Re: Here I am...a healthy person who just needs a physical every 2 y

[Guest guest]

Good thread on who we should make ourselves available to.

I changed my practice in January 2008, and now at the end of 2010, my revenues

after expenses are approaching 2008 levels, with word of mouth about my

patient-centered insurance free practice increasing. New patients are coming

from who knows where, but they have been referred by patients, and through an

email newsletter I put out.

I decided in 2008 to leave, as I have seen it called here, the hamster wheel of

traditional family practice, as it was unsustainable for the future in both a

financial and ability to practice medicine correctly sense. It was the best move

I ever made. I actually enjoy going into the office. Every patient I see wants

to be at my practice. I am not their doctor because I was in the insurance book

or directory. I am not their doctor because I have a hospital or corporate name

before my name on my office door. I was picked, and paid directly by each

patient, with no middleman, because they want what I can give, which is

personalized healthcare with as close to 100% trust you can have.

Everyone should truly think about their practice.

Is it sustainable in it's present form?

If not, what are your plans?

Will you become an employee for a group or hospital, leave the profession, sell

your wares to Big Pharma or some research outfit, maybe write a book? Maybe you

will get disgusted and just retire!

But if you love your profession, and enjoy doing what is right for your

patients, without the third party intrusions, think about changing our style of

practice

Horvitz, D.O.

stown, NJ

Www.drhorvitz.com

Sent from my iPad

[Guest guest]

,

What is your # patients to get back to making a living like 2008?

Are you seeing more, less, the same patient #'s?

Thanks

Locke, MD

 

Good thread on who we should make ourselves available to.I changed my practice in January 2008, and now at the end of 2010, my revenues after expenses are approaching 2008 levels, with word of mouth about my patient-centered insurance free practice increasing. New patients are coming from who knows where, but they have been referred by patients, and through an email newsletter I put out.

I decided in 2008 to leave, as I have seen it called here, the hamster wheel of traditional family practice, as it was unsustainable for the future in both a financial and ability to practice medicine correctly sense. It was the best move I ever made. I actually enjoy going into the office. Every patient I see wants to be at my practice. I am not their doctor because I was in the insurance book or directory. I am not their doctor because I have a hospital or corporate name before my name on my office door. I was picked, and paid directly by each patient, with no middleman, because they want what I can give, which is personalized healthcare with as close to 100% trust you can have.

Everyone should truly think about their practice.Is it sustainable in it's present form?If not, what are your plans?Will you become an employee for a group or hospital, leave the profession, sell your wares to Big Pharma or some research outfit, maybe write a book? Maybe you will get disgusted and just retire!

But if you love your profession, and enjoy doing what is right for your patients, without the third party intrusions, think about changing our style of practice Horvitz, D.O.stown, NJWww.drhorvitz.com

Sent from my iPad

[Guest guest]

A better way to explain is to look at my blog about my practice transition.

http://doctorsh.blogspot.com/2010/08/cash-transition-jan-june-2010.html

I will be posting end of year stats sometime in January.

Steve Horvitz, D.O.

stown, NJ

Www.drhorvitz.com

Http://doctorsh.blogspot.com

Sent from my iPad

[Guest guest]

Steve,Very interesting. Thanks for the link to your blog. Good to see the number behind your thinking and the result of your experience thus far.A question: What do you do about referrals or orders (labs, imaging etc.)Most of the health 'insurance' plans here will not allow an out of plan doc to refer when needed. This requires the pts see yet another provider to do so, incurring more cost. This referral cost is then covered by the plans, however, the plans then will not reimburse the patient for seeing you. Understandably pts don't like this.Thanks KathleenA better way to explain is to look at my blog about my practice transition.http://doctorsh.blogspot.com/2010/08/cash-transition-jan-june-2010.htmlI will be posting end of year stats sometime in January.Steve Horvitz, D.O.stown, NJWww.drhorvitz.comHttp://doctorsh.blogspot.comSent from my iPad

[Guest guest]

Kathleen:Referrals only necessary for hmo's. For these patients we have an arrangement with a few local solo docs who serve as the HMO referral doc. My patients see them once a year for a hi how are you visit, update their charts in case of audit, and then receive their care from my office. If I feel they need a referral I call the referral docs office and request it, no further office visit needed. As for insurers reimbursing my patients for their costs with me, it depends upon their out of network insurance. HMO patients do not get reimbursed, but others will after their deductible. But with the steady growth in my practice, reimbursement by insurers is not too much a limiting factor.Labs do not need referrals, just a requisition slip. We draw our own labs and send the tubes to the lab directly, with patients insurance included. There has not been any denials by insurers for this service.You need to decide who you work for.I work for my patients, not the insurer.Give a good product , fairly and reasonably priced, get control of your overhead, simplify your practice, and you will be surprised, most likely pleasantly with the results. Horvitz, D.O.stown, N.J.Very interesting. Thanks for the link to your blog. Good to see thenumber behind your thinking and the result of your experience thus far.A question: What do you do about referrals or orders (labs, imaging etc.)Most of the health 'insurance' plans here will not allow an out of plan doc to refer when needed. This requires the pts see yet another provider to do so, incurring more cost. This referral cost is then covered by the plans, however, the plans then will not reimburse the patient for seeing you. Understandably pts don't like this.ThanksKathleenSent from my iPad

[Guest guest]

 

If I feel they need a referral I call the referral docs office and request it, no further office visit needed.  

