RE: Survivability- If you can make it here...

[Guest guest]

Congratulations!! Great to hear things

are going well for you!

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From: [mailto: ] On Behalf Of julesandzoemom

Sent: Saturday, October 14, 2006

6:12 PM

To:

Subject:

Survivability- If you can make it here...

Well, after 6 months working part-time I was busy

enough to go full

time three months ago and I just closed my practice last week. I am

solo-solo in Park Slope, Brooklyn and

absolutely astounded at the

response I have had. I have seen slightly over 600 new patients and

have about 200 more new patients scheduled for the next 2 months. I am

seeing about 6-10 patients per day with about 34 patient contact hours

per week. One big surprise has been the number of children I am seeing

and with infants needing frequent visits I am finding there is not

enough time in the day. Financially I am doing ok. Not paying myself a

ton, $72,000/year but covering my rent, salary, and malpractice.

(Hoping for a raise next month...) Was even able to pay off a little

of my small business loan. My huge thanks to Gordon and the rest of

this group for their ideas and encouragement. I have been working on

some colleagues here to do the same as I am finding my work so much

more enjoyable than ever before. My patients love my use of e-mail and

the web and the personal approach that IMPs offer.

All the best,

Maggie Carpenter, MD

www.drmaggiecarpenter.com

[Guest guest]

Congratulations on this year.It sounds as though the community is enjoying this as much as you are!I probably followed a similar trajectory as you in building my practice, finally arrived at about 1000 patients before I closed permanently. It sounds as though 800 would be plenty with so many small children. I did close to new patients several times over the first 2 and 1/2 years to give myself breathing room and make sure I wasn't taking too many patients. I started to pay myself after the first three months of being open, but my salary continued to increase over the first three years of the practice, so I hope yours will also.  GuinnAlbuquerqueWell, after 6 months working part-time I was busy enough to go full time three months ago and I just closed my practice last week. I am solo-solo in Park Slope, Brooklyn and absolutely astounded at the response I have had. I have seen slightly over 600 new patients and have about 200 more new patients scheduled for the next 2 months. I am seeing about 6-10 patients per day with about 34 patient contact hours per week. One big surprise has been the number of children I am seeing and with infants needing frequent visits I am finding there is not enough time in the day. Financially I am doing ok. Not paying myself a ton, $72,000/year but covering my rent, salary, and malpractice. (Hoping for a raise next month...) Was even able to pay off a little of my small business loan. My huge thanks to Gordon and the rest of this group for their ideas and encouragement. I have been working on some colleagues here to do the same as I am finding my work so much more enjoyable than ever before. My patients love my use of e-mail and the web and the personal approach that IMPs offer.All the best,Maggie Carpenter, MDwww.drmaggiecarpenter.com

[Guest guest]

This may not be politically correct-but whatever-what do people think

of the idea that female physicians have an easier time starting these

type of practices and an easier time filling up with patients? I'm

just thinking of other factors that influence survive ability.

Also, as has been mentioned, I think there is no doubt that location

plays a major part in survivability. My other ideas are (and this

may not be politically correct either)-are that there is a good

amount of variation in efficiency of practice. I also think there is

a good amount of variation on the idea of " what is good enough " -that

is how good do you have to be-20 minutes per patient-30 minutes per

patient-45 minutes per patient-60 minutes per patient etc.??-where is

the sweet spot between survivability, patient happiness and outcomes

that are valuable with regard to patient outcomes?

I would also like to comment on the idea that is sometimes expressed

that " my patients would never accept that in this area " - " that " -

meaning paying a little extra for service, a small yearly fee etc. I

also live in an area where I am tempted to say this-but actually

since so few people have done it here I actually do not know that

this is actually the case.

Regards,

Lou Spikol

>

> > Well, after 6 months working part-time I was busy enough to go

full

> > time three months ago and I just closed my practice last week. I

am

> > solo-solo in Park Slope, Brooklyn and absolutely astounded at the

> > response I have had. I have seen slightly over 600 new patients

and

> > have about 200 more new patients scheduled for the next 2 months.

I am

> > seeing about 6-10 patients per day with about 34 patient contact

hours

> > per week. One big surprise has been the number of children I am

seeing

> > and with infants needing frequent visits I am finding there is not

> > enough time in the day. Financially I am doing ok. Not paying

myself a

> > ton, $72,000/year but covering my rent, salary, and malpractice.

