Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FLadam schwarz wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FLadam schwarz wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 Hi Adam -Well, I was just woken up in the middle of the night by a patient for the first time in 2 years. I have a panel of 1000, roughly, and get 2-3 calls/ week, on average, after hours. Never after ten pm, ever (well, except last night). Call is just not one of the problems in IMPing. Pharmacy authorizations are much more irritating. Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours'b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings!Adam Schwarz MDHanoverContinuityClinicHanover NH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 Hi Adam -Well, I was just woken up in the middle of the night by a patient for the first time in 2 years. I have a panel of 1000, roughly, and get 2-3 calls/ week, on average, after hours. Never after ten pm, ever (well, except last night). Call is just not one of the problems in IMPing. Pharmacy authorizations are much more irritating. Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours'b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings!Adam Schwarz MDHanoverContinuityClinicHanover NH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 a) 2, usually one on the weekend, and one in early evening one night during the week... not once after 9pm in the first 7 months my office has been open. no call group support Bottom Line -- 24/7 Call for 400 patients is much, much easier than 1-in-7 call for 14,000!! .... also, rare patients go to any kind of urgent/after-hour services or non-urgent ED care. They seem to make appopriate calls, or leave a non-urgent message on my secure online messaging system for me to catch up with in the morning. Tim -- Malia, MD Malia Family Medicine & Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square Mall Fairport, NY 14450 (phone / fax) www.relayhealth.com/doc/DrMalia www.SkinSenseLaser.com -- Confidentiality Notice -- This email message, including all the attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments. > Many non imp collieges ask me about dealing with 24x7 call; I'm > wondering if " you " could say : > > a. ave number of calls a week 'after hours' > b. do you have some routine call coverage? yes/no - if yes details > > I open 5/2/07 - thanks to your wisdom I'm drying off my wings! > > Adam Schwarz MD > HanoverContinuityClinic > Hanover NH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 a) 2, usually one on the weekend, and one in early evening one night during the week... not once after 9pm in the first 7 months my office has been open. no call group support Bottom Line -- 24/7 Call for 400 patients is much, much easier than 1-in-7 call for 14,000!! .... also, rare patients go to any kind of urgent/after-hour services or non-urgent ED care. They seem to make appopriate calls, or leave a non-urgent message on my secure online messaging system for me to catch up with in the morning. Tim -- Malia, MD Malia Family Medicine & Skin Sense Laser 6720 Pittsford-Palmyra Rd. Perinton Square Mall Fairport, NY 14450 (phone / fax) www.relayhealth.com/doc/DrMalia www.SkinSenseLaser.com -- Confidentiality Notice -- This email message, including all the attachments, is for the sole use of the intended recipient(s) and contains confidential information. Unauthorized use or disclosure is prohibited. If you are not the intended recipient, you may not use, disclose, copy or disseminate this information. If you are not the intended recipient, please contact the sender immediately by reply email and destroy all copies of the original message, including attachments. > Many non imp collieges ask me about dealing with 24x7 call; I'm > wondering if " you " could say : > > a. ave number of calls a week 'after hours' > b. do you have some routine call coverage? yes/no - if yes details > > I open 5/2/07 - thanks to your wisdom I'm drying off my wings! > > Adam Schwarz MD > HanoverContinuityClinic > Hanover NH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 8, 2006 Report Share Posted November 8, 2006 From Drain, Oregon; Maybe two calls in a week since I started doing nursing home stuff. Until then only one or two a month. Only have had one momentary problem with rude calls. One patient of mine was admitted to a rehab center 35 miles north without my knowledge after a knee replacement, and without asking me the place started calling me..at three in the morning for pain management the first time. I am afraid I helped them, but it got worse and worse; I had no op report, no admit report, and no follow through from the orthopedist. My solution: I refused to sign the discharge papers until I visited the rehab center, had a talk with their director about procedures, and got an appology. This is the system I used when the schools did not do what they had agreed to do with my autistic daughter many years ago. Generally these folks in authority hate to have to organize a team, discuss a problem, and define a solution: however they have to do so if you ask them in writing. The administration of any complex group lives in dread of things like this, so they behave when you show up. Voila, no intrusion... Joanne, the MD in Drainadam schwarz wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Sponsored Link Free Uniden 5.8GHz Phone System with Packet8 Internet Phone Service Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2006 Report Share Posted November 9, 2006 I have 815 active patients and get called after hours very rarely (like once every other month or so). I do get called on weekends just about every weekend and have not taken a holiday off in two years, but that is mostly for non-acute stuff… Luther King day is the most desired day