RE: 2005 results for our new clinic

[Guest guest]

Thanks.

Great info. I can't say how much I appreciate you sharing this as I'm

eight weeks from opening and running through the potential money details

over and over both in my head and on paper. I'll try to put together a

summary of start up monies about the time I open and then an update a few

months later just like you have here.

For the fun of it I'll share with the group that today I got some good

news about expenses being negotiated for my likely space. Taxes and

administrative fees were included in a previously described fee (I'd

assumed they'd be extra) so it looks like I'll be renting a 462 sq ft

space for $505/month. Perhaps electricity will be extra but my community

has great electricity rates. Best of all, bathrooms are next to the

office and public, so I don't have to clean them!

I feel like I'm on a Geico commercial... " I just saved a bunch of money...

on my micro-practice rent! "

Tomorrow I meet with a local graphic designer (my patient) to consider

logos and possible web designs. More later on such matters.

Thanks to you who have led the way in this group.

My gratitude is profound --

Tim

> Hi all-

>

>

>

> When I was doing the pro-forma for our clinic, I found numbers from

> existing clinics helpful. So here are ours. I keep intending to do an

> analysis of all our numbers so far, but don't get to it. Here are some

> of our preliminary results:

>

>

>

> We opened August 1, 2005. These are for our first five months. We

> opened in a modified low overhead. We are in a 1,000 square feet with

> one office available for another physician hopefully this august. We

> purchased e-MD's complete EMR/PMS. We bought the recommended servers

> and equipment. (The generic versions though, not Dell.) We have just

> purchased a CLIA Waived Lipid system and an A1c testing system. (More

> on those below.) We handed out a lot of three fold brochures to nurses

> at the hospital and other doctors. (This and being listed on insurance

> company web sites are our primary form of advertising.) We donate 10%

> of our proceeds to charity. We do our own billing.

>

>

>

> Elise is the doctor. I am the part time business guy and receptionist

> up until we hired . I have been working about one day a week

> since then. is an MA who acts as a receptionist and nurse. She

> is working with high cholesterol patients. (Giving a introduction to

> cholesterol appointment with suggestions, literature, a work out and

> diet journal. She follows this up with calls to see how they are doing

> and another lipid panel at two months.) We are hoping to add diabetes

> and hypertension to the list soon. She is also setting up a mothers

> group for our single mothers. (We found that a lot of them were

> suffering with depression and looking for nonjudgmental support.)

>

>

>

> We added the Lipid and A1c test simply so that we could have the results

> before the appointment if we new the patient needed them, eliminating

> the need to call with results. It doesn't take much longer that drawing

> blood to send to the lab and doesn't involve needles, just a finger

> stick. (Hey, it's our ideal practice.)

>

>

>

> Now to the actual results:

>

> Total patients: 330 about 80 who followed Elise

>

> Total visits: 620

>

> Total collected to date: $48,131

>

> Total AR less than one month old: $17,440

>

> Total AR over one month: $2,000

>

> Locum Tenum income: $4,680 (This is in addition to the collected

> amount.)

>

> Operating Expenses: $24,000

>

> Our salary: $40,000

>

> We were able to pay our expenses in the second month without salary.

>

>

>

> We borrowed about $79,000 which was spent on:

>

> Computers and software (anything electronic): $31,000

>

> Testing equipment: $4,000

>

> Office furnishings: $9,000

>

> Start-up (licensing, etc.): $2,000

>

> Expenses and salary: $24,000

>

> Cash on hand: $7,000

>

> Pre-paid expenses: $2,000

>

>

>

> Our monthly cash inflow from patient visits was:

>

> August $200

>

> September: $5,500

>

> October: $8,100

>

> November: $15,380

>

> December: $19,000

>

>

>

> We were fairly conservative until about month two. Then we spent more

> on things we wanted as it became assured that we would have the visits

> to support our clinic long term. We don't anticipate doing another draw

> on our operating line. We do anticipate starting to pay it down soon.

> We do not have additional big ticket items to purchase. We could have

> spent less on our computers, skipped the testing equipment for a while,

> spent less decorating and on furnishings. I would not trade e-MD's for

> a different system.

>

>

>

> Cheers,

>

> Ernie Leland

>

> Orchards Family Medicine, Inc.