> > (Hoping for a raise next month...) Was even able to pay off a

little

> > of my small business loan. My huge thanks to Gordon and the rest

of

> > this group for their ideas and encouragement. I have been working

on

> > some colleagues here to do the same as I am finding my work so

much

> > more enjoyable than ever before. My patients love my use of e-

mail and

> > the web and the personal approach that IMPs offer.

> > All the best,

> > Maggie Carpenter, MD

> > www.drmaggiecarpenter.com

> >

> >

> >

>

[Guest guest]

I do think gender has a lot to do with it with everything else being

equal. Women are larger consumers of healthcare and many like going

to women doctors. They will then drive the health care spending for

their family.

I too wonder how much time is enough for each patient. Some patients

would love to spend 45 minutes to 60 minutes of time going over the

same things 20 different ways. I am not sure they really get much

out of this type of interaction other than make you tired and feel

satisfied wearing you down.

There does have to be a happy middle ground. Much of it is based on

these small practices of how much administrative stuff has to be done

between patients. It seems like 8-10 maximizes those out with no

staff on this list serve, one staff 12-15.

I think you know in your area what will fly and what will not. Some

people are practicing in great areas, some in areas that are awful.

I would be interested to find the greatest areas in the world to

practice medicine and why.

Brent

> >

> > > Well, after 6 months working part-time I was busy enough to go

> full

> > > time three months ago and I just closed my practice last week.

I

> am

> > > solo-solo in Park Slope, Brooklyn and absolutely astounded at

the

> > > response I have had. I have seen slightly over 600 new patients

> and

> > > have about 200 more new patients scheduled for the next 2

months.

> I am

> > > seeing about 6-10 patients per day with about 34 patient

contact

> hours

> > > per week. One big surprise has been the number of children I am

> seeing

> > > and with infants needing frequent visits I am finding there is

not

> > > enough time in the day. Financially I am doing ok. Not paying

> myself a

> > > ton, $72,000/year but covering my rent, salary, and malpractice.

> > > (Hoping for a raise next month...) Was even able to pay off a

> little

> > > of my small business loan. My huge thanks to Gordon and the

rest

> of

> > > this group for their ideas and encouragement. I have been

working

> on

> > > some colleagues here to do the same as I am finding my work so

> much

> > > more enjoyable than ever before. My patients love my use of e-

> mail and

> > > the web and the personal approach that IMPs offer.

> > > All the best,

> > > Maggie Carpenter, MD

> > > www.drmaggiecarpenter.com

> > >

> > >

> > >

> >

>

[Guest guest]

PC or

not, I

agree that it is easier for a female to attract patients. At least in part, this is driven by a

strong preference of female patients to have a female doc, especially for gyn care. And more

women actually go to the doctor than do men, so there you go. The other advantage for female docs is

the relative ease of doing without a chaperone for “intimate”

exams. Of course there are risks

even for women of being accused of “inappropriate” behavior, but it

is a much smaller risk than men face. I often feel badly or worry for men in

many professional settings who run the risk of being wrongly accused; our priest has

had to opt out of parish camping trips if certain teens were along, the man who owns the barn where my horse

lives has to make sure his wife is around anytime he interacts with female

boarders if he doesn’t know them well…just can’t be too

careful. On the flip side, I

sometimes decline to take on male patients if I get the impression that I might

not be safe around them alone…cuts both ways, I guess.

Annie

Re: Survivability- If you can make it here...

This may not be politically correct-but whatever-what do people think

of the idea that female physicians have an easier time starting these

type of practices and an easier time filling up with patients? I'm

just thinking of other factors that influence survive ability.

Also, as has been mentioned, I think there is no doubt that location

plays a major part in survivability. My other ideas are (and this

may not be politically correct either)-are that there is a good

amount of variation in efficiency of practice. I also think there is

a good amount of variation on the idea of " what is good enough " -that

is how good do you have to be-20 minutes per patient-30 minutes per

patient-45 minutes per patient-60 minutes per patient etc.??-where is

the sweet spot between survivability, patient happiness and outcomes

that are valuable with regard to patient outcomes?

I would also like to comment on the idea that is sometimes expressed

that " my patients would never accept that in this area " - " that " -

meaning paying a little extra for service, a small yearly fee etc. I

also live in an area where I am tempted to say this-but actually

since so few people have done it here I actually do not know that

this is actually the case.

Regards,

Lou Spikol

>

> > Well, after 6 months working part-time I was busy enough to go

full

> > time three months ago and I just closed my practice last week. I

am

> > solo-solo in Park Slope, Brooklyn and absolutely astounded at the

> > response I have had. I have seen slightly over 600 new patients

and

> > have about 200 more new patients scheduled for the next 2 months.

