Re: money

[Guest guest]

The

problem is that the average of $160,000 includes docs that do the full gamut of

FP & usually high volumes. The typical FP still likely does AM

inpatient work, sees 30+ office patients, sees nursing home patients, works 60

hrs per week. It is hard to expect an IMP low volume practice to match

that because I personally am not working nearly that hard! I do not do

inpatient, nursing homes, & only work ~ 36 – 40 hrs per week

(averaging 12 – 15 pts/day), so of course I am not going to make

$160,000, but that is a lifestyle tradeoff have chosen. At least that is

the way I have rationalized not making “average” income in my mind.

money

Recently I have had money

on my mind. After 2 years in my new

practice I an finally close to making $150,000 which is still less

than I made at my old job. However I am finding it difficult to

figure out how to make anymore than that since I don't think that I

can see any more patients in a day. The median income of FP's is over

$160.000/yr. How many of you are making more than the median FP

income and what are you doing to make that much. If the micropractice

model is not capable of producing enough income to provide at least

the median income it is probably not going to be a viable model.

Larry Lindeman MD

[Guest guest]

The

problem is that the average of $160,000 includes docs that do the full gamut of

FP & usually high volumes. The typical FP still likely does AM

inpatient work, sees 30+ office patients, sees nursing home patients, works 60

hrs per week. It is hard to expect an IMP low volume practice to match

that because I personally am not working nearly that hard! I do not do

inpatient, nursing homes, & only work ~ 36 – 40 hrs per week

(averaging 12 – 15 pts/day), so of course I am not going to make

$160,000, but that is a lifestyle tradeoff have chosen. At least that is

the way I have rationalized not making “average” income in my mind.

money

Recently I have had money

on my mind. After 2 years in my new

practice I an finally close to making $150,000 which is still less

than I made at my old job. However I am finding it difficult to

figure out how to make anymore than that since I don't think that I

can see any more patients in a day. The median income of FP's is over

$160.000/yr. How many of you are making more than the median FP

income and what are you doing to make that much. If the micropractice

model is not capable of producing enough income to provide at least

the median income it is probably not going to be a viable model.

Larry Lindeman MD

[Guest guest]

The

problem is that the average of $160,000 includes docs that do the full gamut of

FP & usually high volumes. The typical FP still likely does AM

inpatient work, sees 30+ office patients, sees nursing home patients, works 60

hrs per week. It is hard to expect an IMP low volume practice to match

that because I personally am not working nearly that hard! I do not do

inpatient, nursing homes, & only work ~ 36 – 40 hrs per week

(averaging 12 – 15 pts/day), so of course I am not going to make

$160,000, but that is a lifestyle tradeoff have chosen. At least that is

the way I have rationalized not making “average” income in my mind.

money

Recently I have had money

on my mind. After 2 years in my new

practice I an finally close to making $150,000 which is still less

than I made at my old job. However I am finding it difficult to

figure out how to make anymore than that since I don't think that I

can see any more patients in a day. The median income of FP's is over

$160.000/yr. How many of you are making more than the median FP

income and what are you doing to make that much. If the micropractice

model is not capable of producing enough income to provide at least

the median income it is probably not going to be a viable model.

Larry Lindeman MD

[Guest guest]

I have been thinking about the same things lately, Larry. Unfortunately, I only paid myself $45,000 last year (my second year of solo, low volume practice) However, my numbers are still not as good as yours. I think I average about 8 patients a day. But I also only work about 36 hours a week. I am definately curious about what others have to say on this issue

Marie Christensen MD

From: [mailto: ] On Behalf Of Brock DOSent: Wednesday, September 13, 2006 2:23 PMTo: Subject: RE: money

The problem is that the average of $160,000 includes docs that do the full gamut of FP & usually high volumes. The typical FP still likely does AM inpatient work, sees 30+ office patients, sees nursing home patients, works 60 hrs per week. It is hard to expect an IMP low volume practice to match that because I personally am not working nearly that hard! I do not do inpatient, nursing homes, & only work ~ 36 – 40 hrs per week (averaging 12 – 15 pts/day), so of course I am not going to make $160,000, but that is a lifestyle tradeoff have chosen. At least that is the way I have rationalized not making “average” income in my mind.

-----Original Message-----From: [mailto: ] On Behalf Of Larry LindemanSent: Wednesday, September 13, 2006 1:04 PMTo: Subject: money

Recently I have had money on my mind. After 2 years in my new practice I an finally close to making $150,000 which is still less than I made at my old job. However I am finding it difficult to figure out how to make anymore than that since I don't think that I can see any more patients in a day. The median income of FP's is over $160.000/yr. How many of you are making more than the median FP income and what are you doing to make that much. If the micropractice model is not capable of producing enough income to provide at least the median income it is probably not going to be a viable model.Larry Lindeman MD

[Guest guest]

Hi Larry: Let me assume some numbers for now as follows 2000 patients 300,000 collections 150,000 overhead 150,000 salary Collections per patient then 300,000/2000 or $150/year per patient or a little over $12/ month per patient. My practice has fewer patients but last year we collected $200/patient but still less than 20$ per month per patient. I still feel the way we make primary care affordable is by asking patients/insurers/ and employers to pay $1/day. The only other way to increase revenue and salary is to provide quick care. A friend who provided urgeant carewould see 30-40 patients per day in quick care working 3-4 days per week. He was seeing 4-6 patients per hour. Most 99313's one problem one prescription $50-70 per visit

or 200/hour $1600/day. 2000 hours per year 400,000 overhead 200,000 salary. In our low overhead clinic with just medicare, if we could see enough patients with higher level visits for 99214 at two an hour we would collect $158/ hour. For 2000 hours $316,000 in overhead. As it is we are at 35-40 patient per week most are 99214 with in house lab we collect about $92 per patient visit. Overhead is $60,000 to increase to $80,000 next year. At 2000 visits per year we will collect about 180,000. pay $100,000. We feel we will be able to increase daily visits but keep hours the same and hope to evetually provide salary and benefits of $150,000 per year. Note your income is a combination of salary, benefits, CME, professional liscences, health insurance, disability insurance. $20,000 of our overhead covers these expenses. So our real income and benefits is actually

$100,000 this year for seeing less than a patient an hour. But is I needed $150,000 in salary alone, I do not see that as possible unser the IMP model or any primary care model for that matter. Larry Lindeman wrote: Recently I have had money on my mind. After 2 years in my new practice I an finally close to making $150,000 which is still less than I made at my old job. However I am

finding it difficult to figure out how to make anymore than that since I don't think that I can see any more patients in a day. The median income of FP's is over $160.000/yr. How many of you are making more than the median FP income and what are you doing to make that much. If the micropractice model is not capable of producing enough income to provide at least the median income it is probably not going to be a viable model.Larry Lindeman MD

Stay in the know. Pulse on the new Yahoo.com. Check it out.

