Re: Re: Don't jump. Take the right steps at the right time for you.

[Guest guest]

Crystal,

You will want to get a good handle on your bills personally somewhere between 28-36% of your gross income. Closer to 28% makes cashflow easier. Also, you will really need to keep your overhead low unless you have an established patient population.

Know where and how you will land when you jump ship.

Even though our overhead rus 25-35% of revenue it takes about 2 years to get there. You will have more control over your schedule, but you will always be on call to your patients.

It can be done. If you are paying overhead of $20,000 per month your seeing a lot of patients. Our revenue per month is about that +/- 10% in any given average month, but there can be wild swings so managing cashflow is always on the radar.

Good luck and be careful. EstABLISH A PROFORMA FOR AT LEAST THE FIRST 2-3 YEARS IN PRACTICE.

Subject: Re: Wanting to leap but scared to jump...To: Date: Monday, January 30, 2012, 5:20 PM

Mortgage, student loans (me and my non-physician husband), credit cards, car payments... Granted, we are paying them down but I would almost certainly have to take a loan to finance start up costs... Has anyone gotten loans through SBA to start an IMP?> > > > Subject: Wanting to leap but scared to jump...> To: > Date: Monday, January 30, 2012, 3:02 PM> > > > Â > > > > I've been in communication with A. but new to the group...6 months into my first "real" job out of training now (Family Medicine/Sports Medicine) and ready to slit my wrist, throat, any major vessel... I'm in an employed position with a hospital organization with a religious (and very admirable) mission and with actually very likable people but it is so dysfunctional and so poorly run that I think that surely I can do it better myself... They can't even tell me what insurances I'm contracted with ("well we accept them all") or what the contract rates are ("it's about 50%") or what my panel size is...The EMR

that has been chosen for me (and that I pay nearly $800/mo in licensing fees for) probably has potential if all templates/customization didn't have to go before a committee somewhere in FL (I'm in TN)--don't even get me started on that. My overhead for the month of December as part of a 9 provider group was over $20k! It takes me longer to do my> notes on EMR than it ever did on paper and I am a self-confessed techie. I have been working 14 hr days and my poor toddler slams my laptop shut when I'm trying to work at home and says "Mommy put it away" which makes me feel about 2 inches tall. My home life is non-existent. There's got to be something better. I wholeheartedly believe in IMPs and have read all of Gordon's articles, have joined the official IMP site and have read the whole wiki but after reading some of the posts in this group about folks who are struggling, I'm worried about making the leap--I've got a lot of bills to pay and can't

afford to go under. It's not just a dream , right??? If all were to go well, I would be looking at opening in about 6-12 months...> > Looking for reassurance!> > Crystal in TN>

[Guest guest]

Crystal,I agree totally with . Emotionally, the urge is to jump now, but you have to be very cautious if you have other loans. The last thing you want to do is face personal financial ruin and try and run a new practice. If you haven’t seen my business plan, I have posted it on my website at www.thevillagedr.com (click on Practice Management). I have not updated it in a while, but the numbers are the actual numbers I had when I started my practice and can give you a baseline. If you have any questions or problems, e-mail me off list.In the meantime, you are working too hard. You have to talk to your employer and tell them how you feel entirely burned out and that you cannot possibly maintain this pace. Take a salary cut. Consider working somewhere else. Pay off your loans. Plan and dream about your IMP so that when the time is right, you can successfully make the leap. From: [mailto: ] On Behalf Of EglySent: Monday, January 30, 2012 7:55 PMTo: Subject: Re: Re: Don't jump. Take the right steps at the right time for you. Crystal, You will want to get a good handle on your bills personally somewhere between 28-36% of your gross income. Closer to 28% makes cashflow easier. Also, you will really need to keep your overhead low unless you have an established patient population. Know where and how you will land when you jump ship. Even though our overhead rus 25-35% of revenue it takes about 2 years to get there. You will have more control over your schedule, but you will always be on call to your patients. It can be done. If you are paying overhead of $20,000 per month your seeing a lot of patients. Our revenue per month is about that +/- 10% in any given average month, but there can be wild swings so managing cashflow is always on the radar. Good luck and be careful. EstABLISH A PROFORMA FOR AT LEAST THE FIRST 2-3 YEARS IN PRACTICE. Subject: Re: Wanting to leap but scared to jump...To: Date: Monday, January 30, 2012, 5:20 PM Mortgage, student loans (me and my non-physician husband), credit cards, car payments... Granted, we are paying them down but I would almost certainly have to take a loan to finance start up costs... Has anyone gotten loans through SBA to start an IMP?> > > > Subject: Wanting to leap but scared to jump...> To: > Date: Monday, January 30, 2012, 3:02 PM> > > > Â > > > > I've been in communication with A. but new to the group...6 months into my first " real " job out of training now (Family Medicine/Sports Medicine) and ready to slit my wrist, throat, any major vessel... I'm in an employed position with a hospital organization with a religious (and very admirable) mission and with actually very likable people but it is so dysfunctional and so poorly run that I think that surely I can do it better myself... They can't even tell me what insurances I'm contracted with ( " well we accept them all " ) or what the contract rates are ( " it's about 50% " ) or what my panel size is...The EMR that has been chosen for me (and that I pay nearly $800/mo in licensing fees for) probably has potential if all templates/customization didn't have to go before a committee somewhere in FL (I'm in TN)--don't even get me started on that. My overhead for the month of December as part of a 9 provider group was over $20k! It takes me longer to do my> notes on EMR than it ever did on paper and I am a self-confessed techie. I have been working 14 hr days and my poor toddler slams my laptop shut when I'm trying to work at home and says " Mommy put it away " which makes me feel about 2 inches tall. My home life is non-existent. There's got to be something better. I wholeheartedly believe in IMPs and have read all of Gordon's articles, have joined the official IMP site and have read the whole wiki but after reading some of the posts in this group about folks who are struggling, I'm worried about making the leap--I've got a lot of bills to pay and can't afford to go under. It's not just a dream , right??? If all were to go well, I would be looking at opening in about 6-12 months...> > Looking for reassurance!> > Crystal in TN>