I am

> > seeing about 6-10 patients per day with about 34 patient contact

hours

> > per week. One big surprise has been the number of children I am

seeing

> > and with infants needing frequent visits I am finding there is not

> > enough time in the day. Financially I am doing ok. Not paying

myself a

> > ton, $72,000/year but covering my rent, salary, and malpractice.

> > (Hoping for a raise next month...) Was even able to pay off a

little

> > of my small business loan. My huge thanks to Gordon and the rest

of

> > this group for their ideas and encouragement. I have been working

on

> > some colleagues here to do the same as I am finding my work so

much

> > more enjoyable than ever before. My patients love my use of e-

mail and

> > the web and the personal approach that IMPs offer.

> > All the best,

> > Maggie Carpenter, MD

> > www.drmaggiecarpenter.com

> >

> >

> >

>

[Guest guest]

In reference to the comments 'my area won't tolerate extra fees' my grandfather always said that in business one should raise the price of goods until you are just about as busy as you want to be. I haven't made the jump to no insurance, but agree that being female is definitely an advantage in this micro practice area. -- Lynette I Iles MD 210 South Iowa Ste 3 Washington IA 52353 Flexible Family Care 'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

In reference to the comments 'my area won't tolerate extra fees' my grandfather always said that in business one should raise the price of goods until you are just about as busy as you want to be. I haven't made the jump to no insurance, but agree that being female is definitely an advantage in this micro practice area. -- Lynette I Iles MD 210 South Iowa Ste 3 Washington IA 52353 Flexible Family Care 'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

In my experiences (8 person group in

Seattle, 40 + doc group in Orange, California, and in the faculty

practice at UC Irvine), the " guys " filled their panels with

overflow from patients calling that really wanted to be seen by a female

doc. We all have our theories why, but at least part is the fact

that (on average) patients will ask 8-10 questions of a female doctor,

and only 1 of a male doctor. (I'm sure the IMP guys are much more

approachable.) Definitely more people where I've practiced, when

looking at an HMO directory from which they have to pick a PCP, would

choose a Caucasian sounding female name given the option. May be

sad, but true.

On the other hand, when discussing heading

toward a more capitation based model again, I worry that those good

listeners among the docs (many females, but also male IMP's), who tend to

attract & retain the challenging patients that no one can understand

(for whatever reason) or those patients that just need more time, will

lose out. Of course the concept is that we will educate them to

become confident in solving problems, and in the end, this is good for

the health of individuals and the community, but I worry about that

compensation model (not that I have a better one).

Go

Cards!! (sorry to you Mets fans, but the press sure had me rooting

for the underdogs).

Sharon

(while I was growing up, I listened to every Cardinal game on the radio

in the back yard while my dad & I puttered in the garden.....)

now opening my solo-solo home based practice November 1 (and doing

serious remodeling in preparation)

At 01:24 PM 10/15/2006, you wrote:

PC

or not, I agree that it is easier for a female to attract

patients. At least in part, this is driven by a strong preference

of female patients to have a female doc, especially for gyn care.

And more women actually go to the doctor than do men, so there you

go. The other advantage for female docs is the relative ease of

doing without a chaperone for “intimate” exams. Of course there are

risks even for women of being accused of “inappropriate” behavior, but it

is a much smaller risk than men face. I often feel badly or worry

for men in many professional settings who run the risk of being wrongly

accused; our priest has had to opt out of parish camping trips if

certain teens were along, the man who owns the barn where my horse

lives has to make sure his wife is around anytime he interacts with

female boarders if he doesn’t know them well…just can’t be too

careful. On the flip side, I sometimes decline to take on

male patients if I get the impression that I might not be safe around

them alone…cuts both ways, I guess.

Annie

Re: Survivability- If you can make

it here...

This may not be politically

correct-but whatever-what do people think

of the idea that female physicians have an easier time starting these

type of practices and an easier time filling up with patients? I'm

just thinking of other factors that influence survive ability.

Also, as has been mentioned, I think there is no doubt that location

plays a major part in survivability. My other ideas are (and this

may not be politically correct either)-are that there is a good

amount of variation in efficiency of practice. I also think there is

a good amount of variation on the idea of " what is good

enough " -that

is how good do you have to be-20 minutes per patient-30 minutes per

patient-45 minutes per patient-60 minutes per patient etc.??-where is

the sweet spot between survivability, patient happiness and outcomes

that are valuable with regard to patient outcomes?