[Guest guest]

I can

not understand why you are counting CME, disability insurance, licenses, etc as

“income”? Those are overhead items (ie, expenditures) not income,

aren’t they? Also, $92/patient visit is a pretty lofty assumption, at

least where I’m at. Throw a few Medicaid 99213’s in the daily mix

& that average drops precipitously. Still I could certainly make $150,000

per year if I wanted to work a lot harder (longer hours), but I choose not to.

I work 4.5 days per week.

Re:

money

Hi Larry:

Let me assume some numbers for now as follows

2000 patients

300,000 collections

150,000 overhead

150,000 salary

Collections per patient then 300,000/2000 or $150/year

per patient or a little over $12/ month per patient.

My practice has fewer patients but last year we

collected $200/patient but still less than 20$ per month per patient.

I still feel the way we make primary care affordable

is by asking patients/insurers/ and employers to pay $1/day.

The only other way to increase revenue and salary is

to provide quick care. A friend who provided urgeant carewould see 30-40

patients per day in quick care working 3-4 days per week. He was seeing

4-6 patients per hour. Most 99313's one problem one prescription $5! 0-70 per

visit or 200/hour $1600/day. 2000 hours per year 400,000 overhead 200,000

salary.

In our low overhead clinic with just medicare, if we

could see enough patients with higher level visits for 99214 at two an hour we

would collect $158/ hour. For 2000 hours $316,000 in overhead. As

it is we are at 35-40 patient per week most are 99214 with in house lab we

collect about $92 per patient visit. Overhead is $60,000 to increase to

$80,000 next year. At 2000 visits per year we will collect about 180,000. pay

$100,000. We feel we will be able to increase daily visits but keep hours

the same and hope to evetually provide salary and benefits of $150,000 per

year.

Note your income is a combination of salary, benefits,

CME, professional liscences, health insurance, disability insurance.

$20,000 of our overhead covers these expenses. So our real income and

benefits is actually $100,000 this year for seeing less than a patient an

hour. But is I needed $150,000 in salary alone, I do not see that as

possible unser the IMP model or any primary care model for that matter.

Larry Lindeman

<llindemanmac> wrote:

Recently

I have had money on my mind. After 2 years in my new

practice I an finally close to making $150,000 which is still less

than I made at my old job. However I am finding it difficult to

figure out how to make anymore than that since I don't think that I

can see any more patients in a day. The median income of FP's is over

$160.000/yr. How many of you are making more than the median FP

income and what are you doing to make that much. If the micropractice

model is not capable of producing enough income to provide at least

the median income it is probably not going to be a viable model.

Larry Lindeman MD

Stay in the know. Pulse on the new Yahoo.com. Check it

out.

[Guest guest]

: To understand MGMA average compensation I think we need their definition, but I believe those types of perks are part of total compensation. I may be wrong, anyone know the answer? Brock DO wrote: I can not understand why you are counting CME,

disability insurance, licenses, etc as “income”? Those are overhead items (ie, expenditures) not income, aren’t they? Also, $92/patient visit is a pretty lofty assumption, at least where I’m at. Throw a few Medicaid 99213’s in the daily mix & that average drops precipitously. Still I could certainly make $150,000 per year if I wanted to work a lot harder (longer hours), but I choose not to. I work 4.5 days per week. -----Original Message-----From: [mailto: ] On Behalf Of EglySent: Wednesday, September 13, 2006 3:53 PMTo: Subject: Re: money Hi Larry: Let me assume some numbers for now as follows 2000 patients 300,000 collections 150,000 overhead 150,000 salary Collections per patient then 300,000/2000 or $150/year per patient or a little over $12/ month per patient. My practice has fewer patients but last year we collected $200/patient but still less than 20$ per month per patient. I still feel the way we make primary care affordable is by asking patients/insurers/ and employers to

pay $1/day. The only other way to increase revenue and salary is to provide quick care. A friend who provided urgeant carewould see 30-40 patients per day in quick care working 3-4 days per week. He was seeing 4-6 patients per hour. Most 99313's one problem one prescription $5! 0-70 per visit or 200/hour $1600/day. 2000 hours per year 400,000 overhead 200,000 salary. In our low overhead clinic with just medicare, if we could see enough patients with higher level

visits for 99214 at two an hour we would collect $158/ hour. For 2000 hours $316,000 in overhead. As it is we are at 35-40 patient per week most are 99214 with in house lab we collect about $92 per patient visit. Overhead is $60,000 to increase to $80,000 next year. At 2000 visits per year we will collect about 180,000. pay $100,000. We feel we will be able to increase daily visits but keep hours the same and hope to evetually provide salary and benefits of $150,000 per year. Note your income is a combination of salary, benefits, CME, professional liscences, health insurance, disability insurance. $20,000 of our overhead covers these expenses. So our real income and benefits is actually

$100,000 this year for seeing less than a patient an hour. But is I needed $150,000 in salary alone, I do not see that as possible unser the IMP model or any primary care model for that matter. Larry Lindeman <llindemanmac> wrote: Recently I have had money on my mind. After 2 years in my new practice I an finally close to making $150,000 which is still less than I made at my old job. However I am finding it difficult to figure out how to make anymore than that since I don't think that I can see any more patients in a day. The median income of FP's is over $160.000/yr. How many of you are making more than the median FP income and what are you doing to make that much. If the micropractice model is not capable of producing enough income to provide at least the median income it is probably not going to be a viable model.Larry Lindeman

MD Stay in the know. Pulse on the new Yahoo.com. Check it out. Get your own web address for just $1.99/1st yr. We'll help. Yahoo! Small Business.

