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1) does your MA do everything besides doctoring stuff, answer phones, schedule,

call with lab results, vitals/shots/EKG's/finger sticks, etc? That seems almost

insurmountable for one poor MA to do alone. How much do you pay her?

2) what is your monthly gross income? That would help me compare apple to

apples. There must be something I'm missing in your numbers because I don't see

that many less pts than you, my malpractice is less than half of yours, & I'm

sure my rent/building payment is less than yours, yet I'm certainly not making

near $150,000. I do not do inpatient, I work 4.5 days/wk. Are you getting

extraordinary reimbursement for a 99213/99214 there?

Thanks,

>

>

> Date: 2006/09/17 Sun AM 10:18:30 EDT

> To:

> Subject: Re: Re: money

>

> I think that the 3 most important things that are helping me are: 1)

> Having a good medical assistant to help with the many chores that

> need to be done in the office allowing me to see 16-18 patients per

> day. 2) Having a good outside biller who I talk to at least once a

> week on coding or reimbursement issues. 3) Learning everything I can

> about coding. Do you know how much you can reimbursed for splint

> application or using a global fracture code for a broken toe or rib

> instead of an e & m code?

>

> For many people it is the right choice to start with the solo solo

> model to minimize start up costs. However after a practice starts to

> get busy many people might want to expand to having an assistant even

> though this means a higher overhead. I think that you might find

> medicine more enjoyable and profitable spending more time with

> patients and a little less on paper work. Limiting your staff to 1 or

> 1.5 still keeps the practice small enough that you will still know

> every patient well.

> Another thing that I am just starting this week is comparing the

> reimbursement of every insurance company. In January we are going to

> stop participating with the 2 lowest payors

>

> I practice in Chicago, Malpractice is $30,000/yr. I see 75-80

> patients/week, I work 5 days per week. I do minimal hosp work and

> will probably give that up. We draw blood, we bill for labs done at

> quest if the reimbursement is good enough,do ecgs, I do minor skin

> surgery in the office. We have 10,500sq ft office for 1.5 docs

>

> Larry Lindeman MD

>

> Larry Lindeman MD

>

>

> >

> > Larry Lindeman,

> > How do you make nearly 150? How many pts do you see per day, how

> > many days per week, geographic location and malpractice insurance.

> > I am finding it difficult to see how I would ever make anywhere

> > near that.

> > Naureen Mohamed

> >

> >

>

>

>

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Dr Ellsworth, Dr Brock and others,

Sorry for long post and getting back a little late.

I should have clarified that my days are 11 or 12 hr days.

I do Family Medicine and Urgent Care.

I work for my local county hospital 3 days a week (Tuesday, Thursday

and every other weekend) and the salary is 104,000. Yes, I am

usually off every Mon, Wed and Fri.

The clinic is open 1 yr and I see only about 10 pts per day. The max

is 20. (This may change).

All I do is treat the patients.

At the end of the day my eyes are often bleary from too much

computer surfing.

I kept my old job for moon lighting 2 days a month.

I make approximately 23,000 per yr.

80 ($ per hr) x 12 (hrs per shift) x 2(shifts per month) x 12

(months per yr).

These are 12 hr days and very busy occasionally seeing up to 40 pts

per day. (Mostly 27)

At the end of the day I feel satisfied that I did a good job and

kept my skills up.

Total salary approx 127,000/ yr. (104,000 + 23,000)

Working 180 days per year. Not including approx 22 days paid leave

per year.

What does an average Family Medicine Doctor make?

http://swz.salary.com/salarywizard/layouthtmls/swzl_compresult_nation

al_HC07000052.html

The summary is below:

Base Pay only:

25 th Percentile – 137,803.

Median - 156,119.

75th Percentile - 183,281.

Total Cash Compensation (Base + Bonus)

25th percentile – 140,838.

Median – 160,044.

75th percentile - 188541

Total Compensation (Base + Bonus + Benefits)

Only Median Reported – 205,701.

The Total Compensation is an additional 23 % of the Total Cash

Compensation and (the Benefits) include:

Social security (4%); 401k/ 403 b (3%); Disability (2%); Healthcare

(3%); Pension (3%); Time off (8 %).

Of course this web site could have incorrect information and things

do change constantly.

I feel these numbers are quite accurate. Benefits do count (20 %

conservatively).

I was let go from my old (now moonlighting) job as they could hire

new doctors cheaper. I grossed about 155 K working hard (although

only approximately 150 shift).

There I had excellent benefits, including the extremely enviable

defined benefit pension plan. (They pay you a fixed amount till the

latter of you or your spouse dies, like social security).

Some points I would like to raise are

1) Average IMP take home is below average non IMP in spite of

working hard.

This may change though as " The expenses for an average non IMP keep

on going up whereas with an IMP they are somewhat controlled " .

2) For the Average non IMP: Financial reward is a great

motivator for working hard.

This is why they keep up with all the extra hours and

lack of family time.

3) It boils down to time and money.

Do you want more time off or more money?

For me I like the fact that I have a lot of time off. I may regret

this decision in the future.

(I know of no one who went to their death bed wishing they had

worked harder).

4) There may be more day to day hassles with an IMP.

5) It is harder to take prolonged/overseas vacation with an IMP.

6) Why do IMP's feel better at the end of the day? It has to do

with a sense of worth and a personal need being fulfilled which is

hard to measure. It is not a way to be financially wealthy but a

great way to contribute to the community and live an honorable life.

7) With an IMP the burn out rate may be low and one can

definitely work longer years therefore financially it all may even

out in the end.

One of the main reasons for me to start an IMP would be to have the

opportunity to work till I am able to (maybe even into my eighties).

I see a lot of older people who have retired and who miss the

intellectual challenge and now have no opportunity to use their

skills. (If you don't use it you loose it).

These are my views only. I am sure this is not the absolute truth as

each case varies. If one is 80 % satisfied/happy with their career

and financial situation then it's great.

Uday Mehta,

Age 46.

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: Practiceimprovement <mailto:%

40yahoogroups.com>

> 1

> > [mailto:Practiceimprovement

> <mailto:%40yahoogroups.com> 1 ]

On Behalf

> Of

> Brock DO

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

> > To: Practiceimprovement <mailto:%

40yahoogroups.com>

> 1

> > 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

> >

>

>

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Uday --

Thanks for that thorough explanation and your perspectives.

I think you are both smart and wise -- a very valuable combination. Good

luck with your decisions.

Tim

>

> Dr Ellsworth, Dr Brock and others,

> Sorry for long post and getting back a little late.

>

> I should have clarified that my days are 11 or 12 hr days.

> I do Family Medicine and Urgent Care.

>

> I work for my local county hospital 3 days a week (Tuesday, Thursday

> and every other weekend) and the salary is 104,000. Yes, I am

> usually off every Mon, Wed and Fri.

> The clinic is open 1 yr and I see only about 10 pts per day. The max is

> 20. (This may change).

> All I do is treat the patients.

> At the end of the day my eyes are often bleary from too much

> computer surfing.

>

> I kept my old job for moon lighting 2 days a month.

> I make approximately 23,000 per yr.

> 80 ($ per hr) x 12 (hrs per shift) x 2(shifts per month) x 12

> (months per yr).

> These are 12 hr days and very busy occasionally seeing up to 40 pts per

> day. (Mostly 27)

> At the end of the day I feel satisfied that I did a good job and

> kept my skills up.

>

>

> Total salary approx 127,000/ yr. (104,000 + 23,000)

> Working 180 days per year. Not including approx 22 days paid leave per

> year.

>

>

> What does an average Family Medicine Doctor make?

>

> http://swz.salary.com/salarywizard/layouthtmls/swzl_compresult_nation

> al_HC07000052.html

>

> The summary is below:

>

> Base Pay only:

> 25 th Percentile – 137,803.

> Median - 156,119.

> 75th Percentile - 183,281.

>

>

> Total Cash Compensation (Base + Bonus)

> 25th percentile – 140,838.

> Median – 160,044.

> 75th percentile - 188541

>

>

> Total Compensation (Base + Bonus + Benefits)

> Only Median Reported – 205,701.

>

> The Total Compensation is an additional 23 % of the Total Cash

> Compensation and (the Benefits) include:

> Social security (4%); 401k/ 403 b (3%); Disability (2%); Healthcare

> (3%); Pension (3%); Time off (8 %).

