Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2006 Report Share Posted September 13, 2006 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 : 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 : 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 $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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 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. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 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. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 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 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 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 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 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 $160.000/yr. How many of you are making more than the median FP income and what are you doing to make that much. If the micropractice model is not capable of producing enough income to provide at least the median income it is probably not going to be a viable model.Larry Lindeman MD Stay in the know. Pulse on the new Yahoo.com. Check it out. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 I work with a lab that offers CMP for 7$ 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 $1.99/1st yr. We'll help. Yahoo! > Small Business. > > > > --------------------------------- > > Stay in the know. Pulse on the new Yahoo.com. Check it out. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 I work with a lab that offers CMP for 7$ 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. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 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. >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 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 >>> $160.000/yr. How many of you are making more than the median FP >>> income and what are you doing to make that much. If the micropractice >>> model is not capable of producing enough income to provide at least >>> the median income it is probably not going to be a viable model. >>> Larry Lindeman MD >>> >> >> >> Stay in the know. Pulse on the new Yahoo.com. Check it out. >> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 Definitiely yes but not medicare. Anemaria Lutas wrote: I work with a lab that offers CMP for 7$ 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2006 Report Share Posted September 14, 2006 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 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 15, 2006 Report Share Posted September 15, 2006 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 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 15, 2006 Report Share Posted September 15, 2006 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. > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 15, 2006 Report Share Posted September 15, 2006 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. > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 15, 2006 Report Share Posted September 15, 2006 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. > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.