money

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A "rule of thumb" that I use is this: For every extra patient that you see per day, you can expect to make about $10,000 per year....

1 pt x $50 per pt x 4 days per week x 52 weeks equals about $10,000.

This is before overhead, etc....

This is somewhat simplistic, but somewhat helpful for many to understand patient volume needed for extra income.

Tom

______________________________________________Tom P. Mason, M.D.tmasondekalbmemorialhttp://mason.familydoctors.net "Family Physicians.... physicians that specialize in you."

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-----Original Message-----From: [mailto: ] On Behalf Of GuinnSent: Thursday, September 14, 2006 11:07 AMTo: Subject: {Disarmed} Re: money

Patient contact hours is the key - not number of hours in a working day. Also, patient seen for physicals are seen for an hour. New patients are an hour. So I have about 26 patient contact hours per week, averaging 10.5 patients/ day in my busier months. If I see more patients, I suspect that my average per patient would start to go down, as I wouldn't be able to make the effort needed to charge correctly for my services (i.e. 99213 vs 99214). I'm providing this information for people in this group who are starting out and curious about finances. It depends a lot on the reimbursement available in a region. I noted once when we discussing reimbursement that HMOs in southern California, for example, pay badly. I take Medicare and Medicaid as well as self pays. The majority of my practice is HMO though, as that's what rules in this town.

I must be missing something. If you are truly averaging $91 for every pt that walks in the door then: two/hr = $180/hr. If you work 8 hrs/day x 4.5 days/wk x 48 wks/yr that comes out to $311,000/yr before overhead. Even with a traditional 50% overhead you would still be bringing in over $150,000/yr. Now, if you have chosen to work less than these hours I quoted then that is different (personal choice). I could not average $91 per patient without upcoding illegally or not taking any self-pays or Medicaid. Sure, some visits pay more than that but the large majority pay between $50 & $80.

-----Original Message-----From: [mailto: ] On Behalf Of GuinnSent: Wednesday, September 13, 2006 9:43 PMTo: Subject: Re: money

$91.00 per patient visit is about what I average also - about 2000 visits/year.

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

Hi Larry:

Let me assume some numbers for now as follows

2000 patients

300,000 collections

150,000 overhead

150,000 salary

Collections per patient then 300,000/2000 or $150/year per patient or a little over $12/ month per patient.

My practice has fewer patients but last year we collected $200/patient but still less than 20$ per month per patient.

I still feel the way we make primary care affordable is by asking patients/insurers/ and employers to pay $1/day.

The only other way to increase revenue and salary is to provide quick care. A friend who provided urgeant carewould see 30-40 patients per day in quick care working 3-4 days per week. He was seeing 4-6 patients per hour. Most 99313's one problem one prescription $50-70 per visit or 200/hour $1600/day. 2000 hours per year 400,000 overhead 200,000 salary.

In our low overhead clinic with just medicare, if we could see enough patients with higher level visits for 99214 at two an hour we would collect $158/ hour. For 2000 hours $316,000 in overhead. As it is we are at 35-40 patient per week most are 99214 with in house lab we collect about $92 per patient visit. Overhead is $60,000 to increase to $80,000 next year. At 2000 visits per year we will collect about 180,000. pay $100,000. We feel we will be able to increase daily visits but keep hours the same and hope to evetually provide salary and benefits of $150,000 per year.

Note your income is a combination of salary, benefits, CME, professional liscences, health insurance, disability insurance. $20,000 of our overhead covers these expenses. So our real income and benefits is actually $100,000 this year for seeing less than a patient an hour. But is I needed $150,000 in salary alone, I do not see that as possible unser the IMP model or any primary care model for that matter.

Larry Lindeman <llindemanmac> wrote:

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

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