RE: Re: thinking out loud...

[Guest guest]

Greg,

It sounds like you have thought it through somewhat.  We are in a " high rent district " and our overhead, which includes payroll and payroll taxes for 1.5 employees, rent, EMR, supplies, etc, runs about $12K/month.  We are moving this summer and will lop off at least $2K/mo in rent.  Without employees, we would save another $3K.  But the balancing act between no employees vs 1 employee would lower income (can't see as many patients if the MD is doing referrals, phone calls, etc).   Malpractice and other insurance may be higher/lower where you are, also.

 

The question remains how can you survive until you're ready to plunge into IMP-dom?  Firing patients doesn't sound like an option for you.  I would really look at workflow and schedule.  Block more space on your schedule so that the patients even out back to a more manageable pace for you and so you can get in urgent care stuff same day.  Quit managing a wait list.  Patients get what appointment is " next available " unless it is for urgent care.  A la my OB/gyn office, " No, I'm sorry, we don't keep a wait list because as soon as someone cancels, it is usually taken by the next caller as the next available. "   But I do know that she blocks a certain amount each day for urgent stuff because when she had to reschedule my annual exam due to an OB emergency, I got an appointment 1 week later (initially had to wait 2 months because I want to see the MD and not the PA).  In our office, the rule of thumb is to get the patient into the office in half the amount of time that they complain of symptoms unless they specifically request something otherwise (i.e., if they have been sick for 2 weeks, we try to get them in within 1 week).  Sometimes the patient starts to feel better and they cancel, opening up more urgent care slots for patients that really have urgent needs.

 

It blows me away that people still think that MA is a model of a functioning system, where everyone has health care.  From what I see across the country, it is not working - for the docs or the patients.

 

Good luck!

 

 

No.Not sure about local zoning.But the spousal zoning codes would disallow it.Greg > > >> > > Why u want to pay 60k for rent?

> > > 1 room ony? How many paper towels you are> > > Gonna use?> > > > > > Adolfo E. Teran, MD> > > > > > > > > > > >

> > > > -- > > > > > > > > MD> > > > > > ph fax

> > > >>

-- Pratt

[Guest guest]

Greg Hinson,Long time no hear. Remember Dr. Stiff? (And don’t worry, Falball is not on this listserv). I thought you were crazy busy back then. It sounds like your island needs more providers. You have a shortage. I don’t know if you can get anyone to hire more. As far as your numbers, it seems correct. Simple. I don’t know what MA rules are but you need to check with the insurance commissioner that this isn’t considered an insurance plan. And Michele summarized the complexities of being out of network. I guess you don’t deliver babies anymore. You sound busy enough that you could capture enough patients with the cash only. But, you will need to make arrangements for coverage, etc if you take vacation. We had a doctor down here, part of a huge group, went Concierge but stayed in the group. His group covers him weekends and vacations. None of them do their own hospital work, it all goes to hospitalists. Last I talked to him he said it’s going well. I am quite sure he has to pay his group something for the coverage and it really isn’t reciprocated. He does do one Saturday a month in their Urgent Care I think. If you find your overhead is more than expected, you can always adjust your fees or your panel size. I take it there are no concierge doctors already on the island? It’s best to be first in line on this one. Glad to hear you are alive and well albeit overwhelmed. Good luck with this. Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of gregandamyhinsonSent: Wednesday, February 08, 2012 1:43 PMTo: Subject: Re: thinking out loud... No.Not sure about local zoning.But the spousal zoning codes would disallow it.Greg> > >> > > Why u want to pay 60k for rent?> > > 1 room ony? How many paper towels you are> > > Gonna use?> > > > > > Adolfo E. Teran, MD> > > > > > > > > > > > > > > > -- > > > > > > > > MD> > > > > > ph fax > > > >>