Guest guest Posted October 24, 2005 Report Share Posted October 24, 2005 How are you getting malpractice coverage for the cosmetic stuff? When I inquired, my carrier told me “Stress tests?, $10K extra per year. Exercise class one weeknight per week in the office? $8K extra per year? Facial procedures of any kind, on any age? $18K extra per year.” I do skin procedures, but only on NON-facial areas, and if they are younger than 40, on no part not covered by shorts and sleeveless shirt, unless it is a biopsy of something that actually looks like a melanoma, and then only 4 mm punches. Annie Cosmetic Medicine Tim, I graduated from residency last July and immediately saw the frustrations of scratching, tooth-and-nail for pennies from the insurance companines... Many said I should do a " boutique " practice (which I felt I was already doing), but I didn't want to lose a lot of good patients by charging a retainer fee on top of billing insurances (which I also feel is " double-dipping " ). I consider my mix extremely broad...kids/infants (15%) blue/white-collar adults (60%) and Medicare (25%). If I switched to boutique, I'd be left with only the rich who tend to be quite demanding and unpleasant to work with in my opinion. I'll tolerate a few, but not an entire practice. I was somewhat forced to buy a much larger building than my 760 sq ft house that I turned into an office. This building was next door and is 2200 sq ft--previously an ophthalmologist's office. I was sharing parking with the previous owners (who used it as a small church). They outgrew the building and offered to sell. I felt I had no choice but to buy it. My contractor and I became good friends and decided to buy the building together. I knew that if I bought it, it would need a lot of renovations. So, we decided to create a medical spa. My wife is an RN and she is going back to school to become an aesthetician. We aren't finished with renovations yet, but we've already purchased a laser (contractor's money, whom we will lease from) and are making nice profits in my office after hours. We plan to offer everything from laser hair removal, photo-facials (rosacea, telangiectasias, dyschromias), acne treatment as well as Botox and skin peels. I have done some extensive research going to different conferences around the country this past year. I plan on being medical director with a nurse practitioner working next door. This takes very little time out of my schedule and it almost runs itself. There are several consulting firms out there to help get off the ground. There are even franchises out there that you can join in a sort of " turn key " approach. You can offer as much or as little as you want. And for those in rural areas, you may be better off than you think! I know of several examples, like Marquette Michigan, where doctors are making $30-50,000 a month! It's sad that patients will sometimes gripe over a $15 copay, yet they will gladly fork over hundreds of dollars for vanity. I don't feel bad about being a medical director for a cosmetic practic...nor do I feel like a " sell out " ...maybe it is the Robin Hood principle, but if I am providing a service that people want and it makes them feel better about themselves, then I have no problem with this. It just saddens me that we are heading towards a nation of " beautiful sick people " since many physicians (like OB/GYNs) are giving up their high-risk practices entirely in favor of cosmetic medicine. Hope that helps! - -- Graham, MD 1015 - 7th Avenue North St. sburg, FL 33705 Ph. (727)822-6062 (Family Medicine) Ph. (727)502-9000 (EMBRACE Medical Spa) Malia, MD said: > > > > > The discussion about billings suggests the bulk of work > (submitting/EOBs) is not TOO heavy a load. & nbsp; But no one appreciates > the follow up effort to collect the final 5-10% as it takes more effort > and the time-benefit ratio is not as good. > > How crazy would it be to either 1) write off the 5-10% and not use the > time to collect, or 2) write it off and use the time in a higher profit > activity instead? > > Fundamentally this is a & quot;Robin Hood & quot; style question. & nbsp; I > happen to have attended a workshop on lasers today. & nbsp; So I'm > thinking outside the box and imagining a low overhead family medicine > office with 10-20% of time doing cosmetic laser. & nbsp; It happens that > Rochester is relatively under-saturated for lasers, the docs who do it > are bunched together about 10miles from here and this is an up-scale > suburb (ie - if an FP could make a mark, this may be a reasonable place > to do it). > > At the same time, due to a professional interest in caring for Deaf > patients, I do plan to accept Medicaid and Medicare. > > The high dollars per hour rate of a part time laser practice would sure > up the finances so I can then use the rest of my time offering care the > way I want to the patients I want... ie, Robin Hood style. > > I don't mean to open a & quot;hammer-nail & quot; discussion as I think > Gordon outlined that point well, ie - if we have a technology, we'll > tend to find ways to use it. & nbsp; Research consistently shows that is > true. > > I do hope to get feed back about how crazy an idea this is-- tiny bit, a > good bit, or totally? And to find out how others find the right balance > for finances beyond the common moonlighting in urgent care. > > Thanks, > Tim > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 24, 2005 Report Share Posted October 24, 2005 -- Yes, that helps. Good luck with your efforts. Judging from the postings you've had this last year or two I suspect you will be very prepared for whatever comes your way. Tim > Tim, > > I graduated from residency last July and immediately saw the > frustrations of scratching, tooth-and-nail for pennies from the > insurance companines... > > Many said I should do a " boutique " practice (which I felt I was already > doing), but I didn't want to lose a lot of good patients by charging a > retainer fee on top of billing insurances (which I also feel is > " double-dipping " ). I consider my mix extremely broad...kids/infants > (15%) blue/white-collar adults (60%) and Medicare (25%). If I switched > to boutique, I'd be left with only the rich who tend to be quite > demanding and unpleasant to work with in my opinion. I'll tolerate a > few, but not an entire practice. > > I was somewhat forced to buy a much larger building than my 760 sq ft > house that I turned into an office. This building was next door and is > 2200 sq ft--previously an ophthalmologist's office. I was sharing > parking with the previous owners (who used it as a small church). They > outgrew the building and offered to sell. I felt I had no choice but to > buy it. > > My contractor and I became good friends and decided to buy the building > together. I knew that if I bought it, it would need a lot of > renovations. > So, we decided to create a medical spa. My wife is an RN and she is > going back to school to become an aesthetician. We aren't finished with > renovations yet, but we've already purchased a laser (contractor's > money, whom we will lease from) and are making nice profits in my office > after hours. We plan to offer everything from laser hair removal, > photo-facials (rosacea, telangiectasias, dyschromias), acne treatment as > well as Botox and skin peels. > > I have done some extensive research going to different conferences > around the country this past year. I plan on being medical director > with a nurse practitioner working next door. This takes very little > time out of my schedule and it almost runs itself. There are several > consulting firms out there to help get off the ground. There are even > franchises out there that you can join in a sort of " turn key " approach. > > You can offer as much or as little as you want. And for those in rural > areas, you may be better off than you think! I know of several > examples, like Marquette Michigan, where doctors are making $30-50,000 a > month! > > It's sad that patients will sometimes gripe over a $15 copay, yet they > will gladly fork over hundreds of dollars for vanity. I don't feel bad > about being a medical director for a cosmetic practic...nor do I feel > like a " sell out " ...maybe it is the Robin Hood principle, but if I am > providing a service that people want and it makes them feel better about > themselves, then I have no problem with this. > > It just saddens me that we are heading towards a nation of " beautiful > sick people " since many physicians (like OB/GYNs) are giving up their > high-risk practices entirely in favor of cosmetic medicine. > > Hope that helps! > - > > -- > Graham, MD > 1015 - 7th Avenue North > St. sburg, FL 33705 > Ph. (727)822-6062 (Family Medicine) > Ph. (727)502-9000 (EMBRACE Medical Spa) > > Malia, MD said: >> >> >> >> >> The discussion about billings suggests the bulk of work >> (submitting/EOBs) is not TOO heavy a load. & nbsp; But no one >> appreciates the follow up effort to collect the final 5-10% as it >> takes more effort and the time-benefit ratio is not as good. >> >> How crazy would it be to either 1) write off the 5-10% and not use the >> time to collect, or 2) write it off and use the time in a higher >> profit activity instead? >> >> Fundamentally this is a & quot;Robin Hood & quot; style question. & nbsp; I >> happen to have attended a workshop on lasers today. & nbsp; So I'm >> thinking outside the box and imagining a low overhead family medicine >> office with 10-20% of time doing cosmetic laser. & nbsp; It happens that >> Rochester is relatively under-saturated for lasers, the docs who do it >> are bunched together about 10miles from here and this is an up-scale >> suburb (ie - if an FP could make a mark, this may be a reasonable >> place to do it). >> >> At the same time, due to a professional interest in caring for Deaf >> patients, I do plan to accept Medicaid and Medicare. >> >> The high dollars per hour rate of a part time laser practice would >> sure up the finances so I can then use the rest of my time offering >> care the way I want to the patients I want... ie, Robin Hood style. >> >> I don't mean to open a & quot;hammer-nail & quot; discussion as I think >> Gordon outlined that point well, ie - if we have a technology, we'll >> tend to find ways to use it. & nbsp; Research consistently shows that is >> true. >> >> I do hope to get feed back about how crazy an idea this is-- tiny bit, >> a good bit, or totally? And to find out how others find the right >> balance for finances beyond the common moonlighting in urgent care. >> >> Thanks, >> Tim >> >> >> >> >> >> >> >> >> >> >> Quote Link to comment Share on other sites More sharing options...
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