Why I like IMP and won't go back EVER EVER EVER

[Guest guest]



RE IMP

OK what I like the best--

1) Patients who call me I know and can help quickly and easily; alittle harder recently as I got about 150 new pts over last 3 months. On call is easy easy easy.

2) I don't "fear" going to work -- it's fun.

3) I don't do the clinical work I don't like (the hospital, nursing home, early AM hours -- do start at 9 am).

4) I like the office setup and my workflow so things get done today that need to be done (having good parttime staff does help -- find some semi-retired nurses, they're around, and see if they can help you).

5) I like being able to spend 1/2 hour usually with chronic pts and not feel that endless time pressure

Some other gems I've found and learned over the last 5 years solo FP---------------

1) I have an "IMP lite" with 2.5 FTE support, outsource billing at 8% (worth it!); cannot do it all myself, and guess what I don't have to

2) Have to have the demographics: payors (or selfpayors if you can), patients, and low overhead (or manageable overhead, esp rent-- I sublet from 2 specialists at $60/per diem I'm in office)

3) Control your max patient load-- now at 50 pts/day, limit "chronic pts" to every 1/2 hour, with acute in between

4) Leverage technology as much as you can but be willing to change -- recently found out that pharmacies do not use ePrescribing in my area, so default back to giving 'scripts at the time of service but if pharmacy calls in meantime, will refill through amount in chart but tell pharmacy to cancel that date prescription. Will see how that works.

5) Read the book "the Successful Physican" by Laslove (Amazon, author sp?); learn to say no to what you don't want to do. I said no to hospital rounds (another family doc spends 1/2 time in dad's office, 1/2 time in hospital and sees my 0-3 pts) as well as nursing home, weekends, evenings. Guess what? It worked as the area needs docs.

6) Don't be afraid to change to the times -- rented space with another doc at $1200/month, after a year, left and found my per diem rate. Specialists love to help out primary care, and if you're a specialist, find the PCPs who refer appropriately and cultivate them.

7) Dump the bad payors (if you can --> I kept Aetna and just signed onto United Healthcare as the rates were fair but more importantly the pts forced to United stayed with me). Told my last Medicaid pt today that the $23 for her office visit today was ok with me -- she offered to pay me -- but point was I don't take new Medicaid but keep her because she needs me to help her with coordination. This is OK with me, she's shown over the years that she needs it, and I can help her.

8) Don't sweat the small stuff. Be sure to tell us what's bothering you here as your spouse, family hear this all the time from you! :-) Come to camp if you can (first one for me in Oct).

9) If you don't want the control and responsibility of running a business and taking the risk --

A) Find some one who can help you (spouse, family) to help you get started (one of us here?) with the business stuff (have to check out the wiki).

Look for a temp salary job while you develop this model.

I like the business model and enjoy the control (I always have a job, but don't pay myself every day).

Folks, after doing this for 5 years now, finally after my first employer died at 73 up the road, I have enough pts. My first fear when I opened was not enough pts; finally with the death, the "loyal" patients now are following up with me.

I moonlight still 2 AMs a week, OK for now.

Get help when you need it: legal, technical.

Matt Levin, MD

Solo FP in Western PA

Yes, the above looks like a lecture series, maybe at least a panel discussion for the Denver "camp," what do you think?

Comments off list welcome too!

dr-levin@...

[Practiceimprovemen t1] Business model

So, I was scanning Craig's List for used medical equipment. I found this ad. Check this out. A PA set up a walk-in medical 'center' in 2009. Now he is offering it for sale for $340K. Now there's business model. Set it up one year, sell it the next.http://providence. craigslist. org/bfs/16314140 31.htmlWalk-In Center-Profitable, Growing, Repeatable Business Model East Greenwich, Rhode Island Type: Established business Category: Services - Health, Medical Financials Asking: $340,000 Included in the Asking Price: Furniture, Fixtures & Equipment: $55,000 NOT Included in the Asking Price: Inventory: $1,000 Gross: $485,000 Cash Flow: $105,000 Summary Description Walk-in center in busy beach side town. Opened last year and revenues climbed through $500,000 and are heading higher. Expand by increasing hours. This business must be operated by a licensed PA or MD. Licensed PA seller willing to work with new owner via consultancy/ partner and assist in executing long-range multi-location growth opportunities. General Information Year Established: 2009 Employees: 6 Market Outlook Competition: Similar walk-in centers but without main street presence. Growth and Expansion: Expand hours and add other locations. Repeatable business model. About the Sale Support/Training: As required of new owner Reason Selling: Has other growing business Contact Information Flynn United Brokers Group Phone:

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