Stay in the know. Pulse on the new Yahoo.com. Check it out.

[Guest guest]

: To understand MGMA average compensation I think we need their definition, but I believe those types of perks are part of total compensation. I may be wrong, anyone know the answer? Brock DO wrote: I can not understand why you are counting CME,

disability insurance, licenses, etc as “income”? Those are overhead items (ie, expenditures) not income, aren’t they? Also, $92/patient visit is a pretty lofty assumption, at least where I’m at. Throw a few Medicaid 99213’s in the daily mix & that average drops precipitously. Still I could certainly make $150,000 per year if I wanted to work a lot harder (longer hours), but I choose not to. I work 4.5 days per week. -----Original Message-----From: [mailto: ] On Behalf Of EglySent: Wednesday, September 13, 2006 3:53 PMTo: Subject: Re: money Hi Larry: Let me assume some numbers for now as follows 2000 patients 300,000 collections 150,000 overhead 150,000 salary Collections per patient then 300,000/2000 or $150/year per patient or a little over $12/ month per patient. My practice has fewer patients but last year we collected $200/patient but still less than 20$ per month per patient. I still feel the way we make primary care affordable is by asking patients/insurers/ and employers to

pay $1/day. The only other way to increase revenue and salary is to provide quick care. A friend who provided urgeant carewould see 30-40 patients per day in quick care working 3-4 days per week. He was seeing 4-6 patients per hour. Most 99313's one problem one prescription $5! 0-70 per visit or 200/hour $1600/day. 2000 hours per year 400,000 overhead 200,000 salary. In our low overhead clinic with just medicare, if we could see enough patients with higher level

visits for 99214 at two an hour we would collect $158/ hour. For 2000 hours $316,000 in overhead. As it is we are at 35-40 patient per week most are 99214 with in house lab we collect about $92 per patient visit. Overhead is $60,000 to increase to $80,000 next year. At 2000 visits per year we will collect about 180,000. pay $100,000. We feel we will be able to increase daily visits but keep hours the same and hope to evetually provide salary and benefits of $150,000 per year. Note your income is a combination of salary, benefits, CME, professional liscences, health insurance, disability insurance. $20,000 of our overhead covers these expenses. So our real income and benefits is actually

$100,000 this year for seeing less than a patient an hour. But is I needed $150,000 in salary alone, I do not see that as possible unser the IMP model or any primary care model for that matter. Larry Lindeman <llindemanmac> wrote: Recently I have had money on my mind. After 2 years in my new practice I an finally close to making $150,000 which is still less than I made at my old job. However I am finding it difficult to figure out how to make anymore than that since I don't think that I can see any more patients in a day. The median income of FP's is over $160.000/yr. How many of you are making more than the median FP income and what are you doing to make that much. If the micropractice model is not capable of producing enough income to provide at least the median income it is probably not going to be a viable model.Larry Lindeman

MD Stay in the know. Pulse on the new Yahoo.com. Check it out. Get your own web address for just $1.99/1st yr. We'll help. Yahoo! Small Business.

Stay in the know. Pulse on the new Yahoo.com. Check it out.

[Guest guest]

$91.00 per patient visit is about what I average also - about 2000 visits/year. FPs in this town have never averaged $160,000 year.Hi Larry: Let me assume some numbers for now as follows 2000 patients300,000 collections150,000 overhead150,000 salary Collections per patient then 300,000/2000 or $150/year per patient or a little over $12/ month per patient. My practice has fewer patients but last year we collected $200/patient but still less than 20$ per month per patient.  I still feel the way we make primary care affordable is by asking patients/insurers/ and employers to pay $1/day. The only other way to increase revenue and salary is to provide quick care.  A friend who provided urgeant carewould see 30-40 patients per day in quick care working 3-4 days per week.  He was seeing 4-6 patients per hour. Most 99313's one problem one prescription $50-70 per visit or 200/hour $1600/day.  2000 hours per year 400,000 overhead 200,000 salary. In our low overhead clinic with just medicare, if we could see enough patients with higher level visits for 99214 at two an hour we would collect $158/ hour.  For 2000 hours $316,000 in overhead.  As it is we are at 35-40 patient per week most are 99214 with in house lab we collect about $92 per patient visit.  Overhead is $60,000 to increase to $80,000 next year. At 2000 visits per year we will collect about 180,000. pay $100,000.  We feel we will be able to increase daily visits but keep hours the same and hope to evetually provide salary and benefits of $150,000 per year.  Note your income is a combination of salary, benefits, CME, professional liscences, health insurance, disability insurance.  $20,000 of our overhead covers these expenses.  So our real income and benefits is actually $100,000 this year for seeing less than a patient an hour.  But is I needed $150,000 in salary alone, I do not see that as possible unser the IMP model or any primary care model for that matter.    Larry Lindeman <llindemanmac> wrote:Recently I have had money on my mind. After 2 years in my new practice I an finally close to making $150,000 which is still less than I made at my old job. However I am finding it difficult to figure out how to make anymore than that since I don't think that I can see any more patients in a day. The median income of FP's is over $160.000/yr. How many of you are making more than the median FP income and what are you doing to make that much. If the micropractice model is not capable of producing enough income to provide at least the median income it is probably not going to be a viable model.Larry Lindeman MDStay in the know. Pulse on the new Yahoo.com. Check it out.

[Guest guest]

I order to make the income you have to be able to provide some

ancillary services, lab, ekg, pfts, audiograms, xray etc to provide

very complete care. Use Ma or lpns. You still have to do some

volume w an employee once you have opportunity to get a little

busier. The employee can help you keep generating revenue by keeping

you off the phone, seeing appointments and doing what you do. They

can also answer phone when you are not there and plug in an appt for

later that day. They can keep you out of the reach of detail

people.

