Guest guest Posted February 8, 2012 Report Share Posted February 8, 2012 Some docs in the list have 1 room office sharingLobby.Adolfo E. Teran, MD What if... Micropractice. Single exam room. No other employee. Direct pay; no insurance. HelloHealth model. Membership (either yearly or monthly, family rate) and price this to include the typical access (cell, after-hours, email), PLUS, a yearly MDVIP-like wellness visit, AND ER consults AND Inpatient care. (We don't have hospitalists and any hospital visit would involve impersonal care by one of the other PCPs or the ER PAs.) Then charge a reasonable rate for visits, and a lower one for virtual visits. What if the rates were $400 indiv membership, $600 family membership. And the virtual visits were $25 and the office visits were $60? If I then signed up 400 people/families and generated $200K in membership fees, and saw 30 visits per week for an extra $70K. Then if I paid $10K in malpractice and $60K in rent and supplies. Final take home of $200K. Help me here. Where am I being naive? What am I missing? = Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2012 Report Share Posted February 8, 2012 Why u want to pay 60k for rent?1 room ony? How many paper towels you areGonna use?Adolfo E. Teran, MD What if... Micropractice. Single exam room. No other employee. Direct pay; no insurance. HelloHealth model. Membership (either yearly or monthly, family rate) and price this to include the typical access (cell, after-hours, email), PLUS, a yearly MDVIP-like wellness visit, AND ER consults AND Inpatient care. (We don't have hospitalists and any hospital visit would involve impersonal care by one of the other PCPs or the ER PAs.) Then charge a reasonable rate for visits, and a lower one for virtual visits. What if the rates were $400 indiv membership, $600 family membership. And the virtual visits were $25 and the office visits were $60? If I then signed up 400 people/families and generated $200K in membership fees, and saw 30 visits per week for an extra $70K. Then if I paid $10K in malpractice and $60K in rent and supplies. Final take home of $200K. Help me here. Where am I being naive? What am I missing? = Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2012 Report Share Posted February 8, 2012 LOTS of paper towels! I just grabbed a big number to be conservative. Have not shopped for rooms to even know what is available. Also, I needed that overhead number to represent other hidden costs, e.g., utilities, EMR fees, billing fees, etc. G > > Why u want to pay 60k for rent? > 1 room ony? How many paper towels you are > Gonna use? > > Adolfo E. Teran, MD > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2012 Report Share Posted February 9, 2012 Kathy! Wow. Haven't thought about DrStiff and Alan in quite awhile! I wonder how he is doing. I do still have a fairly busy obstetrics practice. But. I recognize that it might be time to give it up to make all of this work. G > > 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. > I guess you don't deliver babies anymore. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2012 Report Share Posted February 9, 2012 I could easily survive on $400 per patient per year, without charging for visits (would just have to figure out the regulation-as-insurance issue). The only real question is whether there are 400 people willing to sign up. It's tough to figure out. Even a survey wouldn't tell you the real answer. But if you have 2500 loyal patients, it's at least possible. For me, 30 visits a week without any help is a lot (but I take insurance). But 500 patients will probably bring closer to 20 established-patient visits per week. Haresch www.onefamilydoctor.com > > What if... > > Micropractice. Single exam room. No other employee. Direct pay; no insurance. > > HelloHealth model. Membership (either yearly or monthly, family rate) and price this to include the typical access (cell, after-hours, email), PLUS, a yearly MDVIP-like wellness visit, AND ER consults AND Inpatient care. (We don't have hospitalists and any hospital visit would involve impersonal care by one of the other PCPs or the ER PAs.) Then charge a reasonable rate for visits, and a lower one for virtual visits. > > What if the rates were $400 indiv membership, $600 family membership. And the virtual visits were $25 and the office visits were $60? > > If I then signed up 400 people/families and generated $200K in membership fees, and saw 30 visits per week for an extra $70K. > > Then if I paid $10K in malpractice and $60K in rent and supplies. > > Final take home of $200K. > > Help me here. Where am I being naive? What am I missing? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2012 Report Share Posted February 9, 2012 Thanks Sharon for all of the thoughtful advice! I had forgotten about the Venus. Love to know it is framed. Photography and graphic design is my hobby and, as physician burnout has started to smolder, it has progressed to even a PT job, as I now show in local galleries. A few thoughts about below. Thoughtful shaping of the payor mix is important to me. I do do obstetrics, and will likely give this up, but because of this, I take care of a lot of young families. This made me think of a family rate. But I have even considered a " kids under 18 are free " policy, seeing that they usually result in more and easier visits. I am concerned about the HMO problem. Like said, I do not want to add undo burden to my local colleagues (ESP. After getting off the ferris wheel and leaving the remaining 3 with even larger patient panels). A symptom of how bad it is right now, last Friday, I was seeing an HMO patient for abdominal pain, wanted to get an abdominal CT, space avail right away in radiology, and had the insurance on hold for approval and was told that approval would take two hours, or maybe until Monday. So what did we do? We sent the patient to th ER where it could be done without such approval! And yet, the HMO products are growing here. High deductible, state and commercial HMO's are how we have complied with Romneycare. Regarding seasonal memberships, I think I would offer them, but without the discount. Our seasonal visitors would not blink at the amounts involved. In fact, going into a summer is going to be my best option, I believe. I'm considering the option of doubling as an urgent care center. Walkin clinic. Post info about the membership and member rates, as well as rates that are doubled, per visit, for non-members. In the summer, if the word is out, it will likely be pretty easy to fill with walk-in's. Regarding HelloHealth, I have a conf call with them this morning. At least their website leads me to believe that they are alive and well. New version just released this month, advertising 10,000 physician users, and Meaningful Use certification. I'll report back on what I learned. Greg > > > > > > What if... > > > > > > Micropractice. Single exam room. No other employee. Direct pay; no > > insurance. > > > > > > HelloHealth model. Membership (either yearly or monthly, family rate) > > and price this to include the typical access (cell, after-hours, email), > > PLUS, a yearly MDVIP-like wellness visit, AND ER consults AND Inpatient > > care. (We don't have hospitalists and any hospital visit would involve > > impersonal care by one of the other PCPs or the ER PAs.) Then charge a > > reasonable rate for visits, and a lower one for virtual visits. > > > > > > What if the rates were $400 indiv membership, $600 family membership. > > And the virtual visits were $25 and the office visits were $60? > > > > > > If I then signed up 400 people/families and generated $200K in > > membership fees, and saw 30 visits per week for an extra $70K. > > > > > > Then if I paid $10K in malpractice and $60K in rent and supplies. > > > > > > Final take home of $200K. > > > > > > Help me here. Where am I being naive? What am I missing? > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2012 Report Share Posted February 9, 2012 I am in Nantucket, MA. I have a website that used to be my practice website, was no longer needed when I became employed by Mass General, and now is my photography website. www.ackdoc.com The island is beautiful, is the inspiration for my art, and the reason (along with the people here) why I put up with the crazy medical environment. Greg > > Greg where are you? small place? > I love photography too, I am a wanna be. > take care, adolfo Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2012 Report Share Posted February 9, 2012 Greg,Welcome back! When I was getting my practice started back in 2004, I remember visiting your website and "borrowing" many practice forms and templates that you graciously posted. They were a big help in starting my micropractice, and I'm sure they helped many others as well. Good luck in your reboot. SetoSouth Pasadena, CA I am in Nantucket, MA. I have a website that used to be my practice website, was no longer needed when I became employed by Mass General, and now is my photography website. www.ackdoc.com The island is beautiful, is the inspiration for my art, and the reason (along with the people here) why I put up with the crazy medical environment. Greg > > Greg where are you? small place? > I love photography too, I am a wanna be. > take care, adolfo Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2012 Report Share Posted February 9, 2012 Access to Primary Care is awful here. I was just looking at stats. The US averages 90 active PCPs/100000. Massachusetts has 129/100,000 (and there is crying statewide about the lack of access). My country has 50/100,000 in the winter and 5/100,000 in the summer!!! But there are really only two large employers. The town and the hospital (I would be leaving). So I don't think there is a role for tacking the service on to one or a few large employers. > > Greg, > How is access to primary care in your area? Is there a group such as business > owners who would apy a fee to have eas of access created by virtual visits, > email consults and same day/next day access. Could this be a niche to create > inside your current practice?? > Musings.... > Dannielle Harwood, MD > www.MyStudioMD.com > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2012 Report Share Posted February 9, 2012 This is how things are with my current practice. I recognize the headache! And this is why this is one of my biggest concerns with the model I am thinking about. > > > > If I am a network PCP and someone who is charging some hundreds of dollars > /family/yr, called me and said could you order this XYZ, exactly what > do you think I should do ? > do it for free? > Are docs treating each other exactly like we complain the insurances are? > Please be mindful > Jean > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 9, 2012 Report Share Posted February 9, 2012 This is our local skating club. Nantucket Ice. It's a relatively new program, but it is growing quickly and my youngest son and daughter are both heavily involved. In that same gallery, there are several pictures of my son Maddux, then 5 years of age, in his Pairs skate with Dorothy Hamill (an island resident) !!! Greg > > > > Greg where are you? small place? > > I love photography too, I am a wanna be. > > take care, adolfo > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2012 Report Share Posted February 10, 2012 Adolfo, you are absolutely right. 8 years ago, I loved problem solving my practice. Invested all of my free thoughts back into my work. Now my passions lie elsewhere, and this just compounds practice dissatisfaction. You are so right. > > > ** > > > > > > I hope Greg find his path ( his Santiago de Compostela). > > I think the trick is finding ur passion again. > > > > > > Adolfo E. Teran, MD > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2012 Report Share Posted February 10, 2012 Sharon I have exactly that relationship with two docs who serve as HMO referral docs for my patients. They only need a meet n greet once a year to keep up with HMO chart reviews. Steve Horvitz stown , NJ Founder of the Institute for Medical Wellness > >>>>> > > >>>>> > What if... > >>>>> > > >>>>> > Micropractice. Single exam room. No other employee. Direct pay; no > >>>>> insurance. > >>>>> > > >>>>> > HelloHealth model. Membership (either yearly or monthly, family > >>>>> rate) and price this to include the typical access (cell, after-hours, > >>>>> email), PLUS, a yearly MDVIP-like wellness visit, AND ER consults AND > >>>>> Inpatient care. (We don't have hospitalists and any hospital visit would > >>>>> involve impersonal care by one of the other PCPs or the ER PAs.) Then > >>>>> charge a reasonable rate for visits, and a lower one for virtual visits. > >>>>> > > >>>>> > What if the rates were $400 indiv membership, $600 family > >>>>> membership. And the virtual visits were $25 and the office visits were $60? > >>>>> > > >>>>> > If I then signed up 400 people/families and generated $200K in > >>>>> membership fees, and saw 30 visits per week for an extra $70K. > >>>>> > > >>>>> > Then if I paid $10K in malpractice and $60K in rent and supplies. > >>>>> > > >>>>> > Final take home of $200K. > >>>>> > > >>>>> > Help me here. Where am I being naive? What am I missing? > >>>>> > > >>>>> > >>>>> > >>>> > >>> > >> > > > > > > -- > > > > > > > > MD > > > > > > ph fax > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 11, 2012 Report Share Posted February 11, 2012 Deb One doc I helped when he started his practice about ten years ago. We have covered for each other for vacas since. It was an easy request. The other is a member of my synagogue, a solo doc, and one of the officers of our county medical society. All I had to do was ask, Steve stown, NJ > > > >>>>> > > > > >>>>> > What if... > > > >>>>> > > > > >>>>> > Micropractice. Single exam room. No other employee. Direct pay; > > no > > > >>>>> insurance. > > > >>>>> > > > > >>>>> > HelloHealth model. Membership (either yearly or monthly, family > > > >>>>> rate) and price this to include the typical access (cell, > > after-hours, > > > >>>>> email), PLUS, a yearly MDVIP-like wellness visit, AND ER consults > > AND > > > >>>>> Inpatient care. (We don't have hospitalists and any hospital visit > > would > > > >>>>> involve impersonal care by one of the other PCPs or the ER PAs.) > > Then > > > >>>>> charge a reasonable rate for visits, and a lower one for virtual > > visits. > > > >>>>> > > > > >>>>> > What if the rates were $400 indiv membership, $600 family > > > >>>>> membership. And the virtual visits were $25 and the office visits > > were $60? > > > >>>>> > > > > >>>>> > If I then signed up 400 people/families and generated $200K in > > > >>>>> membership fees, and saw 30 visits per week for an extra $70K. > > > >>>>> > > > > >>>>> > Then if I paid $10K in malpractice and $60K in rent and supplies. > > > >>>>> > > > > >>>>> > Final take home of $200K. > > > >>>>> > > > > >>>>> > Help me here. Where am I being naive? What am I missing? > > > >>>>> > > > > >>>>> > > > >>>>> > > > >>>> > > > >>> > > > >> > > > > > > > > > > > > -- > > > > > > > > > > > > > > > > MD > > > > > > > > > > > > ph fax > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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