Guest guest Posted September 23, 2004 Report Share Posted September 23, 2004 Excellent case study! Where are you located? Care to break the overhead down (i.e. explore the components)? If the space is your millstone, consider getting someone to sub-lease. I've found that there are more and more docs locally looking to take the leap and would love to practice in the same space, I'm wondering about setting up a larger place for a bunch of us. Gordon At 10:21 AM 9/23/2004, you wrote: I have just discovered this group and I am very glad to see that I am not alone. I have just spent the last three days going through all the old posts and I am more assured that I am on the right road. I started my solo practice in July of 2003. I had read Gordon's articles in FPM and I knew he was on to something. I left residency in 2001 and started with a 23 physician multispecialty group. I soon learned that, like in " Animal Farm " , all the animals are equal, but some are more equal then others. I was appalled by the out of control overhead of the practice, and the fact that I had no control over it, even though I was responsible for paying it (through a hospital guarantee, of course). After one year, I worked for an urgent care facility for 8 months, but when the hospital that owned it decided to play musical chairs and close some practices and shuffle the docs, I found myself soon to be without a job. That is when I started to consider Gordon's model more seriously. I was able to go from concept to opening the doors of the practice in three months. I lease an office 1755 sq ft which has two exam rooms, an office for me, reception area and waiting room. It is a wonderful office, but large for the model. It certainly is the largest source of my overhead. I chose it because of limited time to put this practice together, location, and because it had previously been a physician's office and was already built out perfectly. I have one employee, an MA who acts as my right arm. I have been completely paperless from the begininng. I use soapware for EMR which runs on a SQL database and medisoft for the practice management software. I have a central server which houses all the data. The server has three hard drives with RAID-5 stripping to back up data should one HD go out. I also back up all data to a DVT-4 tape every night, automatically using Veritas Back-up Exec. I built three computers for the practice myself. Initially, I tried a wireless network in the office, but found it could not handle the data traffic of two people accessing the EMR or the PM software at one time. So, I wired the office myself with cat-5 cable for a network which has worked flawlessly. I use a Motion Computing tablet PC which I can take with me into the exam rooms so that I do not leave a computer in the room for small children to destroy. After one year, I have about 900 charts (at this time I am shooting for a patient panel of 1500). This has translated to an average of 41 patient visits a week over the last two months. My overhead averages about $9800.00 per month with reimbusement running pretty close right now. I usually collect about 75% of what I bill. I mostly have PPO insurance, with about 8% HMO, 16% medicaid, and about 5% Medicare. I have just now stopped taking any more medicaid. I do all my own billing, and I use Quickbooks Pro and do all my own accounting with an accountant taking care of tax filing at year end. I am happy with my progress so far. I realize my overhead is much greater then what Gordon was able to achieve, and so it is taking longer to become profitable. I am still able to offer my patients same day service, direct and prompt access to me, and more time with me. In the future, I might consider some kind of patient fee for unreimbursed service or possibly an affordable retainer, but for now I am trying to provide better service by holding down my overhead as best I can. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2004 Report Share Posted September 23, 2004 > Excellent case study! > Where are you located? > Care to break the overhead down (i.e. explore the components)? > > If the space is your millstone, consider getting someone to > sub-lease. I've found that there are more and more docs locally looking to > take the leap and would love to practice in the same space, I'm wondering > about setting up a larger place for a bunch of us. > Gordon > Good to hear from you, Gordon. I am located in Holland, Michigan My overhead breaks down like this: Administrative: 14% Payroll: 28% Professional fees: 5% Insurance: 13% Loan interst/service chg 9% office lease/utilities 28% misc: 3% I haven't really given much thought to sub-leasing some space. It would definitely be worth considering. Most Docs in this area seem to be stuck in the bigger, more patients, more ancillary services mode. Cosmetic centers run by PCPs seems to be a very popular new business. Mark Newberry, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2004 Report Share Posted September 23, 2004 You're just up the road from the Mintek clan (Allegan)! I think you just might find a doc ready to bail & looking for someone to help them with start up. You can say " Come and rent a room for a nominal fee. I'll show you how to get going, and over time, as you start getting some income, the rent will go up to a reasonable proportion of the total, and we can back each other up & share some resources. " Gordon At 12:41 PM 9/23/2004, you wrote: > Excellent case study! > Where are you located? > Care to break the overhead down (i.e. explore the components)? > > If the space is your millstone, consider getting someone to > sub-lease. I've found that there are more and more docs locally looking to > take the leap and would love to practice in the same space, I'm wondering > about setting