of the year for physicals/paps, and I have done skin surgeries on Christmas and New Years the last two years also…people really don’t want to take off work. Since my kids are grown, but no grandkids yet, and my parents are gone, I have no particular place to be those days, but when that changes, I will stop being available to cut on cysts, moles and skin tags on holidays.. Annie Re: Re: curve ball Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if " you " could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2006 Report Share Posted November 9, 2006 I have 815 active patients and get called after hours very rarely (like once every other month or so). I do get called on weekends just about every weekend and have not taken a holiday off in two years, but that is mostly for non-acute stuff… Luther King day is the most desired day of the year for physicals/paps, and I have done skin surgeries on Christmas and New Years the last two years also…people really don’t want to take off work. Since my kids are grown, but no grandkids yet, and my parents are gone, I have no particular place to be those days, but when that changes, I will stop being available to cut on cysts, moles and skin tags on holidays.. Annie Re: Re: curve ball Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if " you " could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2006 Report Share Posted November 9, 2006 Who pays your “modest annual fee”? I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal " Snow Birds " in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing " boutique " practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FL adam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if " you " could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2006 Report Share Posted November 9, 2006 Who pays your “modest annual fee”? I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal " Snow Birds " in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing " boutique " practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FL adam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if " you " could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2006 Report Share Posted November 9, 2006 Annie, I have about 30% Medicare which comprises about 50% of my daily visits. Sadly, Medicare is my best payor, with most of my other payors (Aetna, Cigna, BC/BS, United) paying 80% of Medicare rates. I instituted the "annual fee" 3 years ago and it has been well received. I made it voluntary, to allow those who truly can't afford it the opportunity to stay with the practice, AND to skirt any regulatory skirmishes. Ira Warshaw Norht Palm Beach, FLAnnie Skaggs wrote: Who pays your “modest annual fee”? I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Tuesday, November 07, 2006 10:59 PMTo: Subject: Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FLadam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2006 Report Share Posted November 9, 2006 Annie, I have about 30% Medicare which comprises about 50% of my daily visits. Sadly, Medicare is my best payor, with most of my other payors (Aetna, Cigna, BC/BS, United) paying 80% of Medicare rates. I instituted the "annual fee" 3 years ago and it has been well received. I made it voluntary, to allow those who truly can't afford it the opportunity to stay with the practice, AND to skirt any regulatory skirmishes. Ira Warshaw Norht Palm Beach, FLAnnie Skaggs wrote: Who pays your “modest annual fee”? I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Tuesday, November 07, 2006 10:59 PMTo: Subject: Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FLadam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2006 Report Share Posted November 9, 2006 If the fee is “voluntary” then why would anyone pay it? Where I’m at voluntary would equal “no thanks.” Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seaso! nal " Snow Birds " in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing " boutique " practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. ! Ira Warshaw North Palm Beach, FL adam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if " you " could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2006 Report Share Posted November 9, 2006 If the fee is “voluntary” then why would anyone pay it? Where I’m at voluntary would equal “no thanks.” Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seaso! nal " Snow Birds " in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing " boutique " practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. ! Ira Warshaw North Palm Beach, FL adam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if " you " could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2006 Report Share Posted November 11, 2006 I am in a slightly different situation with my IMP, having located less than 2 miles from my previous practice. This morning I had 5 phone calls. One from a mom stuck in the middle of nowhere, a cranky 9 month old and children's motrin... " will it work and how much can I use?' total call 2 minutes. 'When do you want me to come in this morning?' x 2 from parent who needs child seen, one called last night on way home from oot. total call 2 minutes, in office for total of 45 minutes this am seeing sick folk, 2 99213's plus inhaler instruction chg. One refill request overlooked yesterday, 3 minutes. One 'I have the crud' from my daycare kids, help. All in all, a more active morning than most, still less than on hour (including billing time!) and not really stressed since I knew each person! I average 1-2 calls a night during the week, 2-5 onSat am if a busy weekend. Rarely do I get called Saturday night or Sunday unless they're really sick, and then I usually end up seeing them! I also do hospital and ob! My former partners said the same thing about 24/7, but I had done it for ob for 6 months and hadn't found it too burdonsome so I figured adding the rest of my practice wouldn't be much different. It hasn't been. BtW, I think about 800-1000 pts came with me. Lynette 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 11, 2006 Report Share Posted November 11, 2006 I am in a slightly different situation with my IMP, having located less than 2 miles from my previous practice. This morning I had 5 phone calls. One from a mom stuck in the middle of nowhere, a cranky 9 month old and children's motrin... " will it work and how much can I use?' total call 2 minutes. 