Re: Re: learning, the hard way

[Guest guest]

gee, who was that? i'd like to know are there other IMP's/thinking about being IMP's in the area? i know there's dennis in gig harbor, and gwen in bellevue, and cindy in maple valley, are there others in the tacoma, gig harbor, olympia, kitsap peninsula, olympic peninsula area? if there are, even lurkers and residents just interested and testing the water, please give me a call. i'd like to meet and see who's doing what and how. larry lyon office cell mllaumans wrote: Yes, Larry, there are some docs reaching out to residencies. In fact,we had one physician give a talk at a residency around the corner fromyou - in Olympia, WA.I am a third year family medicine resident and absolutely thrilled bythe idea of starting my own practice as an IMP. Maybe I am just mad.I have several other colleagues that would like to start their ownIMP, too, but their medical school loans do not allow them to beindependent yet.Marius

Cheap Talk? Check out Yahoo! Messenger's low PC-to-Phone call rates.

[Guest guest]

Along the lines of residency education. I have been asked to speak at 2

local residency programs with regards to practice management. (Mostly

because of my participation as a TransforMed practice.) If anyone has done

a presentation already at a program, and could share their lecture format

and/or notes, it would really be helpful to me.

I have been learning a lot from the list-serve and want to thank everyone

for their participation.

Ramona

Re: learning, the hard way

Dear Larry,

RJ and I have been plugging the residents from our local program

(Stanislaus Family Practice Residency Program) in Modesto. We connect

with them as I have been directing the Skin Disorders Clinic for the

past 2-3 years. We have had residents come over for the day, and a

few have come as an elective rotation (2-4 weeks). Most of the time

they have hung out with just one doc at a time, so it would be much

the same as your " solo-solo " experience.

Last year I gave a talk disguised as " The Future of Family Medicine "

which is basically a bald-faced plug for IMPing. I am preparing a

repeat performance this fall.

I also gave a talk at the recent Catholic Medical Association

national meeting in Boston last week on the St. Luke's-Robin Hood

thing, which devoted a significant portion of the time to explaining

what IMP's are and why they are the way of the future.

Interestingly, while in Boston I met up with an acquaintence Rushika

Fenandopulle who was at the AAFP meetings in San Francisco last year.

Perhaps some of you met him? He went to many IMP talks. He

said, " Bob, I have this fascinating guy speaking at the Ether Dome

(site of the first anesthetized surgery) at four o'clock. He is right

up our alley. I think you will really enjoy it. " Any guesses? No, not

Gordon.... It was Wasson! Small world.

Anyway, Rushika is a MGH clinical faculty and all 'round fascinating

guy who is also very interested in care to the uninsured. He created

his own IMPish practice as a test laboratory for his theories.

Unfortunately, the Boston HMO's and hospitals shut down his

additional $40 per month experiemental payment plan for great

service. But he is doing three pilot IMP practices for Boeing in

Washington, and also consulting for a similar project with low income

casino workers in Las Vegas and Atlantic City. Really cool stuff.

What an idea -- pay more for great primary care and see if costs and

outcomes improve.... Gaaasp, could Barbara Starfield be right???

Bob

> I just want to thank everyone for the input. I think I

may move

> forward with a contract lawyer and see how it goes from there.

> Things I need an opinion from thos more experienced so I may sleep

> better at night...

> 1. given that my practice will be very close to the new hospital I

> will be able to send virtually all pts to their rad/lab for tests

> and could limit my initial overhead. On the other hand I want to

> provide as much for my pts as I can. I know I can grow a limited

lab

> in my office but not sure what I should start with. Coming from

> residency, I have no clue what lab services are financially

feasible

> and what are not. There are lots of new " minimalist " lab equipment

> from very small machines, to just fancy clia waived dip tests for

> all kinds of things. Can you guys help me come up with a start up

> plan for this stuff?

> 2. Not quite the micro practice, but here is my theoretical startup

> plan. Start-up with eMDs and an office " manager " type person (a

good

> friend of mine who I can trust, is an accountant and can be very

> flexible with $/time and willing to learn) to help with phones,

> billing, pt check in, etc. And a medical assistant. With clear cut

> job descriptions that everybody does everything as it needs done.

> Does that sound good or like too much?

> 3. As someone mentioned before, I will have to take all insurance

> plans/payors that the hospital takes " within reason. " But the town

> has a good payor mix. Near Dallas, ~50% of the working pop commutes

> to work in the city. The other half works in the many large

> corporations that are located in/just outside the city. City is

> growing quickly and has a good portion of young working people.

This

> is the good thing about the whole area around the DFW metroplex..it

> is growing rapidly and there are alot of workers making it do so.

> Now the whole billing/collecting process is where I know I will

> likely be burned and learn the hard way...but I will do my best to

> plan for that. The medical office consultant is actually to help me

> to negotiate insurance contracts...I can use them as needed. This

> may sound like a waste to you, but since I really don't have

working

> experience with this I would rather invest in getting the help to

> try to do this right, esp since it will be paid for as part of

> my " loan " to be paid of with time in the town. (4 yrs after

> guarantee yr). I feel like I should take advantage of this help.

>

> ..have much more to ask, but just got a page...gotta go round on

> some cardiology patients! Have a good Sunday. God bless you

> all! ...and keep the opinions/thoughts coming.

>

>

>

>

>

>

> ---------------------------------

> We have the perfect Group for you. Check out the handy changes to

Yahoo! Groups.

>