Why do lab? Our local hospital charge 126 for a tsh. I can buy for

a minor percentage of that from a commmercial lab and charge half of

local hospital and still make more than for the whole office visit

some of the times.

All the little things add up and provide for a complete care model.

Immunizations are becoming a much bigger part of my practice, the

problem is margins are so small , many times hard to break even. Will

still do for now.

Brent

>

> Recently I have had money on my mind. After 2 years in my

new

> practice I an finally close to making $150,000 which is still less

> than I made at my old job. However I am finding it difficult to

> figure out how to make anymore than that since I don't think that I

> can see any more patients in a day. The median income of FP's is

over

> $160.000/yr. How many of you are making more than the median FP

> income and what are you doing to make that much. If the

micropractice

> model is not capable of producing enough income to provide at least

> the median income it is probably not going to be a viable model.

> Larry Lindeman MD

>

>

>

>

>

> ---------------------------------

>

> Stay in the know. Pulse on the new Yahoo.com. Check it out.

>

>

>

>

>

>

>

>

>

> ---------------------------------

> Get your own web address for just $1.99/1st yr. We'll help. Yahoo!

Small Business.

>

> ---------------------------------

> Stay in the know. Pulse on the new Yahoo.com. Check it out.

>

[Guest guest]

I order to make the income you have to be able to provide some

ancillary services, lab, ekg, pfts, audiograms, xray etc to provide

very complete care. Use Ma or lpns. You still have to do some

volume w an employee once you have opportunity to get a little

busier. The employee can help you keep generating revenue by keeping

you off the phone, seeing appointments and doing what you do. They

can also answer phone when you are not there and plug in an appt for

later that day. They can keep you out of the reach of detail

people.

Why do lab? Our local hospital charge 126 for a tsh. I can buy for

a minor percentage of that from a commmercial lab and charge half of

local hospital and still make more than for the whole office visit

some of the times.

All the little things add up and provide for a complete care model.

Immunizations are becoming a much bigger part of my practice, the

problem is margins are so small , many times hard to break even. Will

still do for now.

Brent

>

> Recently I have had money on my mind. After 2 years in my

new

> practice I an finally close to making $150,000 which is still less

> than I made at my old job. However I am finding it difficult to

> figure out how to make anymore than that since I don't think that I

> can see any more patients in a day. The median income of FP's is

over

> $160.000/yr. How many of you are making more than the median FP

> income and what are you doing to make that much. If the

micropractice

> model is not capable of producing enough income to provide at least

> the median income it is probably not going to be a viable model.

> Larry Lindeman MD

>

>

>

>

>

> ---------------------------------

>

> Stay in the know. Pulse on the new Yahoo.com. Check it out.

>

>

>

>

>

>

>

>

>

> ---------------------------------

> Get your own web address for just $1.99/1st yr. We'll help. Yahoo!

Small Business.

>

> ---------------------------------

> Stay in the know. Pulse on the new Yahoo.com. Check it out.

>

[Guest guest]

The best source I know of for figures on this is on the AAFP website here:

http://www.aafp.org/online/en/home/aboutus/specialty/facts.html

What you do matters if you're trying to compare apples to apples. The

average doc according to this spends 50.7 hours per week in practice,

31.1 patient contact hours per week, practices 47 weeks per year, sees

85.4 patients plus 9.1 hospital visits and 2.9 NH visits per week. If

you deliver babies, do hopital work and take call, that also helps

lead to extra income.

It seems the average doc makes less than you, depending on where you

live. The median is 160 in the West South Central region, but those

docs also have more patient contact hours and see 10% or more

additional patients than those in other regions.

.

> Recently I have had money on my mind. After 2 years in my new

> practice I an finally close to making $150,000 which is still less

> than I made at my old job. However I am finding it difficult to

> figure out how to make anymore than that since I don't think that I

> can see any more patients in a day. The median income of FP's is over

> $160.000/yr. How many of you are making more than the median FP

> income and what are you doing to make that much. If the micropractice

> model is not capable of producing enough income to provide at least

> the median income it is probably not going to be a viable model.

> Larry Lindeman MD

>

>

[Guest guest]

The best source I know of for figures on this is on the AAFP website here:

http://www.aafp.org/online/en/home/aboutus/specialty/facts.html

What you do matters if you're trying to compare apples to apples. The

average doc according to this spends 50.7 hours per week in practice,

31.1 patient contact hours per week, practices 47 weeks per year, sees

85.4 patients plus 9.1 hospital visits and 2.9 NH visits per week. If

you deliver babies, do hopital work and take call, that also helps

lead to extra income.

It seems the average doc makes less than you, depending on where you

live. The median is 160 in the West South Central region, but those

docs also have more patient contact hours and see 10% or more

additional patients than those in other regions.

.

> Recently I have had money on my mind. After 2 years in my new

> practice I an finally close to making $150,000 which is still less

> than I made at my old job. However I am finding it difficult to

> figure out how to make anymore than that since I don't think that I

> can see any more patients in a day. The median income of FP's is over

> $160.000/yr. How many of you are making more than the median FP

> income and what are you doing to make that much. If the micropractice

> model is not capable of producing enough income to provide at least

> the median income it is probably not going to be a viable model.

> Larry Lindeman MD

>

>

[Guest guest]

I must

be missing something. If you are truly averaging $91 for every pt that

walks in the door then: two/hr = $180/hr. If you work 8 hrs/day x 4.5

days/wk x 48 wks/yr that comes out to $311,000/yr before overhead. Even

with a traditional 50% overhead you would still be bringing in over

$150,000/yr. Now, if you have chosen to work less than these hours I

quoted then that is different (personal choice). I could not average $91

per patient without upcoding illegally or not taking any self-pays or

Medicaid. Sure, some visits pay more than that but the large majority pay

between $50 & $80.

Re:

money

$91.00 per patient visit is about what I average also

- about 2000 visits/year.

FPs in this town have never averaged $160,000 year.