up a larger place for a bunch of us. > Gordon > Good to hear from you, Gordon. I am located in Holland, Michigan My overhead breaks down like this: Administrative: 14% Payroll: 28% Professional fees: 5% Insurance: 13% Loan interst/service chg 9% office lease/utilities 28% misc: 3% I haven't really given much thought to sub-leasing some space. It would definitely be worth considering. Most Docs in this area seem to be stuck in the bigger, more patients, more ancillary services mode. Cosmetic centers run by PCPs seems to be a very popular new business. Mark Newberry, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2004 Report Share Posted September 23, 2004 That would definitely be helpful. Mark > > > Excellent case study! > > > Where are you located? > > > Care to break the overhead down (i.e. explore the components)? > > > > > > If the space is your millstone, consider getting someone to > > > sub-lease. I've found that there are more and more docs locally > >looking to > > > take the leap and would love to practice in the same space, I'm > >wondering > > > about setting up a larger place for a bunch of us. > > > Gordon > > > > > > > > >Good to hear from you, Gordon. > > > >I am located in Holland, Michigan > > > >My overhead breaks down like this: > > > >Administrative: 14% > >Payroll: 28% > >Professional fees: 5% > >Insurance: 13% > >Loan interst/service chg 9% > >office lease/utilities 28% > >misc: 3% > > > >I haven't really given much thought to sub-leasing some space. It > >would definitely be worth considering. Most Docs in this area seem to > >be stuck in the bigger, more patients, more ancillary services mode. > >Cosmetic centers run by PCPs seems to be a very popular new business. > > > >Mark Newberry, MD > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 23, 2004 Report Share Posted September 23, 2004 It works for me. We have two doctors working out of 1700 feet, 4 nurses. It is nice to share the space, phone system, computer system and overhead. It is nice to be able to share equipment and be more full service. Brent > > >I have just discovered this group and I am very glad to see that I am > >not alone. I have just spent the last three days going through all > >the old posts and I am more assured that I am on the right road. > > > >I started my solo practice in July of 2003. I had read Gordon's > >articles in FPM and I knew he was on to something. I left residency > >in 2001 and started with a 23 physician multispecialty group. I soon > >learned that, like in " Animal Farm " , all the animals are equal, but > >some are more equal then others. I was appalled by the out of control > >overhead of the practice, and the fact that I had no control over it, > >even though I was responsible for paying it (through a hospital > >guarantee, of course). After one year, I worked for an urgent care > >facility for 8 months, but when the hospital that owned it decided to > >play musical chairs and close some practices and shuffle the docs, I > >found myself soon to be without a job. That is when I started to > >consider Gordon's model more seriously. I was able to go from concept > >to opening the doors of the practice in three months. > > > >I lease an office 1755 sq ft which has two exam rooms, an office for > >me, reception area and waiting room. It is a wonderful office, but > >large for the model. It certainly is the largest source of my > >overhead. I chose it because of limited time to put this practice > >together, location, and because it had previously been a physician's > >office and was already built out perfectly. I have one employee, an > >MA who acts as my right arm. > > > >I have been completely paperless from the begininng. I use soapware > >for EMR which runs on a SQL database and medisoft for the practice > >management software. I have a central server which houses all the > >data. The server has three hard drives with RAID-5 stripping to back > >up data should one HD go out. I also back up all data to a DVT-4 tape > >every night, automatically using Veritas Back-up Exec. I built three > >computers for the practice myself. Initially, I tried a wireless > >network in the office, but found it could not handle the data traffic > >of two people accessing the EMR or the PM software at one time. So, I > >wired the office myself with cat-5 cable for a network which has > >worked flawlessly. I use a Motion Computing tablet PC which I can > >take with me into the exam rooms so that I do not leave a computer in > >the room for small children to destroy. > > > >After one year, I have about 900 charts (at this time I am shooting > >for a patient panel of 1500). This has translated to an average of 41 > >patient visits a week over the last two months. My overhead averages > >about $9800.00 per month with reimbusement running pretty close right > >now. I usually collect about 75% of what I bill. I mostly have PPO > >insurance, with about 8% HMO, 16% medicaid, and about 5% Medicare. I > >have just now stopped taking any more medicaid. I do all my own > >billing, and I use Quickbooks Pro and do all my own accounting with an > >accountant taking care of tax filing at year end. > > > >I am happy with my progress so far. I realize my overhead is much > >greater then what Gordon was able to achieve, and so it is taking > >longer to become profitable. I am still able to offer my patients > >same day service, direct and prompt access to me, and more time with > >me. In the future, I might consider some kind of patient fee for > >unreimbursed service or possibly an affordable retainer, but for now I > >am trying to provide better service by holding down my overhead as > >best I can. > > > > > > Quote Link to comment Share on other sites More sharing options...
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