>

> Of course this web site could have incorrect information and things do

> change constantly.

> I feel these numbers are quite accurate. Benefits do count (20 %

> conservatively).

>

>

> I was let go from my old (now moonlighting) job as they could hire new

> doctors cheaper. I grossed about 155 K working hard (although only

> approximately 150 shift).

> There I had excellent benefits, including the extremely enviable

> defined benefit pension plan. (They pay you a fixed amount till the

> latter of you or your spouse dies, like social security).

>

>

> Some points I would like to raise are

>

> 1) Average IMP take home is below average non IMP in spite of

> working hard.

> This may change though as " The expenses for an average non IMP keep

> on going up whereas with an IMP they are somewhat controlled " .

>

> 2) For the Average non IMP: Financial reward is a great

> motivator for working hard.

> This is why they keep up with all the extra hours and

> lack of family time.

>

> 3) It boils down to time and money.

> Do you want more time off or more money?

> For me I like the fact that I have a lot of time off. I may regret this

> decision in the future.

> (I know of no one who went to their death bed wishing they had

> worked harder).

>

> 4) There may be more day to day hassles with an IMP.

>

> 5) It is harder to take prolonged/overseas vacation with an IMP.

>

> 6) Why do IMP's feel better at the end of the day? It has to do

> with a sense of worth and a personal need being fulfilled which is hard

> to measure. It is not a way to be financially wealthy but a

> great way to contribute to the community and live an honorable life.

>

> 7) With an IMP the burn out rate may be low and one can

> definitely work longer years therefore financially it all may even out

> in the end.

> One of the main reasons for me to start an IMP would be to have the

> opportunity to work till I am able to (maybe even into my eighties). I

> see a lot of older people who have retired and who miss the

> intellectual challenge and now have no opportunity to use their

> skills. (If you don't use it you loose it).

>

>

> These are my views only. I am sure this is not the absolute truth as

> each case varies. If one is 80 % satisfied/happy with their career and

> financial situation then it's great.

>

> Uday Mehta,

> Age 46.

> 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: Practiceimprovement <mailto:%

> 40yahoogroups.com>

>> 1

>> > [mailto:Practiceimprovement

>> <mailto:%40yahoogroups.com> 1 ]

> On Behalf

>> Of

>> Brock DO

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

>> > To: Practiceimprovement <mailto:%

> 40yahoogroups.com>

>> 1

>> > 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

>> >

>>

>>

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1)My setup with my MA is unique to us and our preferences and I suggest that everybody work out how to divy up the work based on their own circumstances. When my ma and I are working with just the 2 of us (18 months out of the 2 years we have been around) She does most of the phone work. She does vitals, ecg's, draws blood and shots. While she doing those clinical things I sit at the front desk answering the phone and doing my charting. When its working right I have just finished my charting as she has finished her stuff. I like to answer the phone and she likes to draw blood. She also double checks every patient charge to make sure I didn't leave out any charges for things like U/A s or strep tests. Now that we have an lpn , when there are 2 doctors in the office my ma  spends most of her time at the front with phones, insurance etc and the lpn does clinical. When I am the only doc seeing patients it reverts back to the old way with the lpn helping with chronic care management and right now entering our labs into our emr (We are about to get a lab module) The pay scale for ma's in chicago is $11/hr up to $19/hr. My ma started at the bottom of the scale with no benefits and is now in the middle with health insurance. My ma liked the ideals of the practice and was willing to sacrifice to be in at the start. She has read all of Gordon's articles in FPM and gets my FPM journal as soon as I'm finished with it.2)For my 99213 I get $55-$65 dollars, For 99214 I get $90 -100, For preventive visits I get around $110-$140, For things like pre-op consults on my own patients I get $250 (I love those) I average $100 per visit partially because of ancillaries and the skin procedures that I do. I really work on my coding. Coding Tip: Remember that when you do both a koh and a wet prep to charge for 2 slides.1) does your MA do everything besides doctoring stuff, answer phones, schedule, call with lab results, vitals/shots/EKG's/finger sticks, etc? That seems almost insurmountable for one poor MA to do alone. How much do you pay her?2) what is your monthly gross income? That would help me compare apple to apples. There must be something I'm missing in your numbers because I don't see that many less pts than you, my malpractice is less than half of yours, & I'm sure my rent/building payment is less than yours, yet I'm certainly not making near $150,000. I do not do inpatient, I work 4.5 days/wk. Are you getting extraordinary reimbursement for a 99213/99214 there?Thanks,> > From: Larry Lindeman <llindemanmac>> Date: 2006/09/17 Sun AM 10:18:30 EDT> To: > Subject: Re: Re: money> > I think that the 3 most important things that are helping me are: 1) > Having a good medical assistant to help with the many chores that > need to be done in the office allowing me to see 16-18 patients per > day. 2) Having a good outside biller who I talk to at least once a > week on coding or reimbursement issues. 3) Learning everything I can > about coding. Do you know how much you can reimbursed for splint > application or using a global fracture code for a broken toe or rib > instead of an e & m code?> > For many people it is the right choice to start with the solo solo > model to minimize start up costs. However after a practice starts to > get busy many people might want to expand to having an assistant even > though this means a higher overhead. I think that you might find > medicine more enjoyable and profitable spending more time with > patients and a little less on paper work. Limiting your staff to 1 or > 1.5 still keeps the practice small enough that you will still know > every patient well.> Another thing that I am just starting this week is comparing the > reimbursement of every insurance company. In January we are going to > stop participating with the 2 lowest payors> > I practice in Chicago, Malpractice is $30,000/yr. I see 75-80 > patients/week, I work 5 days per week. I do minimal hosp work and > will probably give that up. We draw blood, we bill for labs done at > quest if the reimbursement is good enough,do ecgs, I do minor skin > surgery in the office. We have 10,500sq ft office for 1.5 docs> > Larry Lindeman MD> > Larry Lindeman MD> > > >> > Larry Lindeman,> > How do you make nearly 150? How many pts do you see per day, how > > many days per week, geographic location and malpractice insurance. > > I am finding it difficult to see how I would ever make anywhere > > near that.> > Naureen Mohamed> >> > > > >

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1)My setup with my MA is unique to us and our preferences and I suggest that everybody work out how to divy up the work based on their own circumstances. When my ma and I are working with just the 2 of us (18 months out of the 2 years we have been around) She does most of the phone work. She does vitals, ecg's, draws blood and shots. While she doing those clinical things I sit at the front desk answering the phone and doing my charting. When its working right I have just finished my charting as she has finished her stuff. I like to answer the phone and she likes to draw blood. She also double checks every patient charge to make sure I didn't leave out any charges for things like U/A s or strep tests. Now that we have an lpn , when there are 2 doctors in the office my ma  spends most of her time at the front with phones, insurance etc and the lpn does clinical. When I am the only doc seeing patients it reverts back to the old way with the lpn helping with chronic care management and right now entering our labs into our emr (We are about to get a lab module) The pay scale for ma's in chicago is $11/hr up to $19/hr. My ma started at the bottom of the scale with no benefits and is now in the middle with health insurance. My ma liked the ideals of the practice and was willing to sacrifice to be in at the start. She has read all of Gordon's articles in FPM and gets my FPM journal as soon as I'm finished with it.2)For my 99213 I get $55-$65 dollars, For 99214 I get $90 -100, For preventive visits I get around $110-$140, For things like pre-op consults on my own patients I get $250 (I love those) I average $100 per visit partially because of ancillaries and the skin procedures that I do. I really work on my coding. Coding Tip: Remember that when you do both a koh and a wet prep to charge for 2 slides.1) does your MA do everything besides doctoring stuff, answer phones, schedule, call with lab results, vitals/shots/EKG's/finger sticks, etc? That seems almost insurmountable for one poor MA to do alone. How much do you pay her?2) what is your monthly gross income? That would help me compare apple to apples. There must be something I'm missing in your numbers because I don't see that many less pts than you, my malpractice is less than half of yours, & I'm sure my rent/building payment is less than yours, yet I'm certainly not making near $150,000. I do not do inpatient, I work 4.5 days/wk. Are you getting extraordinary reimbursement for a 99213/99214 there?Thanks,> > From: Larry Lindeman <llindemanmac>> Date: 2006/09/17 Sun AM 10:18:30 EDT> To: > Subject: Re: Re: money> > I think that the 3 most important things that are helping me are: 1) > Having a good medical assistant to help with the many chores that > need to be done in the office allowing me to see 16-18 patients per > day. 2) Having a good outside biller who I talk to at least once a > week on coding or reimbursement issues. 3) Learning everything I can > about coding. Do you know how much you can reimbursed for splint > application or using a global fracture code for a broken toe or rib > instead of an e & m code?> > For many people it is the right choice to start with the solo solo > model to minimize start up costs. However after a practice starts to > get busy many people might want to expand to having an assistant even > though this means a higher overhead. I think that you might find > medicine more enjoyable and profitable spending more time with > patients and a little less on paper work. Limiting your staff to 1 or > 1.5 still keeps the practice small enough that you will still know > every patient well.> Another thing that I am just starting this week is comparing the > reimbursement of every insurance company. In January we are going to > stop participating with the 2 lowest payors> > I practice in Chicago, Malpractice is $30,000/yr. I see 75-80 > patients/week, I work 5 days per week. I do minimal hosp work and > will probably give that up. We draw blood, we bill for labs done at > quest if the reimbursement is good enough,do ecgs, I do minor skin > surgery in the office. We have 10,500sq ft office for 1.5 docs> > Larry Lindeman MD> > Larry Lindeman MD> > > >> > Larry Lindeman,> > How do you make nearly 150? How many pts do you see per day, how > > many days per week, geographic location and malpractice insurance. > > I am finding it difficult to see how I would ever make anywhere > > near that.> > Naureen Mohamed> >> > > > >