Hi Larry:

Let me assume some numbers for now as follows

2000 patients

300,000 collections

150,000 overhead

150,000 salary

Collections per patient then 300,000/2000 or $150/year per patient

or a little over $12/ month per patient.

My practice has fewer patients but last year we collected

$200/patient but still less than 20$ per month per patient.

I still feel the way we make primary care affordable is by asking

patients/insurers/ and employers to pay $1/day.

The only other way to increase revenue and salary is to provide

quick care. A friend who provided urgeant carewould see 30-40 patients

per day in quick care working 3-4 days per week. He was seeing 4-6

patients per hour. Most 99313's one problem one prescription $50-70 per visit

or 200/hour $1600/day. 2000 hours per year 400,000 overhead 200,000 salary.

In our low overhead clinic with just medicare, if we could see

enough patients with higher level visits for 99214 at two an hour we would

collect $158/ hour. For 2000 hours $316,000 in overhead. As it is

we are at 35-40 patient per week most are 99214 with in house lab we collect

about $92 per patient visit. Overhead is $60,000 to increase to $80,000

next year. At 2000 visits per year we will collect about 180,000. pay

$100,000. We feel we will be able to increase daily visits but keep hours

the same and hope to evetually provide salary and benefits of $150,000 per

year.

Note your income is a combination of salary, benefits, CME,

professional liscences, health insurance, disability insurance. $20,000

of our overhead covers these expenses. So our real income and benefits is

actually $100,000 this year for seeing less than a patient an hour. But

is I needed $150,000 in salary alone, I do not see that as possible unser the

IMP model or any primary care model for that matter.

Larry Lindeman <llindemanmac>

wrote:

Recently I have had

money on my mind. After 2 years in my new

practice I an finally close to making $150,000

which is still less

than I made at my old job. However I am finding it

difficult to

figure out how to make anymore than that since I

don't think that I

can see any more patients in a day. The median

income of FP's is over

$160.000/yr. How many of you are making more than

the median FP

income and what are you doing to make that much.

If the micropractice

model is not capable of producing enough income to

provide at least

the median income it is probably not going to be a

viable model.

Larry Lindeman MD

Stay in the know. Pulse on the new Yahoo.com. Check it out.

[Guest guest]

Patient contact hours is the key - not number of hours in a working day. Also, patient seen for physicals are seen for an hour. New patients are an hour. So I have about 26 patient contact hours per week, averaging 10.5 patients/ day in my busier months. If I see more patients, I suspect that my average per patient would start to go down, as I wouldn't be able to make the effort needed to charge correctly for my services (i.e. 99213 vs 99214).  I'm providing this information for people in this group who are starting out and curious about finances. It depends a lot on the reimbursement available in a region. I noted once when we discussing reimbursement that HMOs in southern California, for example, pay badly. I take Medicare and Medicaid as well as self pays. The majority of my practice is HMO though, as that's what rules in this town. I must be missing something.  If you are truly averaging $91 for every pt that walks in the door then: two/hr = $180/hr.  If you work 8 hrs/day x 4.5 days/wk x 48 wks/yr that comes out to $311,000/yr before overhead.  Even with a traditional 50% overhead you would still be bringing in over $150,000/yr.  Now, if you have chosen to work less than these hours I quoted then that is different (personal choice).  I could not average $91 per patient without upcoding illegally or not taking any self-pays or Medicaid.  Sure, some visits pay more than that but the large majority pay between $50 & $80.   -----Original Message-----From: [mailto: ] On Behalf Of GuinnSent: Wednesday, September 13, 2006 9:43 PMTo: Subject: Re: money $91.00 per patient visit is about what I average also - about 2000 visits/year. FPs in this town have never averaged $160,000 year.    Hi Larry: Let me assume some numbers for now as follows 2000 patients300,000 collections150,000 overhead150,000 salary Collections per patient then 300,000/2000 or $150/year per patient or a little over $12/ month per patient. My practice has fewer patients but last year we collected $200/patient but still less than 20$ per month per patient.  I still feel the way we make primary care affordable is by asking patients/insurers/ and employers to pay $1/day. The only other way to increase revenue and salary is to provide quick care.  A friend who provided urgeant carewould see 30-40 patients per day in quick care working 3-4 days per week.  He was seeing 4-6 patients per hour. Most 99313's one problem one prescription $50-70 per visit or 200/hour $1600/day.  2000 hours per year 400,000 overhead 200,000 salary. In our low overhead clinic with just medicare, if we could see enough patients with higher level visits for 99214 at two an hour we would collect $158/ hour.  For 2000 hours $316,000 in overhead.  As it is we are at 35-40 patient per week most are 99214 with in house lab we collect about $92 per patient visit.  Overhead is $60,000 to increase to $80,000 next year. At 2000 visits per year we will collect about 180,000. pay $100,000.  We feel we will be able to increase daily visits but keep hours the same and hope to evetually provide salary and benefits of $150,000 per year.  Note your income is a combination of salary, benefits, CME, professional liscences, health insurance, disability insurance.  $20,000 of our overhead covers these expenses.  So our real income and benefits is actually $100,000 this year for seeing less than a patient an hour.  But is I needed $150,000 in salary alone, I do not see that as possible unser the IMP model or any primary care model for that matter.    Larry Lindeman <llindemanmac> wrote:Recently I have had money on my mind. After 2 years in my new practice I an finally close to making $150,000 which is still less than I made at my old job. However I am finding it difficult to figure out how to make anymore than that since I don't think that I can see any more patients in a day. The median income of FP's is over $160.000/yr. How many of you are making more than the median FP income and what are you doing to make that much. If the micropractice model is not capable of producing enough income to provide at least the median income it is probably not going to be a viable model.Larry Lindeman MD  Stay in the know. Pulse on the new Yahoo.com. Check it out.  

[Guest guest]

I work with a lab that offers CMP for 7$ and CBC for 5, PAP for 20 if I

do the billing. I did not think to make money on this, actually I use

it mostly for cash patients. Can I do the billing and charge the

insurance for this ?