[Guest guest]

She may not be able  to leave. They have paid her bank  alot ofmoney to pay off her loans and she may be stuck for a little while

  i told her to find a lawyer/medcial assocaiton to find out how to get out of her contract

It sounds messy.

she worries me

Ideas?

Jean

 

In the meantime, you are working too hard. You have to talk to your employer and tell them how you feel entirely burned out and that you cannot possibly maintain this pace. Take a salary cut. Consider working somewhere else. Pay off your loans. Plan and dream about your IMP so that when the time is right, you can successfully make the leap.

 

From: [mailto: ] On Behalf Of Egly

Sent: Monday, January 30, 2012 7:55 PMTo: Subject: Re: Re: Don't jump. Take the right steps at the right time for you.

 

 

Crystal,

 

You will want to get a good handle on your bills personally somewhere between 28-36% of your gross income.  Closer to 28% makes cashflow easier.  Also, you will really need to keep your overhead low unless you have an established patient population. 

 

Know where and how you will land when you jump ship. 

 

Even though our overhead rus 25-35% of revenue it takes about 2 years to get there.  You will have more control over your schedule, but you will always be on call to your patients. 

 

It can be done.  If you are paying overhead of $20,000 per month your seeing a lot of patients. Our revenue per month is about that +/- 10% in any given average month, but there can be wild swings so managing cashflow is always on the radar. 

 

Good luck and be careful. EstABLISH A PROFORMA FOR AT LEAST THE FIRST 2-3 YEARS IN PRACTICE.

 

Subject: Re: Wanting to leap but scared to jump...To:

Date: Monday, January 30, 2012, 5:20 PM

 

Mortgage, student loans (me and my non-physician husband), credit cards, car payments... Granted, we are paying them down but I would almost certainly have to take a loan to finance start up costs... Has anyone gotten loans through SBA to start an IMP?

> > >

> Subject: Wanting to leap but scared to jump...> To:

> Date: Monday, January 30, 2012, 3:02 PM> > > >   > > > > I've been in communication with A. but new to the group...6 months into my first " real " job out of training now (Family Medicine/Sports Medicine) and ready to slit my wrist, throat, any major vessel... I'm in an employed position with a hospital organization with a religious (and very admirable) mission and with actually very likable people but it is so dysfunctional and so poorly run that I think that surely I can do it better myself... They can't even tell me what insurances I'm contracted with ( " well we accept them all " ) or what the contract rates are ( " it's about 50% " ) or what my panel size is...The EMR that has been chosen for me (and that I pay nearly $800/mo in licensing fees for) probably has potential if all templates/customization didn't have to go before a committee somewhere in FL (I'm in TN)--don't even get me started on that. My overhead for the month of December as part of a 9 provider group was over $20k! It takes me longer to do my

> notes on EMR than it ever did on paper and I am a self-confessed techie. I have been working 14 hr days and my poor toddler slams my laptop shut when I'm trying to work at home and says " Mommy put it away " which makes me feel about 2 inches tall. My home life is non-existent. There's got to be something better. I wholeheartedly believe in IMPs and have read all of Gordon's articles, have joined the official IMP site and have read the whole wiki but after reading some of the posts in this group about folks who are struggling, I'm worried about making the leap--I've got a lot of bills to pay and can't afford to go under. It's not just a dream , right??? If all were to go well, I would be looking at opening in about 6-12 months...

> > Looking for reassurance!> > Crystal in TN>

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