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Your E/M codes pay about $20 more per visit than I get here in central Ohio, so

that is part of it.

>

>

> Date: 2006/09/18 Mon PM 09:24:02 EDT

> To:

> Subject: Re: Re: money

>

> 1)My setup with my MA is unique to us and our preferences and I

> suggest that everybody work out how to divy up the work based on

> their own circumstances. When my ma and I are working with just the 2

> of us (18 months out of the 2 years we have been around) She does

> most of the phone work. She does vitals, ecg's, draws blood and

> shots. While she doing those clinical things I sit at the front desk

> answering the phone and doing my charting. When its working right I

> have just finished my charting as she has finished her stuff. I like

> to answer the phone and she likes to draw blood. She also double

> checks every patient charge to make sure I didn't leave out any

> charges for things like U/A s or strep tests. Now that we have an

> lpn , when there are 2 doctors in the office my ma spends most of

> her time at the front with phones, insurance etc and the lpn does

> clinical. When I am the only doc seeing patients it reverts back to

> the old way with the lpn helping with chronic care management and

> right now entering our labs into our emr (We are about to get a lab

> module) The pay scale for ma's in chicago is $11/hr up to $19/hr. My

> ma started at the bottom of the scale with no benefits and is now in

> the middle with health insurance. My ma liked the ideals of the

> practice and was willing to sacrifice to be in at the start. She has

> read all of Gordon's articles in FPM and gets my FPM journal as soon

> as I'm finished with it.

>

> 2)For my 99213 I get $55-$65 dollars, For 99214 I get $90 -100, For

> preventive visits I get around $110-$140, For things like pre-op

> consults on my own patients I get $250 (I love those) I average $100

> per visit partially because of ancillaries and the skin procedures

> that I do. I really work on my coding. Coding Tip: Remember that when

> you do both a koh and a wet prep to charge for 2 slides.

>

>

> > 1) does your MA do everything besides doctoring stuff, answer

> > phones, schedule, call with lab results, vitals/shots/EKG's/finger

> > sticks, etc? That seems almost insurmountable for one poor MA to do

> > alone. How much do you pay her?

> >

> > 2) what is your monthly gross income? That would help me compare

> > apple to apples. There must be something I'm missing in your

> > numbers because I don't see that many less pts than you, my

> > malpractice is less than half of yours, & I'm sure my rent/building

> > payment is less than yours, yet I'm certainly not making near

> > $150,000. I do not do inpatient, I work 4.5 days/wk. Are you

> > getting extraordinary reimbursement for a 99213/99214 there?

> >

> > Thanks,

> >

> >

> > >

> > >

> > > Date: 2006/09/17 Sun AM 10:18:30 EDT

> > > To:

> > > Subject: Re: Re: money

> > >

> > > I think that the 3 most important things that are helping me are: 1)

> > > Having a good medical assistant to help with the many chores that

> > > need to be done in the office allowing me to see 16-18 patients per

> > > day. 2) Having a good outside biller who I talk to at least once a

> > > week on coding or reimbursement issues. 3) Learning everything I can

> > > about coding. Do you know how much you can reimbursed for splint

> > > application or using a global fracture code for a broken toe or rib

> > > instead of an e & m code?

> > >

> > > For many people it is the right choice to start with the solo solo

> > > model to minimize start up costs. However after a practice starts to

> > > get busy many people might want to expand to having an assistant

> > even

> > > though this means a higher overhead. I think that you might find

> > > medicine more enjoyable and profitable spending more time with

> > > patients and a little less on paper work. Limiting your staff to

> > 1 or

> > > 1.5 still keeps the practice small enough that you will still know

> > > every patient well.

> > > Another thing that I am just starting this week is comparing the

> > > reimbursement of every insurance company. In January we are going to

> > > stop participating with the 2 lowest payors

> > >

> > > I practice in Chicago, Malpractice is $30,000/yr. I see 75-80

> > > patients/week, I work 5 days per week. I do minimal hosp work and

> > > will probably give that up. We draw blood, we bill for labs done at

> > > quest if the reimbursement is good enough,do ecgs, I do minor skin

> > > surgery in the office. We have 10,500sq ft office for 1.5 docs

> > >

> > > Larry Lindeman MD

> > >

> > > Larry Lindeman MD

> > >

> > >

> > > >

> > > > Larry Lindeman,

> > > > How do you make nearly 150? How many pts do you see per day, how

> > > > many days per week, geographic location and malpractice insurance.

> > > > I am finding it difficult to see how I would ever make anywhere

> > > > near that.

> > > > Naureen Mohamed

> > > >

> > > >

> > >

> > >

> > >

> >

> >

> >

>

>

>

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Your E/M codes pay about $20 more per visit than I get here in central Ohio, so

that is part of it.

>

>

> Date: 2006/09/18 Mon PM 09:24:02 EDT

> To:

> Subject: Re: Re: money

>

> 1)My setup with my MA is unique to us and our preferences and I

> suggest that everybody work out how to divy up the work based on

> their own circumstances. When my ma and I are working with just the 2

> of us (18 months out of the 2 years we have been around) She does

> most of the phone work. She does vitals, ecg's, draws blood and

> shots. While she doing those clinical things I sit at the front desk

> answering the phone and doing my charting. When its working right I

> have just finished my charting as she has finished her stuff. I like

> to answer the phone and she likes to draw blood. She also double

> checks every patient charge to make sure I didn't leave out any

> charges for things like U/A s or strep tests. Now that we have an

> lpn , when there are 2 doctors in the office my ma spends most of

> her time at the front with phones, insurance etc and the lpn does

> clinical. When I am the only doc seeing patients it reverts back to

> the old way with the lpn helping with chronic care management and

> right now entering our labs into our emr (We are about to get a lab

> module) The pay scale for ma's in chicago is $11/hr up to $19/hr. My

> ma started at the bottom of the scale with no benefits and is now in

> the middle with health insurance. My ma liked the ideals of the

> practice and was willing to sacrifice to be in at the start. She has

> read all of Gordon's articles in FPM and gets my FPM journal as soon

> as I'm finished with it.

>

> 2)For my 99213 I get $55-$65 dollars, For 99214 I get $90 -100, For

> preventive visits I get around $110-$140, For things like pre-op

> consults on my own patients I get $250 (I love those) I average $100

> per visit partially because of ancillaries and the skin procedures

> that I do. I really work on my coding. Coding Tip: Remember that when

> you do both a koh and a wet prep to charge for 2 slides.

>

>

> > 1) does your MA do everything besides doctoring stuff, answer

> > phones, schedule, call with lab results, vitals/shots/EKG's/finger

> > sticks, etc? That seems almost insurmountable for one poor MA to do

> > alone. How much do you pay her?