'When do you want me to come in this morning?' x 2 from parent who needs child seen, one called last night on way home from oot. total call 2 minutes, in office for total of 45 minutes this am seeing sick folk, 2 99213's plus inhaler instruction chg. One refill request overlooked yesterday, 3 minutes. One 'I have the crud' from my daycare kids, help. All in all, a more active morning than most, still less than on hour (including billing time!) and not really stressed since I knew each person! I average 1-2 calls a night during the week, 2-5 onSat am if a busy weekend. Rarely do I get called Saturday night or Sunday unless they're really sick, and then I usually end up seeing them! I also do hospital and ob! My former partners said the same thing about 24/7, but I had done it for ob for 6 months and hadn't found it too burdonsome so I figured adding the rest of my practice wouldn't be much different. It hasn't been. BtW, I think about 800-1000 pts came with me. Lynette 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2006 Report Share Posted November 12, 2006 Annie, I suspect that you may be underestimating the value your patients place on the care that you provide, or else quality primary care must be much more accessible there than here. I’ve been thinking seriously about a “modest annual fee” myself, and I don’t think that I would lose more than 20% of my practice due to it and the ones who would stay would be the ones who truly value the access and care that I provide, and understand that it is very rare in this environment. I would be able to quickly fill the slots left open. Regards, M. Wilterding, M.D. 711 Encino Pl. NE; Suite D Albuquerque, NM 87102 (505) 265-2244 Fax: From: [mailto: ] On Behalf Of Annie Skaggs Sent: Wednesday, November 08, 2006 6:17 PM To: Subject: RE: Re: curve ball Who pays your “modest annual fee”? I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message----- From: [mailto: ] On Behalf Of Ira Warshaw Sent: Tuesday, November 07, 2006 10:59 PM To: Subject: Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal " Snow Birds " in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing " boutique " practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FL adam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if " you " could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.409 / Virus Database: 268.14.0/524 - Release Date: 11/8/2006 -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.409 / Virus Database: 268.14.2/528 - Release Date: 11/10/2006 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2006 Report Share Posted November 12, 2006 & Annie: I too am considering an annual fee. Patients would have a choice of my care or others. The critical qwuestion is what is legal and what value would the fee purchase? Wilterding wrote: Annie, I suspect that you may be underestimating the value your patients place on the care that you provide, or else quality primary care must be much more accessible there than here. I’ve been thinking seriously about a “modest annual fee” myself, and I don’t think that I would lose more than 20% of my practice due to it and the ones who would stay would be the ones who truly value the access and care that I provide, and understand that it is very rare in this environment. I would be able to quickly fill the slots left open. Regards, M. Wilterding, M.D.711 Encino Pl. NE; Suite D Albuquerque, NM 87102 Fax: From: [mailto: ] On Behalf Of Annie SkaggsSent: Wednesday, November 08, 2006 6:17 PMTo: Subject: RE: Re: curve ball Who pays your “modest annual fee”? I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Tuesday, November 07, 2006 10:59 PMTo: Subject: Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FLadam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 --No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.409 / Virus Database: 268.14.0/524 - Release Date: 11/8/2006 --No virus found in this outgoing message.Checked by AVG Free Edition.Version: 7.1.409 / Virus Database: 268.14.2/528 - Release Date: 11/10/2006 Everyone is raving about the all-new Yahoo! Mail beta. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2006 Report Share Posted November 12, 2006 & Annie: I too am considering an annual fee. Patients would have a choice of my care or others. The critical qwuestion is what is legal and what value would the fee purchase? Wilterding wrote: Annie, I suspect that you may be underestimating the value your patients place on the care that you provide, or else quality primary care must be much more accessible there than here. I’ve been thinking seriously about a “modest annual fee” myself, and I don’t think that I would lose more than 20% of my practice due to it and the ones who would stay would be the ones who truly value the access and care that I provide, and understand that it is very rare in this environment. I would be able to quickly fill the slots left open. Regards, M. Wilterding, M.D.711 Encino Pl. NE; Suite D Albuquerque, NM 87102 Fax: From: [mailto: ] On Behalf Of Annie SkaggsSent: Wednesday, November 08, 2006 6:17 PMTo: Subject: RE: Re: curve ball Who pays your “modest annual fee”? I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Tuesday, November 07, 2006 10:59 PMTo: Subject: Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FLadam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 --No virus found in this incoming message.Checked by AVG Free Edition.Version: 7.1.409 / Virus Database: 268.14.0/524 - Release Date: 11/8/2006 --No virus found in this outgoing message.Checked by AVG Free Edition.Version: 7.1.409 / Virus Database: 268.14.2/528 - Release Date: 11/10/2006 Everyone is raving about the all-new Yahoo! Mail beta. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2006 Report Share Posted November 12, 2006 So if it is voluntary, what percentage of patients pay it? Do any Medicare beneficiaries? My Medicare numbers are close to yours, but though they are more likely to appreciate my care enough to pay extra than are young people, I still believe most would balk …. Annie Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal " Snow Birds " in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing " boutique " practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FL adam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if " you " could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2006 Report Share Posted November 12, 2006 You have hit the nail on the head….primary care (and most specialties except renal, rheumatology and psychiatry) are very numerous here, so much so that patients routinely shop around just like you would run into the corner “Quik Mart” across town form your regular grocer just because you happened to be in the neighborhood and it was convenient. And my patients often say they value my care, and will even schedule an “out of network” appointment after their insurance changes..but once they find out that their plan REALLY won’t pay me, they usually disappear for good and stiff me for the cost of their “out of network” visit. Heck, most of them think they are doing me a favor when they come in for a visit, so their insurance will pay me something. And if the insurance doesn’t pay….Well, that’s too bad. A shortage of PCPs is my best hope. Annie Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal " Snow Birds " in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing " boutique " practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FL adam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if " you " could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D. 1216 U.S. Highway #1 North Palm Beach, FL 33408 (561)626-1000 -- No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.1.409 / Virus Database: 268.14.0/524 - Release Date: 11/8/2006 -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.409 / Virus Database: 268.14.2/528 - Release Date: 11/10/2006 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 12, 2006 Report Share Posted November 12, 2006 Annie, Most of my Medicare patients do pay it, usually happily, and since it's voluntary, which allows it to glide under any regulatory concerns, the one's for whom it would be a true hardship, don't have to pay. The folks I only see every 2 or 3 years for an acute problem might not pay it...but MANY do! I try to make a point of NOT knowing who has paid, a I feel my whole practice is "Value Added" service. IraAnnie Skaggs wrote: So if it is voluntary, what percentage of patients pay it? Do any Medicare beneficiaries? My Medicare numbers are close to yours, but though they are more likely to appreciate my care enough to pay extra than are young people, I still believe most would balk …. Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Thursday, November 09, 2006 5:31 AMTo: Subject: RE: Re: curve ball Annie, I have about 30% Medicare which comprises about 50% of my daily visits. Sadly, Medicare is my best payor, with most of my other payors (Aetna, Cigna, BC/BS, United) paying 80% of Medicare rates. I instituted the "annual fee" 3 years ago and it has been well received. I made it voluntary, to allow those who truly can't afford it the opportunity to stay with the practice, AND to skirt any regulatory skirmishes. Ira Warshaw Norht Palm Beach, FLAnnie Skaggs <askaggsfayettefamilymed> wrote: Who pays your “modest annual fee”? I have 815 active charts and I’m pretty sure 100% of them would leave in a huff if I asked for even $20. Do you take Medicare? Can you charge them any such fees? Annie -----Original Message-----From: [mailto: ] On Behalf Of Ira WarshawSent: Tuesday, November 07, 2006 10:59 PMTo: Subject: Re: Re: curve ball Again, I rise from the shadows, as an admirer of IMP, but living in the 180 degree universe. I have a PA, 2 MA's and 3 from office staff, and probably >3,000 patients (hard to know with so many seasonal "Snow Birds" in North Palm Beach). I rotate call by the week with my PA (he's been a PA for >25 yrs), and I back him up on his call week. I get at most 1 call during the week, and maybe 2 on the weekend (a UTI or similar). The call is far less than when I shared coverage with other practices. I have friends doing "boutique" practices, with about the same # of calls as I receive. I charge a modest annual fee of $175/year. Ira Warshaw North Palm Beach, FLadam schwarz <adamschwrz> wrote: Many non imp collieges ask me about dealing with 24x7 call; I'm wondering if "you" could say : a. ave number of calls a week 'after hours' b. do you have some routine call coverage? yes/no - if yes details I open 5/2/07 - thanks to your wisdom I'm drying off my wings! Adam Schwarz MD HanoverContinuityClinic Hanover NH Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Ira G. Warshaw, M.D.1216 U.S. Highway #1North Palm Beach, FL 33408(561)626-1000 Quote Link to comment Share on other sites More sharing options...
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