> I order to make the income you have to be able to provide some

> ancillary services, lab, ekg, pfts, audiograms, xray etc to provide

> very complete care. Use Ma or lpns. You still have to do some

> volume w an employee once you have opportunity to get a little

> busier. The employee can help you keep generating revenue by keeping

> you off the phone, seeing appointments and doing what you do. They

> can also answer phone when you are not there and plug in an appt for

> later that day. They can keep you out of the reach of detail

> people.

>

> Why do lab? Our local hospital charge 126 for a tsh. I can buy for

> a minor percentage of that from a commmercial lab and charge half of

> local hospital and still make more than for the whole office visit

> some of the times.

>

> All the little things add up and provide for a complete care model.

> Immunizations are becoming a much bigger part of my practice, the

> problem is margins are so small , many times hard to break even. Will

> still do for now.

> Brent

>

> >

> > Recently I have had money on my mind. After 2 years in my

> new

> > practice I an finally close to making $150,000 which is still less

> > than I made at my old job. However I am finding it difficult to

> > figure out how to make anymore than that since I don't think that I

> > can see any more patients in a day. The median income of FP's is

> over

> > $160.000/yr. How many of you are making more than the median FP

> > income and what are you doing to make that much. If the

> micropractice

> > model is not capable of producing enough income to provide at least

> > the median income it is probably not going to be a viable model.

> > Larry Lindeman MD

> >

> >

> >

> >

> >

> > ---------------------------------

> >

> > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > ---------------------------------

> > Get your own web address for just $1.99/1st yr. We'll help. Yahoo!

> Small Business.

> >

> > ---------------------------------

> > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> >

>

>

>

[Guest guest]

I work with a lab that offers CMP for 7$ and CBC for 5, PAP for 20 if I

do the billing. I did not think to make money on this, actually I use

it mostly for cash patients. Can I do the billing and charge the

insurance for this ?

> I order to make the income you have to be able to provide some

> ancillary services, lab, ekg, pfts, audiograms, xray etc to provide

> very complete care. Use Ma or lpns. You still have to do some

> volume w an employee once you have opportunity to get a little

> busier. The employee can help you keep generating revenue by keeping

> you off the phone, seeing appointments and doing what you do. They

> can also answer phone when you are not there and plug in an appt for

> later that day. They can keep you out of the reach of detail

> people.

>

> Why do lab? Our local hospital charge 126 for a tsh. I can buy for

> a minor percentage of that from a commmercial lab and charge half of

> local hospital and still make more than for the whole office visit

> some of the times.

>

> All the little things add up and provide for a complete care model.

> Immunizations are becoming a much bigger part of my practice, the

> problem is margins are so small , many times hard to break even. Will

> still do for now.

> Brent

>

> >

> > Recently I have had money on my mind. After 2 years in my

> new

> > practice I an finally close to making $150,000 which is still less

> > than I made at my old job. However I am finding it difficult to

> > figure out how to make anymore than that since I don't think that I

> > can see any more patients in a day. The median income of FP's is

> over

> > $160.000/yr. How many of you are making more than the median FP

> > income and what are you doing to make that much. If the

> micropractice

> > model is not capable of producing enough income to provide at least

> > the median income it is probably not going to be a viable model.

> > Larry Lindeman MD

> >

> >

> >

> >

> >

> > ---------------------------------

> >

> > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> >

> >

> >

> >

> >

> >

> >

> >

> >

> > ---------------------------------

> > Get your own web address for just $1.99/1st yr. We'll help. Yahoo!

> Small Business.

> >

> > ---------------------------------

> > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> >

>

>

>

[Guest guest]

I think you are right, as far as I know, FP is about 140.000 average.

Am I wrong ?

> $91.00 per patient visit is about what I average also - about 2000

> visits/year. 

> FPs in this town have never averaged $160,000 year.

>

>

>

>

>

>

>>

>> Hi Larry:

>>  

>> Let me assume some numbers for now as follows

>>  

>> 2000 patients

>> 300,000 collections

>> 150,000 overhead

>> 150,000 salary

>>  

>> Collections per patient then 300,000/2000 or $150/year per patient or

>> a little over $12/ month per patient.

>>  

>> My practice has fewer patients but last year we collected

>> $200/patient but still less than 20$ per month per patient. 

>>  

>> I still feel the way we make primary care affordable is by asking

>> patients/insurers/ and employers to pay $1/day.

>>  

>> The only other way to increase revenue and salary is to provide quick

>> care.  A friend who provided urgeant carewould see 30-40 patients per

>> day in quick care working 3-4 days per week.  He was seeing 4-6

>> patients per hour. Most 99313's one problem one prescription $50-70

>> per visit or 200/hour $1600/day.  2000 hours per year 400,000

>> overhead 200,000 salary.

>>  

>> In our low overhead clinic with just medicare, if we could see enough

>> patients with higher level visits for 99214 at two an hour we would

>> collect $158/ hour.  For 2000 hours $316,000 in overhead.  As it is

>> we are at 35-40 patient per week most are 99214 with in house lab we

>> collect about $92 per patient visit.  Overhead is $60,000 to increase

>> to $80,000 next year. At 2000 visits per year we will collect about

>> 180,000. pay $100,000.  We feel we will be able to increase daily

>> visits but keep hours the same and hope to evetually provide salary

>> and benefits of $150,000 per year. 

>>  

>> Note your income is a combination of salary, benefits, CME,

>> professional liscences, health insurance, disability insurance. 

>> $20,000 of our overhead covers these expenses.  So our real income

>> and benefits is actually $100,000 this year for seeing less than a

>> patient an hour.  But is I needed $150,000 in salary alone, I do not

>> see that as possible unser the IMP model or any primary care model

>> for that matter.

>>  

>>  

>>

>>  

>>  

>>

>> Larry Lindeman wrote:Recently I have had money on

>> my mind. After 2 years in my new

>>> practice I an finally close to making $150,000 which is still less

>>> than I made at my old job. However I am finding it difficult to

>>> figure out how to make anymore than that since I don't think that I

>>> can see any more patients in a day. The median income of FP's is over

>>> $160.000/yr. How many of you are making more than the median FP

>>> income and what are you doing to make that much. If the micropractice

>>> model is not capable of producing enough income to provide at least

>>> the median income it is probably not going to be a viable model.