> >

> > 2) what is your monthly gross income? That would help me compare

> > apple to apples. There must be something I'm missing in your

> > numbers because I don't see that many less pts than you, my

> > malpractice is less than half of yours, & I'm sure my rent/building

> > payment is less than yours, yet I'm certainly not making near

> > $150,000. I do not do inpatient, I work 4.5 days/wk. Are you

> > getting extraordinary reimbursement for a 99213/99214 there?

> >

> > Thanks,

> >

> >

> > >

> > >

> > > Date: 2006/09/17 Sun AM 10:18:30 EDT

> > > To:

> > > Subject: Re: Re: money

> > >

> > > I think that the 3 most important things that are helping me are: 1)

> > > Having a good medical assistant to help with the many chores that

> > > need to be done in the office allowing me to see 16-18 patients per

> > > day. 2) Having a good outside biller who I talk to at least once a

> > > week on coding or reimbursement issues. 3) Learning everything I can

> > > about coding. Do you know how much you can reimbursed for splint

> > > application or using a global fracture code for a broken toe or rib

> > > instead of an e & m code?

> > >

> > > For many people it is the right choice to start with the solo solo

> > > model to minimize start up costs. However after a practice starts to

> > > get busy many people might want to expand to having an assistant

> > even

> > > though this means a higher overhead. I think that you might find

> > > medicine more enjoyable and profitable spending more time with

> > > patients and a little less on paper work. Limiting your staff to

> > 1 or

> > > 1.5 still keeps the practice small enough that you will still know

> > > every patient well.

> > > Another thing that I am just starting this week is comparing the

> > > reimbursement of every insurance company. In January we are going to

> > > stop participating with the 2 lowest payors

> > >

> > > I practice in Chicago, Malpractice is $30,000/yr. I see 75-80

> > > patients/week, I work 5 days per week. I do minimal hosp work and

> > > will probably give that up. We draw blood, we bill for labs done at

> > > quest if the reimbursement is good enough,do ecgs, I do minor skin

> > > surgery in the office. We have 10,500sq ft office for 1.5 docs

> > >

> > > Larry Lindeman MD

> > >

> > > Larry Lindeman MD

> > >

> > >

> > > >

> > > > Larry Lindeman,

> > > > How do you make nearly 150? How many pts do you see per day, how

> > > > many days per week, geographic location and malpractice insurance.

> > > > I am finding it difficult to see how I would ever make anywhere

> > > > near that.

> > > > Naureen Mohamed

> > > >

> > > >

> > >

> > >

> > >

> >

> >

> >

>

>

>

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What code do you use to charge for a slide Koh or wetprep? what is the reimbursement? What dx do you submit for for it? Thanks

Re: Re: money> > >> > > I think that the 3 most important things that are helping me are: 1)> > > Having a good medical assistant to help with the many chores that> > > need to be done in the office allowing me to see 16-18 patients per> > > day. 2) Having a good outside biller who I talk to at least once a> > > week on coding or reimbursement issues. 3) Learning everything I can> > > about coding. Do you know how much you can reimbursed for splint> > > application or using a global fracture code for a broken toe or rib> > > instead of an e & m code?> > >> > > For many people it is the right choice to start with the solo solo> > > model to minimize start up costs. However after a practice starts to> > > get busy many people might want to expand to having an assistant > > even> > > though this means a higher overhead. I think that you might find> > > medicine more enjoyable and profitable spending more time with> > > patients and a little less on paper work. Limiting your staff to > > 1 or> > > 1.5 still keeps the practice small enough that you will still know> > > every patient well.> > > Another thing that I am just starting this week is comparing the> > > reimbursement of every insurance company. In January we are going to> > > stop participating with the 2 lowest payors> > >> > > I practice in Chicago, Malpractice is $30,000/yr. I see 75-80> > > patients/week, I work 5 days per week. I do minimal hosp work and> > > will probably give that up. We draw blood, we bill for labs done at> > > quest if the reimbursement is good enough,do ecgs, I do minor skin> > > surgery in the office. We have 10,500sq ft office for 1.5 docs> > >> > > Larry Lindeman MD> > >> > > Larry Lindeman MD> > > > > >> > > >> > > > Larry Lindeman,> > > > How do you make nearly 150? How many pts do you see per day, how> > > > many days per week, geographic location and malpractice insurance.> > > > I am finding it difficult to see how I would ever make anywhere> > > > near that.> > > > Naureen Mohamed> > > >> > > >> > >> > >> > >> >> >> > > > >

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What code do you use to charge for a slide Koh or wetprep? what is the reimbursement? What dx do you submit for for it? Thanks

Re: Re: money> > >> > > I think that the 3 most important things that are helping me are: 1)> > > Having a good medical assistant to help with the many chores that> > > need to be done in the office allowing me to see 16-18 patients per> > > day. 2) Having a good outside biller who I talk to at least once a> > > week on coding or reimbursement issues. 3) Learning everything I can> > > about coding. Do you know how much you can reimbursed for splint> > > application or using a global fracture code for a broken toe or rib> > > instead of an e & m code?> > >> > > For many people it is the right choice to start with the solo solo> > > model to minimize start up costs. However after a practice starts to> > > get busy many people might want to expand to having an assistant > > even> > > though this means a higher overhead. I think that you might find> > > medicine more enjoyable and profitable spending more time with> > > patients and a little less on paper work. Limiting your staff to > > 1 or> > > 1.5 still keeps the practice small enough that you will still know> > > every patient well.> > > Another thing that I am just starting this week is comparing the> > > reimbursement of every insurance company. In January we are going to> > > stop participating with the 2 lowest payors> > >> > > I practice in Chicago, Malpractice is $30,000/yr. I see 75-80> > > patients/week, I work 5 days per week. I do minimal hosp work and> > > will probably give that up. We draw blood, we bill for labs done at> > > quest if the reimbursement is good enough,do ecgs, I do minor skin> > > surgery in the office. We have 10,500sq ft office for 1.5 docs> > >> > > Larry Lindeman MD> > >> > > Larry Lindeman MD> > > > > >> > > >> > > > Larry Lindeman,> > > > How do you make nearly 150? How many pts do you see per day, how> > > > many days per week, geographic location and malpractice insurance.> > > > I am finding it difficult to see how I would ever make anywhere> > > > near that.> > > > Naureen Mohamed> > > >> > > >> > >> > >> > >> >> >> > > > >

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Your local county hospital- which one?

Overlake was private last time I was there. I raised my kids in Bellevue and the plateau

(now Sammamish). (You are talking to the former PTA co-president of Odle Middle

School)

Before being an IMP I did some

moonlighting at a large clinic where I saw 30-35 in 7 hours, or 25 during

extended hours at night.

I will be able to answer your

questions on money after my accountant who I just hired sifts through my

financials.

And my average working day is 12-14 hours(patient

time is 9 hours) As an IMP, I average 15-20 patients a day without a MA or RN.

However, my practice is a joy and I cannot

really call it work. Sometimes…microseconds… I feel guilty for

being so happy with what I’m doing. I don’t have that twisted

gripping in my stomach or pounding in my chest when climbing out or the car and

entering the workplace that use to haunt me.

The support from Gordon and from

this group is incalculable. You are not isolated or alone.

However, what you have outlined

compensation-wise seems excellent.

T. Ellsworth, MD

sdale, Az

From: [mailto: ] On Behalf Of umehta00

Sent: Monday, September 18, 2006

3:09 PM

To:

Subject:

Re: money

Dr Ellsworth, Dr Brock and others,

Sorry for long post and getting back a little late.

I should have clarified that my days are 11 or 12 hr days.

I do Family Medicine and Urgent Care.

I work for my local county hospital 3 days a week (Tuesday, Thursday

and every other weekend) and the salary is 104,000. Yes, I am

usually off every Mon, Wed and Fri.

The clinic is open 1 yr and I see only about 10 pts per day. The max

is 20. (This may change).

All I do is treat the patients.

At the end of the day my eyes are often bleary from too much

computer surfing.

I kept my old job for moon lighting 2 days a month.

I make approximately 23,000 per yr.

80 ($ per hr) x 12 (hrs per shift) x 2(shifts per month) x 12

(months per yr).

These are 12 hr days and very busy occasionally seeing up to 40 pts

per day. (Mostly 27)

At the end of the day I feel satisfied that I did a good job and

kept my skills up.

Total salary approx 127,000/ yr. (104,000 + 23,000)

Working 180 days per year. Not including approx 22 days paid leave

per year.