>

>

>

>

>

>

>

>

>

>

[Guest guest]

Wow! Congratulations on an impressive

startup. What part of the country

are you in? I ask because your December “cash flow from patients is so high”

considering a patient panel of just 330. My panel is about 900 and the most I have

ever pulled in in a month is just a little over

$11,000. With a panel of 900 and

open access I generally see 110-150 patients per month. Is that a lot fewer than you are seeing?

Annie

2005 results for our new clinic

Hi all-

When I was doing the

pro-forma for our clinic, I found numbers from existing clinics helpful.

So here are ours. I keep intending to do an analysis of all our numbers

so far, but don’t get to it. Here are some of our preliminary results:

We opened August 1,

2005. These are for our first five months. We opened in a modified

low overhead. We are in a 1,000 square feet with one office available for

another physician hopefully this august. We purchased e-MD’s complete

EMR/PMS. We bought the recommended servers and equipment. (The

generic versions though, not Dell.) We have just purchased a CLIA Waived

Lipid system and an A1c testing system. (More on those below.) We

handed out a lot of three fold brochures to nurses at the hospital and other

doctors. (This and being listed on insurance company web sites are our

primary form of advertising.) We donate 10% of our proceeds to

charity. We do our own billing.

Elise is the

doctor. I am the part time business guy and receptionist up until we

hired . I have been working about one day a week since then.

is an MA who acts as a receptionist and nurse. She is working

with high cholesterol patients. (Giving a introduction to cholesterol

appointment with suggestions, literature, a work out and diet journal.

She follows this up with calls to see how they are doing and another lipid

panel at two months.) We are hoping to add diabetes and hypertension to

the list soon. She is also setting up a mothers group for our single

mothers. (We found that a lot of them were suffering with depression and

looking for nonjudgmental support.)

We added the Lipid and

A1c test simply so that we could have the results before the appointment if we

new the patient needed them, eliminating the need to call with results.

It doesn’t take much longer that drawing blood to send to the lab and

doesn’t involve needles, just a finger stick. (Hey, it’s our

ideal practice.)

Now to the actual

results:

Total patients: 330 about

80 who followed Elise

Total visits: 620

Total collected to date:

$48,131

Total AR less than one

month old: $17,440

Total AR over one month:

$2,000

Locum Tenum income:

$4,680 (This is in addition to the collected amount.)

Operating Expenses:

$24,000

Our salary: $40,000

We were able to pay our

expenses in the second month without salary.

We borrowed about $79,000

which was spent on:

Computers and software

(anything electronic): $31,000

Testing equipment: $4,000

Office furnishings:

$9,000

Start-up (licensing,

etc.): $2,000

Expenses and salary:

$24,000

Cash on hand: $7,000

Pre-paid expenses: $2,000

Our monthly cash inflow

from patient visits was:

August $200

September: $5,500

October: $8,100

November: $15,380

December: $19,000

We were fairly

conservative until about month two. Then we spent more on things we

wanted as it became assured that we would have the visits to support our clinic

long term. We don’t anticipate doing another draw on our operating

line. We do anticipate starting to pay it down soon. We do not have

additional big ticket items to purchase. We could have spent less on our

computers, skipped the testing equipment for a while, spent less decorating and

on furnishings. I would not trade e-MD’s for a different system.

Cheers,

Ernie Leland

Orchards Family Medicine,

Inc.

[Guest guest]

Wow! Congratulations on an impressive

startup. What part of the country

are you in? I ask because your December “cash flow from patients is so high”

considering a patient panel of just 330. My panel is about 900 and the most I have

ever pulled in in a month is just a little over

$11,000. With a panel of 900 and

open access I generally see 110-150 patients per month. Is that a lot fewer than you are seeing?

Annie

2005 results for our new clinic

Hi all-

When I was doing the

pro-forma for our clinic, I found numbers from existing clinics helpful.

So here are ours. I keep intending to do an analysis of all our numbers

so far, but don’t get to it. Here are some of our preliminary results:

We opened August 1,

2005. These are for our first five months. We opened in a modified

low overhead. We are in a 1,000 square feet with one office available for

another physician hopefully this august. We purchased e-MD’s complete

EMR/PMS. We bought the recommended servers and equipment. (The

generic versions though, not Dell.) We have just purchased a CLIA Waived

Lipid system and an A1c testing system. (More on those below.) We

handed out a lot of three fold brochures to nurses at the hospital and other

doctors. (This and being listed on insurance company web sites are our

primary form of advertising.) We donate 10% of our proceeds to

charity. We do our own billing.