I would also like to comment on the idea that is sometimes expressed

that " my patients would never accept that in this

area " - " that " -

meaning paying a little extra for service, a small yearly fee etc. I

also live in an area where I am tempted to say this-but actually

since so few people have done it here I actually do not know that

this is actually the case.

Regards,

Lou Spikol

>

> > Well, after 6 months working part-time I was busy enough to go

full

> > time three months ago and I just closed my practice last week.

I

am

> > solo-solo in Park Slope, Brooklyn and absolutely astounded at

the

> > response I have had. I have seen slightly over 600 new patients

and

> > have about 200 more new patients scheduled for the next 2

months.

I am

> > seeing about 6-10 patients per day with about 34 patient

contact

hours

> > per week. One big surprise has been the number of children I am

seeing

> > and with infants needing frequent visits I am finding there is

not

> > enough time in the day. Financially I am doing ok. Not paying

myself a

> > ton, $72,000/year but covering my rent, salary, and

malpractice.

> > (Hoping for a raise next month...) Was even able to pay off a

little

> > of my small business loan. My huge thanks to Gordon and the

rest

of

> > this group for their ideas and encouragement. I have been

working

on

> > some colleagues here to do the same as I am finding my work so

much

> > more enjoyable than ever before. My patients love my use of

e-

mail and

> > the web and the personal approach that IMPs offer.

> > All the best,

> > Maggie Carpenter, MD

> >

www.drmaggiecarpenter.com

> >

> >

> >

>

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10/14/2006

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Checked by AVG Free Edition.

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[Guest guest]

I would

agree that female patients are more likely to seek a female doctor, but not

male patients. I’m not even sure females always prefer a female OB/GYN,

I have heard that argued both ways.

Re: Survivability- If you can make it here...

This may not be politically correct-but whatever-what do people think

of the idea that female physicians have an easier time starting these

type of practices and an easier time filling up with patients? I'm

just thinking of other factors that influence survive ability.

Also, as has been mentioned, I think there is no doubt that location

plays a major part in survivability. My other ideas are (and this

may not be politically correct either)-are that there is a good

amount of variation in efficiency of practice. I also think there is

a good amount of variation on the idea of " what is good enough " -that

is how good do you have to be-20 minutes per patient-30 minutes per

patient-45 minutes per patient-60 minutes per patient etc.??-where is

the sweet spot between survivability, patient happiness and outcomes

that are valuable with regard to patient outcomes?

I would also like to comment on the idea that is sometimes expressed

that " my patients would never accept that in this

area " - " that " -

meaning paying a little extra for service, a small yearly fee etc. I

also live in an area where I am tempted to say this-but actually

since so few people have done it here I actually do not know that

this is actually the case.

Regards,

Lou Spikol

>

> > Well, after 6 months working part-time I was busy enough to go

full

> > time three months ago and I just closed my practice last week. I

am

> > solo-solo in Park Slope, Brooklyn and absolutely astounded at the

> > response I have had. I have seen slightly over 600 new patients

and

> > have about 200 more new patients scheduled for the next 2 months.

I am

> > seeing about 6-10 patients per day with about 34 patient contact

hours

> > per week. One big surprise has been the number of children I am

seeing

> > and with infants needing frequent visits I am finding there is not

> > enough time in the day. Financially I am doing ok. Not paying

myself a

> > ton, $72,000/year but covering my rent, salary, and malpractice.

> > (Hoping for a raise next month...) Was even able to pay off a

little

> > of my small business loan. My huge thanks to Gordon and the rest

of

> > this group for their ideas and encouragement. I have been working

on

> > some colleagues here to do the same as I am finding my work so

much

> > more enjoyable than ever before. My patients love my use of e-

mail and

> > the web and the personal approach that IMPs offer.

> > All the best,

> > Maggie Carpenter, MD

> > www.drmaggiecarpenter.com

> >

> >

> >

>

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.0.408 / Virus Database: 268.13.4/476 - Release Date: 10/14/2006

[Guest guest]

Sorry to Met fans, but we are diehard

Cards fans, there was nothing like sweating in the old outdoor arena watching Mark

McGuire

T. Ellsworth, MD

9377 E. Bell Road, Suite 175

sdale, Az 85260

From: [mailto: ] On Behalf Of Sharon McCoy , M.D.

Sent: Friday, October 20, 2006

12:20 AM

To:

Subject: RE:

Re: Survivability- If you can make it here...

In my experiences (8

person group in Seattle, 40 + doc group in Orange, California, and in the

faculty practice at UC Irvine), the " guys " filled their panels with

overflow from patients calling that really wanted to be seen by a female doc.

