My practice model- waht do you think?

[Guest guest]

I have been reading the posts about how others have set up their IMP. I am hoping to have my practice up and running some time this later this summer ( I was hoping to be working already...but everything takes a little longer and it adds up to months). I have requested PPO insurance contracts. Blue Cross was the first to arrive and I can't sign it. Its not what I imagined myself doing. Signing a Big business contract which is a unilateral, non negotiable, restricting me to their rules is counter intuitive. So I am going to be out of network (interestingly, I was talking to a local chiropractor, she says when she was in school, they told her never be in network, do cash only...we should have that in Med school...).

So here' what is happening in my local area- the same as Seto's. One large int med group in town is now charging $2000 membership fee and also cash only. Hence many people are now w/o a primary care doctor (good for me when I finally start up). I came across an ad where this FP charges $800 per year, no co pay, he takes no insurance, but insists his pt have insurance. His hours on his web site are M-F 9-1pm, does not vaccines, no inpts. Lucky the local hospital has 3 hopitalist gps we can refer to. I also decided it was not worth applying for hospital privileges, just to apply they want $600.

So I was thinking I would charge $800 pp per year (they must carry insurance, too stressful to worry about pts who has something major and refuses to get more work up because they can't afford it- been in that situation before and it was needless stress), limited to 20 visits or so, shots, meds, extra costs. I finished my acupuncture training so I can charge extra for that of say $30 per visit on top of the $800. Local non MD AP charge $60-80, more for the first visit. Since I don't take medicare, $800 is not so much for a pt >65 to pay out of pocket. For non members hourly rate of $200, 30 mins 125, 15-20 mins $70. Our local CVS has minute clinics, run by NP or PA's charge about $69 per visit. There are 2 clinic of this sort near me.

I would limit my panel to 200-300 pts. Take 4 wks vacation, 2 wks CME.

Use Paypal to do my credit cards. Looking for Emr that can be remotely available. I am told one can make Amazing charts remotely available.

So I already have several pts from my old practice who have PPO's. already told me that this is too expensive. I suppose I have to hold my ground (I do have the tendency to give thinks out for free) and tell these pts if they pay cash, some of it will be reimbursed. Their co pays are $40, so $70 is not that much more.

I also plan to teach one day and have a portion of that days $ (details I have not worked out yet) go to a local homeless shelter. BYW malpractice insurance here in LA is reduced by 75%!?What do people think of my plan? You are all have more experience than me. Appreciate any comments. I definitely need encouragement, its like jumping into some deep dark pool of water

-- see you at IMP camp.

You go through this life but once, so go in the directions of your dreams, live the life you imagined. M.D.www.elainemd.com