What does an average Family Medicine Doctor make?

http://swz.salary.com/salarywizard/layouthtmls/swzl_compresult_nation

al_HC07000052.html

The summary is below:

Base Pay only:

25 th Percentile – 137,803.

Median - 156,119.

75th Percentile - 183,281.

Total Cash Compensation (Base + Bonus)

25th percentile – 140,838.

Median – 160,044.

75th percentile - 188541

Total Compensation (Base + Bonus + Benefits)

Only Median Reported – 205,701.

The Total Compensation is an additional 23 % of the Total Cash

Compensation and (the Benefits) include:

Social security (4%); 401k/ 403 b (3%); Disability (2%); Healthcare

(3%); Pension (3%); Time off (8 %).

Of course this web site could have incorrect information and things

do change constantly.

I feel these numbers are quite accurate. Benefits do count (20 %

conservatively).

I was let go from my old (now moonlighting) job as they could hire

new doctors cheaper. I grossed about 155 K working hard (although

only approximately 150 shift).

There I had excellent benefits, including the extremely enviable

defined benefit pension plan. (They pay you a fixed amount till the

latter of you or your spouse dies, like social security).

Some points I would like to raise are

1) Average IMP take home is below average non IMP in spite of

working hard.

This may change though as " The expenses for an average non IMP keep

on going up whereas with an IMP they are somewhat controlled " .

2) For the Average non IMP: Financial reward is a great

motivator for working hard.

This is why they keep up with all the extra hours and

lack of family time.

3) It boils down to time and money.

Do you want more time off or more money?

For me I like the fact that I have a lot of time off. I may regret

this decision in the future.

(I know of no one who went to their death bed wishing they had

worked harder).

4) There may be more day to day hassles with an IMP.

5) It is harder to take prolonged/overseas vacation with an IMP.

6) Why do IMP's feel better at the end of the day? It has to do

with a sense of worth and a personal need being fulfilled which is

hard to measure. It is not a way to be financially wealthy but a

great way to contribute to the community and live an honorable life.

7) With an IMP the burn out rate may be low and one can

definitely work longer years therefore financially it all may even

out in the end.

One of the main reasons for me to start an IMP would be to have the

opportunity to work till I am able to (maybe even into my eighties).

I see a lot of older people who have retired and who miss the

intellectual challenge and now have no opportunity to use their

skills. (If you don't use it you loose it).

These are my views only. I am sure this is not the absolute truth as

each case varies. If one is 80 % satisfied/happy with their career

and financial situation then it's great.

Uday Mehta,

Age 46.

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: Practiceimprovement <mailto:%

40yahoogroups.com>

> 1

> > [mailto:Practiceimprovement

> <mailto:%40yahoogroups.com> 1 ]

On Behalf

> Of

> Brock DO

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

> > To: Practiceimprovement <mailto:%

40yahoogroups.com>

> 1

> > 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

> >

>

>

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Larry,

What codes are you using for the pre-op

clearances? Is that Medicare reimbursement or other insurances? Do you need a

request from the surgeon in order to do this or is a patient request enough? What

about EKGs and blood work, are they included in the price? Thanks!

Re: Re: money

>

> I think that the 3 most important things that

are helping me are: 1)

> Having a good medical assistant to help with

the many chores that

> need to be done in the office allowing me to

see 16-18 patients per

> day. 2) Having a good outside biller who I

talk to at least once a

> week on coding or reimbursement issues. 3)

Learning everything I can

> about coding. Do you know how much you can

reimbursed for splint

> application or using a global fracture code

for a broken toe or rib

> instead of an e & m code?

>

> For many people it is the right choice to start

with the solo solo

> model to minimize start up costs. However

after a practice starts to

> get busy many people might want to expand to

having an assistant even

> though this means a higher overhead. I think

that you might find

> medicine more enjoyable and profitable

spending more time with

> patients and a little less on paper work.

Limiting your staff to 1 or

> 1.5 still keeps the practice small enough

that you will still know

> every patient well.

> Another thing that I am just starting this

week is comparing the

> reimbursement of every insurance company. In

January we are going to

> stop participating with the 2 lowest payors

>

> I practice in Chicago, Malpractice is

$30,000/yr. I see 75-80

> patients/week, I work 5 days per week. I do

minimal hosp work and

> will probably give that up. We draw blood, we

bill for labs done at

> quest if the reimbursement is good enough,do

ecgs, I do minor skin

> surgery in the office. We have 10,500sq ft

office for 1.5 docs

>

> Larry Lindeman MD

>

> Larry Lindeman MD

> On Sep 16, 2006, at 8:51 PM, Naureen Mohamed

wrote:

>

> >

> > Larry Lindeman,

> > How do you make nearly 150? How many pts

do you see per day, how

> > many days per week, geographic location and

malpractice insurance.

> > I am finding it difficult to see how I

would ever make anywhere

> > near that.

> > Naureen Mohamed

> >

> >

>

>

>

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Yes,

I bet that $250 includes an EKG, labs, etc. I know I do not get anywhere

near $250 for a preop consult. And yes, that does have to be preceded by

a request from the referring consultant (usually surgeon) & you do have to

send a letter/note back to code as a consult yourself. I assume you mean

CPT code 99243? That is basically the only office consult code I ever

use.

Re: Re: money

>

> I think that the 3 most important things that

are helping me are: 1)

> Having a good medical assistant to help with

the many chores that

> need to be done in the office allowing me to

see 16-18 patients per

> day. 2) Having a good outside biller who I

talk to at least once a

> week on coding or reimbursement issues. 3)

Learning everything I can

> about coding. Do you know how much you can

reimbursed for splint

> application or using a global fracture code

for a broken toe or rib

> instead of an e & m code?

>

> For many people it is the right choice to

start with the solo solo

> model to minimize start up costs. However

after a practice starts to

> get busy many people might want to expand to

having an assistant even

> though this means a higher overhead. I think

that you might find

> medicine more enjoyable and profitable

spending more time with

> patients and a little less on paper work.

Limiting your staff to 1 or

> 1.5 still keeps the practice small enough

that you will still know

> every patient well.

> Another thing that I am just starting this

week is comparing the

> reimbursement of every insurance company. In

January we are going to

> stop participating with the 2 lowest payors

>

> I practice in Chicago, Malpractice is

$30,000/yr. I see 75-80

> patients/week, I work 5 days per week. I do

minimal hosp work and

> will probably give that up. We draw blood, we

bill for labs done at

> quest if the reimbursement is good enough,do

ecgs, I do minor skin

> surgery in the office. We have 10,500sq ft

office for 1.5 docs

>

> Larry Lindeman MD

>

> Larry Lindeman MD

> On Sep 16, 2006, at 8:51 PM, Naureen Mohamed

wrote:

>

> >

> > Larry Lindeman,

> > How do you make nearly 150? How many pts

do you see per day, how

> > many days per week, geographic location

and malpractice insurance.

> > I am finding it difficult to see how I

would ever make anywhere

> > near that.

> > Naureen Mohamed

> >

> >

>

>

>

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Hi Dr Ellsworth,

Wow! We were in the same neck of the woods. My son just left Odle

Middle School (from the prism program) to start ninth grade at

Bellevue High.

Dr Hanson's daughter is currently in the prism program. For those

who are not in the Bellevue School District, the prism program is

for educationally gifted children.

Thank you for donating your time and expertise with our school

district.

I work for Snoqualmie Valley Hospital. The one on I 90 beyond

Issaquah. Yes, it has reopened. They are King County Public Hospital

District No 4.The others being Harborview, Valley and (I think)

Evergreen .I work at the Maple Valley Clinic.

My moonlighting is with Multicare. I work at their Urgent Care

Centers in South King County and Pierce County. The commute is not

bad as I am against the rush hour traffic.

Congratulations to those physicians who have found that right

balance between Work (Quality and hours spent), Financial reward and

overall life satisfaction.