Elise is the

doctor. I am the part time business guy and receptionist up until we

hired . I have been working about one day a week since then.

is an MA who acts as a receptionist and nurse. She is working

with high cholesterol patients. (Giving a introduction to cholesterol

appointment with suggestions, literature, a work out and diet journal.

She follows this up with calls to see how they are doing and another lipid

panel at two months.) We are hoping to add diabetes and hypertension to

the list soon. She is also setting up a mothers group for our single

mothers. (We found that a lot of them were suffering with depression and

looking for nonjudgmental support.)

We added the Lipid and

A1c test simply so that we could have the results before the appointment if we

new the patient needed them, eliminating the need to call with results.

It doesn’t take much longer that drawing blood to send to the lab and

doesn’t involve needles, just a finger stick. (Hey, it’s our

ideal practice.)

Now to the actual

results:

Total patients: 330 about

80 who followed Elise

Total visits: 620

Total collected to date:

$48,131

Total AR less than one

month old: $17,440

Total AR over one month:

$2,000

Locum Tenum income:

$4,680 (This is in addition to the collected amount.)

Operating Expenses:

$24,000

Our salary: $40,000

We were able to pay our

expenses in the second month without salary.

We borrowed about $79,000

which was spent on:

Computers and software

(anything electronic): $31,000

Testing equipment: $4,000

Office furnishings:

$9,000

Start-up (licensing,

etc.): $2,000

Expenses and salary:

$24,000

Cash on hand: $7,000

Pre-paid expenses: $2,000

Our monthly cash inflow

from patient visits was:

August $200

September: $5,500

October: $8,100

November: $15,380

December: $19,000

We were fairly

conservative until about month two. Then we spent more on things we

wanted as it became assured that we would have the visits to support our clinic

long term. We don’t anticipate doing another draw on our operating

line. We do anticipate starting to pay it down soon. We do not have

additional big ticket items to purchase. We could have spent less on our

computers, skipped the testing equipment for a while, spent less decorating and

on furnishings. I would not trade e-MD’s for a different system.

Cheers,

Ernie Leland

Orchards Family Medicine,

Inc.

[Guest guest]

Yes, same question for me. I still

think location can have a huge effect on our start-ups, especially community

demand & apparently amount of reimbursement we get for the exact same

services.

2005 results for our new clinic

Hi all-

When I

was doing the pro-forma for our clinic, I found numbers from existing clinics

helpful. So here are ours. I keep intending to do an analysis of

all our numbers so far, but don’t get to it. Here are some of our

preliminary results:

We

opened August 1, 2005. These are for our first five months. We opened in a

modified low overhead. We are in a 1,000 square feet with one office

available for another physician hopefully this august. We purchased

e-MD’s complete EMR/PMS. We bought the recommended servers and

equipment. (The generic versions though, not Dell.) We have just

purchased a CLIA Waived Lipid system and an A1c testing system. (More on

those below.) We handed out a lot of three fold brochures to nurses at

the hospital and other doctors. (This and being listed on insurance

company web sites are our primary form of advertising.) We donate 10% of

our proceeds to charity. We do our own billing.

Elise is

the doctor. I am the part time business guy and receptionist up until we

hired . I have been working about one day a week since then.

is an MA who acts as a receptionist and nurse. She is working

with high cholesterol patients. (Giving a introduction to cholesterol

appointment with suggestions, literature, a work out and diet journal.

She follows this up with calls to see how they are doing and another lipid

panel at two months.) We are hoping to add diabetes and hypertension to

the list soon. She is also setting up a mothers group for our single

mothers. (We found that a lot of them were suffering with depression and

looking for nonjudgmental support.)

We added

the Lipid and A1c test simply so that we could have the results before the

appointment if we new the patient needed them, eliminating the need to call

with results. It doesn’t take much longer that drawing blood to

send to the lab and doesn’t involve needles, just a finger stick.

(Hey, it’s our ideal practice.)

Now to

the actual results:

Total

patients: 330 about 80 who followed Elise

Total

visits: 620

Total

collected to date: $48,131

Total AR

less than one month old: $17,440

Total AR

over one month: $2,000

Locum

Tenum income: $4,680 (This is in addition to the collected amount.)

Operating

Expenses: $24,000

Our

salary: $40,000

We were

able to pay our expenses in the second month without salary.