>>> Larry Lindeman MD

>>>

>>

>>

>> Stay in the know. Pulse on the new Yahoo.com. Check it out.

>>

>

>

>

[Guest guest]

I think you are right, as far as I know, FP is about 140.000 average.

Am I wrong ?

> $91.00 per patient visit is about what I average also - about 2000

> visits/year. 

> FPs in this town have never averaged $160,000 year.

>

>

>

>

>

>

>>

>> Hi Larry:

>>  

>> Let me assume some numbers for now as follows

>>  

>> 2000 patients

>> 300,000 collections

>> 150,000 overhead

>> 150,000 salary

>>  

>> Collections per patient then 300,000/2000 or $150/year per patient or

>> a little over $12/ month per patient.

>>  

>> My practice has fewer patients but last year we collected

>> $200/patient but still less than 20$ per month per patient. 

>>  

>> I still feel the way we make primary care affordable is by asking

>> patients/insurers/ and employers to pay $1/day.

>>  

>> The only other way to increase revenue and salary is to provide quick

>> care.  A friend who provided urgeant carewould see 30-40 patients per

>> day in quick care working 3-4 days per week.  He was seeing 4-6

>> patients per hour. Most 99313's one problem one prescription $50-70

>> per visit or 200/hour $1600/day.  2000 hours per year 400,000

>> overhead 200,000 salary.

>>  

>> In our low overhead clinic with just medicare, if we could see enough

>> patients with higher level visits for 99214 at two an hour we would

>> collect $158/ hour.  For 2000 hours $316,000 in overhead.  As it is

>> we are at 35-40 patient per week most are 99214 with in house lab we

>> collect about $92 per patient visit.  Overhead is $60,000 to increase

>> to $80,000 next year. At 2000 visits per year we will collect about

>> 180,000. pay $100,000.  We feel we will be able to increase daily

>> visits but keep hours the same and hope to evetually provide salary

>> and benefits of $150,000 per year. 

>>  

>> Note your income is a combination of salary, benefits, CME,

>> professional liscences, health insurance, disability insurance. 

>> $20,000 of our overhead covers these expenses.  So our real income

>> and benefits is actually $100,000 this year for seeing less than a

>> patient an hour.  But is I needed $150,000 in salary alone, I do not

>> see that as possible unser the IMP model or any primary care model

>> for that matter.

>>  

>>  

>>

>>  

>>  

>>

>> Larry Lindeman wrote:Recently I have had money on

>> my mind. After 2 years in my new

>>> practice I an finally close to making $150,000 which is still less

>>> than I made at my old job. However I am finding it difficult to

>>> figure out how to make anymore than that since I don't think that I

>>> can see any more patients in a day. The median income of FP's is over

>>> $160.000/yr. How many of you are making more than the median FP

>>> income and what are you doing to make that much. If the micropractice

>>> model is not capable of producing enough income to provide at least

>>> the median income it is probably not going to be a viable model.

>>> Larry Lindeman MD

>>>

>>

>>

>> Stay in the know. Pulse on the new Yahoo.com. Check it out.

>>

>

>

>

[Guest guest]

Definitiely yes but not medicare. Anemaria Lutas wrote: I work with a lab that offers CMP for 7$ and CBC for 5, PAP for 20 if I do the billing. I did not think to make money on this, actually I use it mostly for cash patients. Can I do the billing and charge the insurance for this ?> I order to make the income you have to be able to provide some> ancillary services, lab, ekg, pfts, audiograms, xray etc to provide> very complete care. Use Ma or lpns. You still have to do some> volume w an employee once you have opportunity to get a little> busier. The employee can help you keep generating revenue by keeping> you off the phone, seeing appointments and doing what you do.

They> can also answer phone when you are not there and plug in an appt for> later that day. They can keep you out of the reach of detail> people.>> Why do lab? Our local hospital charge 126 for a tsh. I can buy for> a minor percentage of that from a commmercial lab and charge half of> local hospital and still make more than for the whole office visit> some of the times.>> All the little things add up and provide for a complete care model.> Immunizations are becoming a much bigger part of my practice, the> problem is margins are so small , many times hard to break even. Will> still do for now.> Brent> > >> > Recently I have had money on my mind. After 2 years in my> new> > practice I an finally close to

making $150,000 which is still less> > than I made at my old job. However I am finding it difficult to> > figure out how to make anymore than that since I don't think that I> > can see any more patients in a day. The median income of FP's is> over> > $160.000/yr. How many of you are making more than the median FP> > income and what are you doing to make that much. If the> micropractice> > model is not capable of producing enough income to provide at least> > the median income it is probably not going to be a viable model.> > Larry Lindeman MD> >> >> >> >> >> > ---------------------------------> >> > Stay in the know. Pulse on the new Yahoo.com. Check it out.> >> >> >> >> >> >> >> >> >> >

---------------------------------> > Get your own web address for just $1.99/1st yr. We'll help. Yahoo!> Small Business.> >> > ---------------------------------> > Stay in the know. Pulse on the new Yahoo.com. Check it out.> >>> >

Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

I am agonizing about opening an IMP.

At present I make 130,000. Working 14 days per month usually light

work. I too was very disappointed that my income was in the bottom

third of Family Medicine doctors.

The benefits of an IMP are that I can work for more years. It

appears less stressful and a more satisfying lifestyle. (Anyone

disagree with this?).

The disadvantages of an IMP for me are that I cannot leave my

practice for prolonged periods of time. I am sure there are a lot of

day to day hassles which I am unaware about.

If there is no chance for me to increase my income, I probably will

not open an IMP.

Uday Mehta, MD

Bellevue, WA.

>

> I have been thinking about the same things lately, Larry.

Unfortunately, I

> only paid myself $45,000 last year (my second year of solo, low

volume

> practice) However, my numbers are still not as good as yours. I

think I

> average about 8 patients a day. But I also only work about 36

hours a week.