Uday Mehta

> > >

> > > 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: Practiceimprovement <mailto:%

> 40yahoogroups.com>

> > 1yahoogroups (DOT) <mailto:1%40yahoogroups.com> com

> > > [mailto:Practiceimprovement

> > <mailto:%40yahoogroups.com> 1yahoogroups (DOT)

> <mailto:1%40yahoogroups.com> com]

> On Behalf

> > Of

> > Brock DO

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

> > > To: Practiceimprovement <mailto:%

> 40yahoogroups.com>

> > 1yahoogroups (DOT) <mailto:1%40yahoogroups.com> com

> > > 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

> > >

> >

> >

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The code for koh amd saline wet prep vaginal slides is 87210 or for Medicare Q0111. If you you 1 slide for each you get to charge for each slide. From Family practice management 5/04. Another coding tip: This morning I saw a person with a nondisplaced fracture of the 5th metatarsal that will not need casting. I used the code 28470 which is a fracture care global code. Our blue cross pays $366 for this. I discovered that they weight ortho higher than E & M codes but no matter who your carrier is you should get paid a lot more for using a global fracture code. A global code includes all visits for this condition. Otherwise this would have been a level 3 visit which around here pays about $60. Larry Lindeman MDWhat code do you use to charge for a slide Koh or wetprep?  what is the reimbursement?  What dx do you submit for for it?  Thanks Re: Re: money> > >> > > I think that the 3 most important things that are helping me are: 1)> > > Having a good medical assistant to help with the many chores that> > > need to be done in the office allowing me to see 16-18 patients per> > > day. 2) Having a good outside biller who I talk to at least once a> > > week on coding or reimbursement issues. 3) Learning everything I can> > > about coding. Do you know how much you can reimbursed for splint> > > application or using a global fracture code for a broken toe or rib> > > instead of an e & m code?> > >> > > For many people it is the right choice to start with the solo solo> > > model to minimize start up costs. However after a practice starts to> > > get busy many people might want to expand to having an assistant > > even> > > though this means a higher overhead. I think that you might find> > > medicine more enjoyable and profitable spending more time with> > > patients and a little less on paper work. Limiting your staff to > > 1 or> > > 1.5 still keeps the practice small enough that you will still know> > > every patient well.> > > Another thing that I am just starting this week is comparing the> > > reimbursement of every insurance company. In January we are going to> > > stop participating with the 2 lowest payors> > >> > > I practice in Chicago, Malpractice is $30,000/yr. I see 75-80> > > patients/week, I work 5 days per week. I do minimal hosp work and> > > will probably give that up. We draw blood, we bill for labs done at> > > quest if the reimbursement is good enough,do ecgs, I do minor skin> > > surgery in the office. We have 10,500sq ft office for 1.5 docs> > >> > > Larry Lindeman MD> > >> > > Larry Lindeman MD> > > > > >> > > >> > > > Larry Lindeman,> > > > How do you make nearly 150? How many pts do you see per day, how> > > > many days per week, geographic location and malpractice insurance.> > > > I am finding it difficult to see how I would ever make anywhere> > > > near that.> > > > Naureen Mohamed> > > >> > > >> > >> > >> > >> >> >> > > > >

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Those

codes are for “closed treatment of fracture.” What was your “closed

treatment”? Observation? Are you sure you can use a fracture

code if you did not apply a cast? I do not know, but I’m just

surprised that it sounds so simple to code it that way yet I’ve never

heard it before. How would that be any different than coding a non-sutured

wound using a global “wound repair” code rather just an E/M?

I think you may be extrapolating the codes, but I could be wrong. Anyone

else?

Re:

Re: money

The code for koh amd saline wet prep vaginal slides is

87210 or for Medicare Q0111. If you you 1 slide for each you get to charge for

each slide. From Family practice management 5/04.

Another coding tip: This morning I saw a person with a

nondisplaced fracture of the 5th metatarsal that will not need casting. I used

the code 28470 which is a fracture care global code. Our blue cross pays $366

for this. I discovered that they weight ortho higher than E & M codes but no

matter who your carrier is you should get paid a lot more for using a global

fracture code. A global code includes all visits for this condition. Otherwise

this would have been a level 3 visit which around here pays about $60.

Larry Lindeman MD

What code do you use to charge for a slide Koh or wetprep?

what is the reimbursement? What dx do you submit for for it? Thanks

Re: Re: money

> > >

> > > I think that the 3 most important

things that are helping me are: 1)

> > > Having a good medical assistant to

help with the many chores that

> > > need to be done in the office

allowing me to see 16-18 patients per

> > > day. 2) Having a good outside

biller who I talk to at least once a

> > > week on coding or reimbursement

issues. 3) Learning everything I can

> > > about coding. Do you know how much

you can reimbursed for splint

> > > application or using a global

fracture code for a broken toe or rib

> > > instead of an e & m code?

> > >

> > > For many people it is the right

choice to start with the solo solo

> > > model to minimize start up costs.

However after a practice starts to

> > > get busy many people might want to

expand to having an assistant

> > even

> > > though this means a higher overhead.

I think that you might find

> > > medicine more enjoyable and

profitable spending more time with

> > > patients and a little less on paper

work. Limiting your staff to

> > 1 or

> > > 1.5 still keeps the practice small

enough that you will still know

> > > every patient well.

> > > Another thing that I am just

starting this week is comparing the

> > > reimbursement of every insurance

company. In January we are going to

> > > stop participating with the 2

lowest payors

> > >

> > > I practice in Chicago, Malpractice

is $30,000/yr. I see 75-80

> > > patients/week, I work 5 days per

week. I do minimal hosp work and

> > > will probably give that up. We draw

blood, we bill for labs done at

> > > quest if the reimbursement is good

enough,do ecgs, I do minor skin

> > > surgery in the office. We have

10,500sq ft office for 1.5 docs

> > >

> > > Larry Lindeman MD

> > >

> > > Larry Lindeman MD

> > > On Sep 16, 2006, at 8:51 PM,

Naureen Mohamed wrote:

> > >

> > > >

> > > > Larry Lindeman,

> > > > How do you make nearly 150?

How many pts do you see per day, how

> > > > many days per week, geographic

location and malpractice insurance.

> > > > I am finding it difficult to

see how I would ever make anywhere

> > > > near that.

> > > > Naureen Mohamed

> > > >

> > > >

> > >

> > >

> > >

> >

> >

> >

>

>

>

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Larry,

You are my idol. Thanks for all the help

you constantly give this listserve.

From: [mailto: ] On Behalf Of Larry Lindeman

Sent: Wednesday, September 20,

2006 12:42 PM

To:

Subject: Re:

Re: money

The code

for koh amd saline wet prep vaginal slides is 87210 or for Medicare Q0111. If

you you 1 slide for each you get to charge for each slide. From Family practice

management 5/04.

Another coding tip: This morning I saw a person with a nondisplaced

fracture of the 5th metatarsal that will not need casting. I used the code

28470 which is a fracture care global code. Our blue cross pays $366 for this.

I discovered that they weight ortho higher than E & M codes but no matter who

your carrier is you should get paid a lot more for using a global fracture

code. A global code includes all visits for this condition. Otherwise this

would have been a level 3 visit which around here pays about $60.

Larry Lindeman MD

What

code do you use to charge for a slide Koh or wetprep? what is the

reimbursement? What dx do you submit for for it? Thanks

-----

Original Message -----

From: drbrockrrohio

To:

Sent: Monday, September 18, 2006 9:46 PM

Subject: Re: Re:

Re:

money

Your E/M codes pay

about $20 more per visit than I get here in central Ohio, so that is part of it.

>

> From: Larry Lindeman <llindemanmac>

> Date: 2006/09/18 Mon PM 09:24:02 EDT

> To:

> Subject: Re: Re: money

>

> 1)My setup with my MA is unique to us and our

preferences and I

> suggest that everybody work out how to divy

up the work based on

> their own circumstances. When my ma and I are

working with just the 2

> of us (18 months out of the 2 years we have

been around) She does

> most of the phone work. She does vitals,

ecg's, draws blood and

> shots. While she doing those clinical things

I sit at the front desk

> answering the phone and doing my charting.

When its working right I

> have just finished my charting as she has

finished her stuff. I like

> to answer the phone and she likes to draw

blood. She also double

> checks every patient charge to make sure I

didn't leave out any

> charges for things like U/A s or strep tests.

Now that we have an

> lpn , when there are 2 doctors in the office

my ma spends most of

> her time at the front with phones, insurance

etc and the lpn does

> clinical. When I am the only doc seeing

patients it reverts back to

> the old way with the lpn helping with chronic

care management and

> right now entering our labs into our emr (We

are about to get a lab

> module) The pay scale for ma's in chicago is

$11/hr up to $19/hr. My

> ma started at the bottom of the scale with no

benefits and is now in

> the middle with health insurance. My ma liked

the ideals of the

> practice and was willing to sacrifice to be

in at the start. She has

> read all of Gordon's articles in FPM and gets

my FPM journal as soon

> as I'm finished with it.