We

borrowed about $79,000 which was spent on:

Computers

and software (anything electronic): $31,000

Testing

equipment: $4,000

Office

furnishings: $9,000

Start-up

(licensing, etc.): $2,000

Expenses

and salary: $24,000

Cash on

hand: $7,000

Pre-paid

expenses: $2,000

Our

monthly cash inflow from patient visits was:

August

$200

September:

$5,500

October:

$8,100

November:

$15,380

December:

$19,000

We were

fairly conservative until about month two. Then we spent more on things

we wanted as it became assured that we would have the visits to support our

clinic long term. We don’t anticipate doing another draw on our

operating line. We do anticipate starting to pay it down soon. We

do not have additional big ticket items to purchase. We could have spent

less on our computers, skipped the testing equipment for a while, spent less

decorating and on furnishings. I would not trade e-MD’s for a

different system.

Cheers,

Ernie

Leland

Orchards

Family Medicine, Inc.

[Guest guest]

Ernie: Glad everything going smoothly. Great numbers to start. keep us informed as the clinic ages the ratio of new to follow up visits changes and we experienced a dip in AR at about 6 months and one year. Leland wrote: Hi all- When I was doing the pro-forma for our clinic, I found numbers from existing

clinics helpful. So here are ours. I keep intending to do an analysis of all our numbers so far, but don’t get to it. Here are some of our preliminary results: We opened August 1, 2005. These are for our first five months. We opened in a modified low overhead. We are in a 1,000 square feet with one office available for another physician hopefully this august. We purchased e-MD’s complete EMR/PMS. We bought the recommended servers and equipment. (The generic versions though, not Dell.) We have just purchased a CLIA Waived Lipid system and an A1c testing system. (More on those below.) We handed out a lot of

three fold brochures to nurses at the hospital and other doctors. (This and being listed on insurance company web sites are our primary form of advertising.) We donate 10% of our proceeds to charity. We do our own billing. Elise is the doctor. I am the part time business guy and receptionist up until we hired . I have been working about one day a week since then. is an MA who acts as a receptionist and nurse. She is working with high cholesterol patients. (Giving a introduction to cholesterol appointment with suggestions, literature, a work out and diet journal. She follows this up with calls to see how they are doing

and another lipid panel at two months.) We are hoping to add diabetes and hypertension to the list soon. She is also setting up a mothers group for our single mothers. (We found that a lot of them were suffering with depression and looking for nonjudgmental support.) We added the Lipid and A1c test simply so that we could have the results before the appointment if we new the patient needed them, eliminating the need to call with results. It doesn’t take much longer that drawing blood to send to the lab and doesn’t involve needles, just a finger stick. (Hey, it’s our ideal practice.) Now to the actual results: Total patients: 330 about 80 who followed Elise Total visits: 620 Total collected to date: $48,131 Total AR less

than one month old: $17,440 Total AR over one month: $2,000 Locum Tenum income: $4,680 (This is in addition to the collected amount.) Operating Expenses: $24,000 Our salary: $40,000 We were able to pay our expenses in the second month without

salary. We borrowed about $79,000 which was spent on: Computers and software (anything electronic): $31,000 Testing equipment: $4,000 Office furnishings: $9,000 Start-up (licensing, etc.): $2,000 Expenses and salary: $24,000 Cash on hand: $7,000 Pre-paid expenses: $2,000 Our monthly cash inflow from patient visits

was: August $200 September: $5,500 October: $8,100 November: $15,380 December: $19,000 We were fairly conservative until about month two. Then we spent more on things we wanted as it became assured that we would have the visits to support our clinic long term. We don’t anticipate doing another draw on our operating line. We do anticipate starting to pay it down soon. We do not have additional big ticket items to purchase. We could have spent less on our computers, skipped the testing equipment for a while, spent less decorating and on furnishings. I would not trade e-MD’s for a different system. Cheers, Ernie Leland Orchards Family Medicine, Inc.

Yahoo! Photos Ring in the New Year with Photo Calendars. Add photos, events, holidays, whatever.

[Guest guest]

We are in Vancouver,

Washington, right across the river from Portland Oregon.

It is an aggressively growing area. (I think one of the fastest in the

nation.) Based on the list serve, we are in a relatively high

reimbursement rate area. A 99214 can net us $138. But the majority

of our business right now is Medicare and Medicaid HMO (non-capitated) at more

like avg. $90 for a 99214. We have capped Medicare and will cap the Medicaid

HMO soon (I think). We bill mostly 99214 or 99203, combined with skin procedures,

injections and well child/adult preventive visits. We had 120 visit in December

with about 40 -50 new patients. (This is all educated guessing.

