it risky.  If you want total security, you have to work for someone else and take their systems.  The low overhead thing is what this group is doing different,  that makes solo practice possible.  The massive delay in insurance and medicare payments makes it much more difficult.        Skip this if you don't like to see someone on a soap box:     Most small businesses have immediate feedback:  I buy shoes and I pay for them or go barefoot until I do.  If I want medical treatment and have no insurance, I have to balance my need against my other priorities (like shoes),  remembering that the costs are enough to make most people gasp.  If I want medical treatment and have insurance, I get the treatment and it may be six months before the last dollar comes to the "provider", and the payment may not have much to do with the charge.  We have turned our health care over to the hands of money managers:  people with training and mandates to make as much money as possible.  Of course this is an  insane system.                                Joanne Holland DVM/MDTalk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.