>

> 2)For my 99213 I get $55-$65 dollars, For

99214 I get $90 -100, For

> preventive visits I get around $110-$140, For

things like pre-op

> consults on my own patients I get $250 (I

love those) I average $100

> per visit partially because of ancillaries

and the skin procedures

> that I do. I really work on my coding. Coding

Tip: Remember that when

> you do both a koh and a wet prep to charge

for 2 slides.

> On Sep 17, 2006, at 8:38 PM, drbrockrrohio

wrote:

>

> > 1) does your MA do everything besides

doctoring stuff, answer

> > phones, schedule, call with lab results,

vitals/shots/EKG's/finger

> > sticks, etc? That seems almost

insurmountable for one poor MA to do

> > alone. How much do you pay her?

> >

> > 2) what is your monthly gross income?

That would help me compare

> > apple to apples. There must be something

I'm missing in your

> > numbers because I don't see that many

less pts than you, my

> > malpractice is less than half of yours,

& I'm sure my rent/building

> > payment is less than yours, yet I'm

certainly not making near

> > $150,000. I do not do inpatient, I work

4.5 days/wk. Are you

> > getting extraordinary reimbursement for

a 99213/99214 there?

> >

> > Thanks,

> >

> >

> > >

> > > From: Larry Lindeman <llindemanmac>

> > > Date: 2006/09/17 Sun AM 10:18:30

EDT

> > > To:

> > > Subject: Re: Re: money

> > >

> > > I think that the 3 most important

things that are helping me are: 1)

> > > Having a good medical assistant to

help with the many chores that

> > > need to be done in the office

allowing me to see 16-18 patients per

> > > day. 2) Having a good outside

biller who I talk to at least once a

> > > week on coding or reimbursement

issues. 3) Learning everything I can

> > > about coding. Do you know how much

you can reimbursed for splint

> > > application or using a global

fracture code for a broken toe or rib

> > > instead of an e & m code?

> > >

> > > For many people it is the right

choice to start with the solo solo

> > > model to minimize start up costs.

However after a practice starts to

> > > get busy many people might want to

expand to having an assistant

> > even

> > > though this means a higher overhead.

I think that you might find

> > > medicine more enjoyable and

profitable spending more time with

> > > patients and a little less on paper

work. Limiting your staff to

> > 1 or

> > > 1.5 still keeps the practice small

enough that you will still know

> > > every patient well.

> > > Another thing that I am just

starting this week is comparing the

> > > reimbursement of every insurance

company. In January we are going to

> > > stop participating with the 2

lowest payors

> > >

> > > I practice in Chicago, Malpractice is $30,000/yr. I see

75-80

> > > patients/week, I work 5 days per

week. I do minimal hosp work and

> > > will probably give that up. We draw

blood, we bill for labs done at

> > > quest if the reimbursement is good

enough,do ecgs, I do minor skin

> > > surgery in the office. We have

10,500sq ft office for 1.5 docs

> > >

> > > Larry Lindeman MD

> > >

> > > Larry Lindeman MD

> > > On Sep 16, 2006, at 8:51 PM,

Naureen Mohamed wrote:

> > >

> > > >

> > > > Larry Lindeman,

> > > > How do you make nearly 150?

How many pts do you see per day, how

> > > > many days per week, geographic

location and malpractice insurance.

> > > > I am finding it difficult to

see how I would ever make anywhere

> > > > near that.

> > > > Naureen Mohamed

> > > >

> > > >

> > >

> > >

> > >

> >

> >

> >

>

>

>

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RJ and I are in our third year and will earn almost $200K this year.

Our model is very different in that we are " retainer-based " (avg $1K

per Benefactor). We do not deal with insurance. That saves us a ton of

toil and trouble and allows us to spend more time doctoring. We also

spend half our time caring for the unisured of our community at no

charge, and thus we are a 501©(3) org. Many of our Benefactors write

off the amount they give to us in excess of the RBRVS value of the

services we provide. We are supported by a Board of Directors who

provide tremendous professional support and also make up

our " Executive Compensation Committee " that determines our salary cap

(so far $200K Y2004 dollars plus COLA). Financially it has proven to

be a very viable model. Try the website for a start --

www.stlukesfp.org

Bob Forester

P.S. my direct email drf@... is MORE RELIABLE than my

infrequent visits to the listserv.

>

> 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

>

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Is “retainer”

the same as “concierge” essentially? That type of thing sounds

great on the surface to us as doctors, but the majority of patients in my

semi-rural farming community simply would not pay out of pocket. That type of

thing just won’t fly around here. Besides, I’ve never heard of

operating a medical office as a 501©(3)? Is that even legal in all states?

Re: money

RJ and I are in our third

year and will earn almost $200K this year.

Our model is very different in that we are " retainer-based " (avg $1K

per Benefactor). We do not deal with insurance. That saves us a ton of

toil and trouble and allows us to spend more time doctoring. We also

spend half our time caring for the unisured of our community at no

charge, and thus we are a 501©(3) org. Many of our Benefactors write

off the amount they give to us in excess of the RBRVS value of the

services we provide. We are supported by a Board of Directors who

provide tremendous professional support and also make up

our " Executive Compensation Committee " that determines our salary cap

(so far $200K Y2004 dollars plus COLA). Financially it has proven to

be a very viable model. Try the website for a start --

www.stlukesfp.org

Bob Forester

P.S. my direct email drfstlukesfp (DOT) org

is MORE RELIABLE than my

infrequent visits to the listserv.

>

> 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

>

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Dear Bob, It was really nice to hear an update on RJ, as I had heard about this project that you had both started. My husband and I had the great pleasure of doing our residency training with RJ. He's a phenomenal person, so I am really happy to hear that you are doing so well. Please send our regards, and Bob Forester MD wrote: RJ and I are in our third year and will earn almost $200K this year. Our model is

very different in that we are "retainer-based" (avg $1K per Benefactor). We do not deal with insurance. That saves us a ton of toil and trouble and allows us to spend more time doctoring. We also spend half our time caring for the unisured of our community at no charge, and thus we are a 501©(3) org. Many of our Benefactors write off the amount they give to us in excess of the RBRVS value of the services we provide. We are supported by a Board of Directors who provide tremendous professional support and also make up our "Executive Compensation Committee" that determines our salary cap (so far $200K Y2004 dollars plus COLA). Financially it has proven to be a very viable model. Try the website for a start -- www.stlukesfp.orgBob ForesterP.S. my direct email drfstlukesfp (DOT) org is MORE RELIABLE than my infrequent visits to the listserv.>> 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> Bowey, MDEncanto Family Medicine, PLLC333 E. Virginia Ave, Suite 110Phoenix, AZ 85004email: encantofm@...website: encantofamilymedicine.net office fax cell

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Dear Bob, It was really nice to hear an update on RJ, as I had heard about this project that you had both started. My husband and I had the great pleasure of doing our residency training with RJ. He's a phenomenal person, so I am really happy to hear that you are doing so well. Please send our regards, and Bob Forester MD wrote: RJ and I are in our third year and will earn almost $200K this year. Our model is

very different in that we are "retainer-based" (avg $1K per Benefactor). We do not deal with insurance. That saves us a ton of toil and trouble and allows us to spend more time doctoring. We also spend half our time caring for the unisured of our community at no charge, and thus we are a 501©(3) org. Many of our Benefactors write off the amount they give to us in excess of the RBRVS value of the services we provide. We are supported by a Board of Directors who provide tremendous professional support and also make up our "Executive Compensation Committee" that determines our salary cap (so far $200K Y2004 dollars plus COLA). Financially it has proven to be a very viable model. Try the website for a start -- www.stlukesfp.orgBob ForesterP.S. my direct email drfstlukesfp (DOT) org is MORE RELIABLE than my infrequent visits to the listserv.>> 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> Bowey, MDEncanto Family Medicine, PLLC333 E. Virginia Ave, Suite 110Phoenix, AZ 85004email: encantofm@...website: encantofamilymedicine.net office fax cell

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Dear ,

Thank you for your interest. We really dislike the semantics

of " retainer " , " boutique " and " concierge " practices to try and

describe what we do. Basically, among imps and non-profit do-gooder

folks they are pejoritive terms -- but hey, it's the jargon we have.