These are the numbers I want to get figured out. When I do, I will

publish the results.) We find a lot of our new patents come for a follow

up within a month and then we don’t see them for a while. (So we

end up with 40 new visits with maybe 20 follow up visits from just those 40

people.) We also find that new patients are high on skin procedures,

which are paid fairly well. (“Oh, by the way, can you look at this

mole/bump/lump? I have been meaning to have it looked at for five years,

but haven’t had a doctor.”) I will post our distribution of

income from which CPT when I get the computer to give me the report the way I

want it.

We get paid about three weeks after the

visit from our biggest commercial insurance. However, they were not able

to sign new contracts for the first two and a half months, but would let us see

the patients and to be paid after the contract was signed (The state of Washington was

behind.) We saw a few patients and the income didn’t show up until November

or even some of it in December. So our November and December numbers are

a little inflated from August and September. (Maybe a couple of thousand

dollars at most.)

Ernie

From: [mailto: ] On Behalf Of Brock DO

Sent: Friday, January 06, 2006

6:14 AM

To:

Subject: RE:

2005 results for our new clinic

Yes, same question for me. I still

think location can have a huge effect on our start-ups, especially community

demand & apparently amount of reimbursement we get for the exact same

services.

2005 results for our new clinic

Hi all-

When I

was doing the pro-forma for our clinic, I found numbers from existing clinics

helpful. So here are ours. I keep intending to do an analysis of

all our numbers so far, but don’t get to it. Here are some of our

preliminary results:

We

opened August 1, 2005. These are for our first five months. We

opened in a modified low overhead. We are in a 1,000 square feet with one

office available for another physician hopefully this august. We

purchased e-MD’s complete EMR/PMS. We bought the recommended

servers and equipment. (The generic versions though, not Dell.) We

have just purchased a CLIA Waived Lipid system and an A1c testing system.

(More on those below.) We handed out a lot of three fold brochures

to nurses at the hospital and other doctors. (This and being listed on

insurance company web sites are our primary form of advertising.) We

donate 10% of our proceeds to charity. We do our own billing.

Elise is

the doctor. I am the part time business guy and receptionist up until we

hired . I have been working about one day a week since then.

is an MA who acts as a receptionist and nurse. She is working

with high cholesterol patients. (Giving a introduction to cholesterol

appointment with suggestions, literature, a work out and diet journal.

She follows this up with calls to see how they are doing and another lipid

panel at two months.) We are hoping to add diabetes and hypertension to

the list soon. She is also setting up a mothers group for our single

mothers. (We found that a lot of them were suffering with depression and

looking for nonjudgmental support.)

We added

the Lipid and A1c test simply so that we could have the results before the

appointment if we new the patient needed them, eliminating the need to call

with results. It doesn’t take much longer that drawing blood to

send to the lab and doesn’t involve needles, just a finger stick.

(Hey, it’s our ideal practice.)

Now to

the actual results:

Total

patients: 330 about 80 who followed Elise

Total

visits: 620

Total

collected to date: $48,131

Total AR

less than one month old: $17,440

Total AR

over one month: $2,000

Locum

Tenum income: $4,680 (This is in addition to the collected amount.)

Operating

Expenses: $24,000

Our

salary: $40,000

We were able

to pay our expenses in the second month without salary.

We

borrowed about $79,000 which was spent on:

Computers

and software (anything electronic): $31,000

Testing

equipment: $4,000

Office

furnishings: $9,000

Start-up

(licensing, etc.): $2,000

Expenses

and salary: $24,000

Cash on

hand: $7,000

Pre-paid

expenses: $2,000

Our

monthly cash inflow from patient visits was:

August

$200

September:

$5,500

October:

$8,100

November:

$15,380

December:

$19,000

We were

fairly conservative until about month two. Then we spent more on things

we wanted as it became assured that we would have the visits to support our

clinic long term. We don’t anticipate doing another draw on our

operating line. We do anticipate starting to pay it down soon. We

do not have additional big ticket items to purchase. We could have spent

less on our computers, skipped the testing equipment for a while, spent less

decorating and on furnishings. I would not trade e-MD’s for a

different system.

Cheers,

Ernie Leland

Orchards

Family Medicine, Inc.