oops

[Guest guest]

My financial thoughts (didn't get posted I guess):

Like most Americans, I guess I live too much month to month and

haven't tallied actual numbers, but things seem to be going well with

the small practice. I, like the peppered moth of England, have tried

to adapt to the current circumstances: I find my small practice (see

anywhere from 3-12/day) the most rewarding, and yet the most

challenging financially at times. I have a part time office assistant

who works very well for probably very little.

My supplement continues to come from a week or weekend of locum

tenens/moonlighting here and there, which is about 1/4-1/2 of my

monthly goal (gross: 11,000).

I also have a nice relationship with a local general surgeon who

*needs* (I'm not sure how much time I really save him) an

assist--averages about 2-3/week. The endearing quality to his office

nurse is that I can usually be very flexible to their time needs--for

me, a surgical assist is good revenue, whereas in a traditional

model--you might not even break even from the interruption in your

clinic schedule. I encourage you all to look into this is a suitable

situation exists.

My overhead runs very low I think, but there are always

fees/memberships, and little things here and there (probably runs

about 50-60k/year).

I don't know exactly where my salary is after taxes: but not too bad.

We recently were able to purchase a new minivan for our burgeoning

family--not something I would have thought possible in the first year

of practice. We are hoping to build on to our home soon as well.

I am currently negotiating with a small community to provide some

weekend coverage and phone backup (to their P.A.'s) in exchange for a

reasonable rate and health/dental--I'm sure just a short term solution

to our health care coverage struggles (reminder: we have a young son

with C.P. who helps us meet our deductible every year--currently on

COBRA), but will be well appreciated and could translate into about

40K plus income/year plus health/dental.

Quality of life: I think I'm getting very spoiled. After many long

initial nights in the office getting policies and procedures straight,

I now seldom devote more than one long night/week for billing/catch

up, and can usually get away during the week anytime necessary. I,

like others, take pride of ownership in the business and don't really

mind extra time here or there--I KNOW I WOULD HATE an under-educated

office manager trying to tell me how to do things better (translation:

pedal faster to churn out more money). I don't think I'd be

completely happy unless I won the lottery and could spend all of my

time at home with my family, but this is the next best thing. My wife

recently got to happily turn down a part time teaching job to continue

to stay at home with our 2 children (can you put a price tag on that?)

I continue to worry about inevitable coding audits--I see more 214's

than 213's with occasional -215's. I feel ethically very justified in

my coding--for crying out loud the CPT system is based on LEVEL OF

SERVICE, and our level of service demands proper (and likely higher)

coding.

We'll see how the future goes: I feel my practice is very " malleable "

at this point. I have closed out to new patients (around 500) now, as

we see how demand continues to be handled (I don't like my delays in

responding to labwork). We continue to trickle in new patients

(family members of existing or as favors to others).