We all have our theories why, but at least part is the fact that (on average)

patients will ask 8-10 questions of a female doctor, and only 1 of a male

doctor. (I'm sure the IMP guys are much more approachable.)

Definitely more people where I've practiced, when looking at an HMO directory

from which they have to pick a PCP, would choose a Caucasian sounding female

name given the option. May be sad, but true.

On the other hand, when discussing heading

toward a more capitation based model again, I worry that those good listeners

among the docs (many females, but also male IMP's), who tend to attract &

retain the challenging patients that no one can understand (for whatever

reason) or those patients that just need more time, will lose out. Of course

the concept is that we will educate them to become confident in solving

problems, and in the end, this is good for the health of individuals and the

community, but I worry about that compensation model (not that I have a better

one).

Go Cards!! (sorry

to you Mets fans, but the press sure had me rooting for the underdogs).

Sharon

(while I was growing up, I listened to every Cardinal game on the radio in the

back yard while my dad & I puttered in the garden.....)

now opening my solo-solo home based practice November 1 (and doing serious

remodeling in preparation)

At 01:24 PM 10/15/2006, you wrote:

PC or not, I agree that it is easier

for a female to attract patients. At least in part, this is driven by a

strong preference of female patients to have a female doc, especially for gyn

care. And more women actually go to the doctor than do men, so there you

go. The other advantage for female docs is the relative ease of doing

without a chaperone for “intimate” exams. Of course there are

risks even for women of being accused of “inappropriate” behavior,

but it is a much smaller risk than men face. I often feel badly or worry

for men in many professional settings who run the risk of being wrongly

accused; our priest has had to opt out of parish camping trips if certain

teens were along, the man who owns the barn where my horse lives has to

make sure his wife is around anytime he interacts with female boarders if he

doesn’t know them well…just can’t be too careful.

On the flip side, I sometimes decline to take on male patients if I get the

impression that I might not be safe around them alone…cuts both ways, I

guess.

Annie

-----Original

Message-----

From:

[

mailto: ] On Behalf Of l_spikol

Sent: Sunday, October 15, 2006

11:49 AM

To:

Subject:

Re: Survivability- If you can make it here...

This may not be politically correct-but whatever-what do people think

of the idea that female physicians have an easier time starting these

type of practices and an easier time filling up with patients? I'm

just thinking of other factors that influence survive ability.

Also, as has been mentioned, I think there is no doubt that location

plays a major part in survivability. My other ideas are (and this

may not be politically correct either)-are that there is a good

amount of variation in efficiency of practice. I also think there is

a good amount of variation on the idea of " what is good enough " -that

is how good do you have to be-20 minutes per patient-30 minutes per

patient-45 minutes per patient-60 minutes per patient etc.??-where is

the sweet spot between survivability, patient happiness and outcomes

that are valuable with regard to patient outcomes?

I would also like to comment on the idea that is sometimes expressed

that " my patients would never accept that in this

area " - " that " -

meaning paying a little extra for service, a small yearly fee etc. I

also live in an area where I am tempted to say this-but actually

since so few people have done it here I actually do not know that

this is actually the case.

Regards,

Lou Spikol

>

> > Well, after 6 months working part-time I was busy enough to go

full

> > time three months ago and I just closed my practice last week. I

am

> > solo-solo in Park Slope, Brooklyn

and absolutely astounded at the

> > response I have had. I have seen slightly over 600 new patients

and

> > have about 200 more new patients scheduled for the next 2 months.

I am

> > seeing about 6-10 patients per day with about 34 patient contact

hours

> > per week. One big surprise has been the number of children I am

seeing

> > and with infants needing frequent visits I am finding there is not

> > enough time in the day. Financially I am doing ok. Not paying

myself a

> > ton, $72,000/year but covering my rent, salary, and malpractice.

> > (Hoping for a raise next month...) Was even able to pay off a

little

> > of my small business loan. My huge thanks to Gordon and the rest

of

> > this group for their ideas and encouragement. I have been working

on

> > some colleagues here to do the same as I am finding my work so

much

> > more enjoyable than ever before. My patients love my use of e-

mail and

> > the web and the personal approach that IMPs offer.

> > All the best,

> > Maggie Carpenter, MD

> > www.drmaggiecarpenter.com

> >

> >

> >

>

No virus found in this incoming message.

Checked by AVG Free Edition.

Version: 7.0.408 / Virus Database: 268.13.4/476 - Release Date: 10/14/2006