> I am definately curious about what others have to say on this issue

> Marie Christensen MD

>

> _____

>

> From:

> [mailto: ] On Behalf Of

Brock DO

> Sent: Wednesday, September 13, 2006 2:23 PM

> To:

> Subject: RE: money

>

>

>

>

> The problem is that the average of $160,000 includes docs that do

the full

> gamut of FP & usually high volumes. The typical FP still likely

does AM

> inpatient work, sees 30+ office patients, sees nursing home

patients, works

> 60 hrs per week. It is hard to expect an IMP low volume practice

to match

> that because I personally am not working nearly that hard! I do

not do

> inpatient, nursing homes, & only work ~ 36 - 40 hrs per week

(averaging 12 -

> 15 pts/day), so of course I am not going to make $160,000, but

that is a

> lifestyle tradeoff have chosen. At least that is the way I have

> rationalized not making " average " income in my mind.

>

>

>

>

>

>

>

> money

>

>

>

> Recently I have had money on my mind. After 2 years in my new

> practice I an finally close to making $150,000 which is still less

> than I made at my old job. However I am finding it difficult to

> figure out how to make anymore than that since I don't think that

I

> can see any more patients in a day. The median income of FP's is

over

> $160.000/yr. How many of you are making more than the median FP

> income and what are you doing to make that much. If the

micropractice

> model is not capable of producing enough income to provide at

least

> the median income it is probably not going to be a viable model.

> Larry Lindeman MD

>

[Guest guest]

Wow, you work 14 days a month, light work and make 130,000? Wow, that would

be hard to beat.

T. Ellsworth, MD

sdale, Az

money

>

>

>

> Recently I have had money on my mind. After 2 years in my new

> practice I an finally close to making $150,000 which is still less

> than I made at my old job. However I am finding it difficult to

> figure out how to make anymore than that since I don't think that

I

> can see any more patients in a day. The median income of FP's is

over

> $160.000/yr. How many of you are making more than the median FP

> income and what are you doing to make that much. If the

micropractice

> model is not capable of producing enough income to provide at

least

> the median income it is probably not going to be a viable model.

> Larry Lindeman MD

>

[Guest guest]

quite easily. You will have to tie the lab code to the dx. Our lab

charges around 100 for a pap , more w hpv testing, heck if you charge

50 everybody comes out ahead. Our local hospital will charge 60 plus

for a cbc, who knows for a comp. You can not bill medicaid and

medicare due to the way their system is set up unless you do the lab

directly.

Brent

> > >

> > > Recently I have had money on my mind. After 2 years in my

> > new

> > > practice I an finally close to making $150,000 which is still

less

> > > than I made at my old job. However I am finding it difficult to

> > > figure out how to make anymore than that since I don't think

that I

> > > can see any more patients in a day. The median income of FP's

is

> > over

> > > $160.000/yr. How many of you are making more than the median FP

> > > income and what are you doing to make that much. If the

> > micropractice

> > > model is not capable of producing enough income to provide at

least

> > > the median income it is probably not going to be a viable

model.

> > > Larry Lindeman MD

> > >

> > >

> > >

> > >

> > >

> > > ---------------------------------

> > >

> > > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > ---------------------------------

> > > Get your own web address for just $1.99/1st yr. We'll help.

Yahoo!

> > Small Business.

> > >

> > > ---------------------------------

> > > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> > >

> >

> >

> >

>

[Guest guest]

quite easily. You will have to tie the lab code to the dx. Our lab

charges around 100 for a pap , more w hpv testing, heck if you charge

50 everybody comes out ahead. Our local hospital will charge 60 plus

for a cbc, who knows for a comp. You can not bill medicaid and

medicare due to the way their system is set up unless you do the lab

directly.

Brent

> > >

> > > Recently I have had money on my mind. After 2 years in my

> > new

> > > practice I an finally close to making $150,000 which is still

less

> > > than I made at my old job. However I am finding it difficult to

> > > figure out how to make anymore than that since I don't think

that I

> > > can see any more patients in a day. The median income of FP's

is

> > over

> > > $160.000/yr. How many of you are making more than the median FP

> > > income and what are you doing to make that much. If the

> > micropractice

> > > model is not capable of producing enough income to provide at

least

> > > the median income it is probably not going to be a viable

model.

> > > Larry Lindeman MD

> > >

> > >

> > >

> > >

> > >

> > > ---------------------------------

> > >

> > > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > ---------------------------------

> > > Get your own web address for just $1.99/1st yr. We'll help.

Yahoo!

> > Small Business.

> > >

> > > ---------------------------------

> > > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> > >

> >

> >

> >

>

[Guest guest]

Thank you, I think I will start doing that.

> quite easily. You will have to tie the lab code to the dx. Our lab

> charges around 100 for a pap , more w hpv testing, heck if you charge

> 50 everybody comes out ahead. Our local hospital will charge 60 plus

> for a cbc, who knows for a comp. You can not bill medicaid and

> medicare due to the way their system is set up unless you do the lab

> directly.

> Brent

>

> > > >

> > > > Recently I have had money on my mind. After 2 years in my

> > > new

> > > > practice I an finally close to making $150,000 which is still

> less

> > > > than I made at my old job. However I am finding it difficult to

> > > > figure out how to make anymore than that since I don't think

> that I

> > > > can see any more patients in a day. The median income of FP's

> is

> > > over

> > > > $160.000/yr. How many of you are making more than the median FP

> > > > income and what are you doing to make that much. If the

> > > micropractice

> > > > model is not capable of producing enough income to provide at

> least

> > > > the median income it is probably not going to be a viable

> model.

> > > > Larry Lindeman MD

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > ---------------------------------

> > > >

> > > > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > >

> > > > ---------------------------------

> > > > Get your own web address for just $1.99/1st yr. We'll help.

> Yahoo!

> > > Small Business.

> > > >

> > > > ---------------------------------

> > > > Stay in the know. Pulse on the new Yahoo.com. Check it out.

> > > >

> > >

> > >

> > >

> >

>

>

>