More to my liking is Gordon's label of " a Robin Hood practice. "

We are an imp that uses an annual pre-payment to fund care to the

uninsured. It wouldn't work for every community, but certainly it

will work for more than just ours. Our primary focus is free care to

the uninsured. In California, there are many who have no coverage.

No MediCal (MedicAid), no MIA (Medically Indigent Adults Program),

no nothing -- those folks are the primary recipients of our

practice.

We fund our practice by providing " boutique " type payment for great

service -- the same kind of service you are all providing to your

patients utilizing an imp model. We are in the enviable setting of

having:

1. Solid, established (10-15 year) reputations in a medium-sized

community (200K).

2. Living in a relatively primary care doctor deficient area with a

history of less than optimal customer service to patients.

3. The support of our local Catholic and do-gooder community.

4. A Board of Directors.

5. A favorable 501©(3) ruling from the IRS after a protracted

process.

, I am not surprised that you have never heard of a medical

office operating as a 501©(3) before; because as far as we know

from discussions with many imps, do-gooder groups and the IRS, none

of them have either. However, with the help of our Board,

Benefactors and Donors we have set the precedent. Now the challenge

is up to a few of you to adopt, adapt and improve the model to help

worthy causes (like the uninsured) your communities and carve out a

sustainable lifestyle and practice high-quality imp medicine at the

same time too.

Again, please take a look at our website www.stlukesfp.org. On

the " News " page in the left hand column, you will be able to read

the articles from the Modesto Bee about how the community perceives

and supports our practce. Soon we will post the recent article from

Catholic Digest (July 2006). You may also view our IRS ruling

letter.

I look forward to trying to answer your further questions as it may

help me form my thoughts for future presentations and publications.

Bob Forester

> >

> > 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

> >

>

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Bob --

It's great to hear from you on the list. You may not know it, but you gave

me the final push to jump ship from my old practice and start my imp. We

met briefly at the SF assembly last year and hearing you speak helped me

fit together the last pieces of the puzzle I had in my head... yes, " robin

hood practice " stood out in my mind.

I happen to know sign language and have provided medical care for hundreds

of Deaf patients... about 30% of my patients are Deaf (Rochester has a

huge Deaf community, deaf college, etc). Many of them are undereducated

and have received lousy care for years (today, met new Deaf man... 51 yo,

24 yrs diabetic on insulin but not taking aspirin... he said he'd never

been told that a diabetic has increased risk of heart disease and had

never had a fasting blood test!!!!!... I got tons of examples like

that...)... anyway, many of the Deaf have medicare and medicaid. But when

I did my financial calculations I worried I'd have to drop medicare and

medicaid to make the office float. But that didn't sit right with me

personally and I wondered what cI ould do.... Robin Hood model came along

and I decided to take a part of my practice and add aesthetic services so

with the financial support of that I could keep practicing medicine the

way I want for the patients I want! So far, so good and I'm soon to enter

a new stage as I may close to new family med patients and am about to

train in botox and Restylane.

So, thanks for developing your model and helping me know I could still

offer a special, though low paying, service to patients who need primary

care AND still make money for comfort. ... and, about the money, I'm

still working to improve t as I'm not yet making a great salary but think

that by my 1 yr anniversary (March) I'll be where I need to be.

Have a good weekend

Tim

> Dear ,

> Thank you for your interest. We really dislike the semantics

> of " retainer " , " boutique " and " concierge " practices to try and

> describe what we do. Basically, among imps and non-profit do-gooder

> folks they are pejoritive terms -- but hey, it's the jargon we have.

> More to my liking is Gordon's label of " a Robin Hood practice. "

>

> We are an imp that uses an annual pre-payment to fund care to the

> uninsured. It wouldn't work for every community, but certainly it will

> work for more than just ours. Our primary focus is free care to the

> uninsured. In California, there are many who have no coverage. No

> MediCal (MedicAid), no MIA (Medically Indigent Adults Program), no

> nothing -- those folks are the primary recipients of our

> practice.

>

> We fund our practice by providing " boutique " type payment for great

> service -- the same kind of service you are all providing to your

> patients utilizing an imp model. We are in the enviable setting of

> having:

> 1. Solid, established (10-15 year) reputations in a medium-sized

> community (200K).

> 2. Living in a relatively primary care doctor deficient area with a

> history of less than optimal customer service to patients.

> 3. The support of our local Catholic and do-gooder community.

> 4. A Board of Directors.

> 5. A favorable 501©(3) ruling from the IRS after a protracted

> process.

>

> , I am not surprised that you have never heard of a medical

> office operating as a 501©(3) before; because as far as we know from

> discussions with many imps, do-gooder groups and the IRS, none of them

> have either. However, with the help of our Board,

> Benefactors and Donors we have set the precedent. Now the challenge is

> up to a few of you to adopt, adapt and improve the model to help worthy

> causes (like the uninsured) your communities and carve out a

> sustainable lifestyle and practice high-quality imp medicine at the

> same time too.

>

> Again, please take a look at our website www.stlukesfp.org. On

> the " News " page in the left hand column, you will be able to read the

> articles from the Modesto Bee about how the community perceives and

> supports our practce. Soon we will post the recent article from

> Catholic Digest (July 2006). You may also view our IRS ruling

> letter.

>

> I look forward to trying to answer your further questions as it may

> help me form my thoughts for future presentations and publications.

>

> Bob Forester

>

>

>> >

>> > 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

>> >

>>

>

>

>

>

>

>

>

>

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Guest guest

I’m

still not clear though on who exactly pays the “retainer” fee? The

patients with no insurance & minimal income? I’m sure that is not

where it comes from. Donations?

Re: money

Dear ,

Thank you for your interest. We really dislike the semantics

of " retainer " , " boutique " and " concierge "

practices to try and

describe what we do. Basically, among imps and non-profit do-gooder

folks they are pejoritive terms -- but hey, it's the jargon we have.

More to my liking is Gordon's label of " a Robin Hood practice. "

We are an imp that uses an annual pre-payment to fund care to the

uninsured. It wouldn't work for every community, but certainly it

will work for more than just ours. Our primary focus is free care to

the uninsured. In California, there are many who have no coverage.

No MediCal (MedicAid), no MIA (Medically Indigent Adults Program),

no nothing -- those folks are the primary recipients of our

practice.

We fund our practice by providing " boutique " type payment for great

service -- the same kind of service you are all providing to your

patients utilizing an imp model. We are in the enviable setting of

having:

1. Solid, established (10-15 year) reputations in a medium-sized

community (200K).

2. Living in a relatively primary care doctor deficient area with a

history of less than optimal customer service to patients.

3. The support of our local Catholic and do-gooder community.

4. A Board of Directors.

5. A favorable 501©(3) ruling from the IRS after a protracted

process.

, I am not surprised that you have never heard of a medical

office operating as a 501©(3) before; because as far as we know

from discussions with many imps, do-gooder groups and the IRS, none

of them have either. However, with the help of our Board,

Benefactors and Donors we have set the precedent. Now the challenge

is up to a few of you to adopt, adapt and improve the model to help

worthy causes (like the uninsured) your communities and carve out a

sustainable lifestyle and practice high-quality imp medicine at the

same time too.

Again, please take a look at our website www.stlukesfp.org. On

the " News " page in the left hand column, you will be able to read

the articles from the Modesto Bee about how the community perceives

and supports our practce. Soon we will post the recent article from

Catholic Digest (July 2006). You may also view our IRS ruling

letter.

I look forward to trying to answer your further questions as it may

help me form my thoughts for future presentations and publications.

Bob Forester

> >

> > 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

> >

>

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Guest guest

Dear Tim,

And all this time I thought I was brow-beating up you and Uday at

the restaurant in San Francisco! I learned of your venture and was

hoping that I had in some small way encouraged you to look outside

the box for funding -- way to go! I look forward to seeing you soon.

Bob Forester

> >> >

> >> > 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

> >> >

> >>

> >

> >

> >

> >

> >

> >

> >

> >

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Guest guest

Dear Tim,

And all this time I thought I was brow-beating up you and Uday at

the restaurant in San Francisco! I learned of your venture and was

hoping that I had in some small way encouraged you to look outside

the box for funding -- way to go! I look forward to seeing you soon.

Bob Forester

> >> >

> >> > 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

> >> >

> >>

> >

> >

> >

> >

> >

> >

> >

> >

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