When you do this, you're asking that other Dr. to do uncompensated work.  I would be quite reluctant to do this and  in addition ,.the definition I use for referral is that the patient needs care that I cannot provide and I need to send them on.  I'm glad to hear this works for you but I don't think that this is replicable --certifying that a referral is needed without having seen the patient? I would be uncomfortable with that.  To be honest

r

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[Guest guest]

I think they ( the referral docs) would be more than happy to, they get the year long capitation without any of the visit expenses... and great quality p4p, and low er/uc utilisation

 

 

If I feel they need a referral I call the referral docs office and request it, no further office visit needed.  

When you do this, you're asking that other Dr. to do uncompensated work.  I would be quite reluctant to do this and  in addition ,.the definition I use for referral is that the patient needs care that I cannot provide and I need to send them on.  I'm glad to hear this works for you but I don't think that this is replicable --certifying that a referral is needed without having seen the patient? I would be uncomfortable with that.  To be honest

r

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-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)

Email is best used for appointment making and  brief  questionsEmail replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD    

     ph    fax impcenter.org

-- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com

[Guest guest]

HMOs here NOT capitated.I  know some are...

 

I think they ( the referral docs) would be more than happy to, they get the year long capitation without any of the visit expenses... and great quality p4p, and low er/uc utilisation

 

 

If I feel they need a referral I call the referral docs office and request it, no further office visit needed.  

When you do this, you're asking that other Dr. to do uncompensated work.  I would be quite reluctant to do this and  in addition ,.the definition I use for referral is that the patient needs care that I cannot provide and I need to send them on.  I'm glad to hear this works for you but I don't think that this is replicable --certifying that a referral is needed without having seen the patient? I would be uncomfortable with that.  To be honest

r

Switch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use

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-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)

Email is best used for appointment making and  brief  questionsEmail replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD    

     ph    fax impcenter.org

-- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com

-- PATIENTS-please remember  that email may not be entirely secure, and that Email is part of the medical  record and is placed into your  chart ( be careful what you say!)

Email is best used for appointment making and  brief  questionsEmail replies can be expected within 24 hours-Please CALL  if the  matter is more urgent .     MD    

     ph    fax impcenter.org

[Guest guest]

Our HMO isn’t capitated either. We get

paid FFS plus a P4P bonus quarterly. I doubt Steve would enter into an

arrangement like does. It’s his performance that is being measured each

and every time someone is referred out. But I’m glad for & his

patients that he was able to work out that arrangement.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of

Sent: Monday, December 06, 2010

3:26 AM

To:

Subject: Re:

Re: Here I am...a healthy person who just needs a

physical every 2 y

HMOs here NOT capitated.I know some are...

On Mon, Dec 6, 2010 at 12:30 AM, Sangeetha Murthy

wrote:

I think they ( the referral docs) would be more

than happy to, they get the year long capitation without any of the visit

expenses... and great quality p4p, and low er/uc utilisation

On Sun, Dec 5, 2010 at 6:29 PM,

wrote:

On Sun, Dec 5, 2010 at 9:12 PM, Drhorvitz

wrote:

If I feel they need a referral I call the referral

docs office and request it, no further office visit needed.

When

you do this, you're asking that other Dr. to do uncompensated work.

I would be quite reluctant to do this and in addition ,.the definition I

use for referral is that the patient needs care that I cannot provide and I

need to send them on. I'm glad to hear this works for you but I don't

think that this is replicable --certifying that a referral is needed without

having seen the patient? I would be uncomfortable with that. To be honest

r

Switch

to: Text-Only, Daily Digest • Unsubscribe • Terms of Use

..

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart (

be careful what you say!)

Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

--

Sangeetha Murthy M.D

7830

mont Mesa Blvd #287

San

Diego, CA 92111

www.mypcponline.com

--

PATIENTS-please remember that email may not be entirely secure, and that

Email is part of the medical record and is placed into your chart (

be careful what you say!)

Email is best used for appointment making and brief questions

Email replies can be expected within 24 hours-Please CALL if the

matter is more urgent .

MD

115 Mt Blue

Circle

Farmington

ME 04938

ph fax

impcenter.org

[Guest guest]

1- who is ?

2- when it comes to providing top notch medical care, why are we worried about

what the insurer thinks, as opposed to the patient. Last I checked we are

supposed to be only concerned with the patients health, or am I mistaken?

3- goodwill between doctors, especially those in solo private practice is still

important.

Horvitz, D.O.

stown, NJ 08057

Sent from my iPad

[Guest guest]

Everything old is new again. The next experiment is called 'bundled payment'. As I understand it, this is supposed to make sure the docs have some skin in the game and 'incentivize' us to work together to coordinate care. Like not enough of our skin is at risk as is? This bundled payment thing is supposed to save money. For whom? So the stockholders of the company can make more money? Or make more money for those who manage all of this arcana? And the patient benefits how?We are so blind. HMOs here NOT capitated.I know some are... I think they ( the referral docs) would be more than happy to, they get the year long capitation without any of the visit expenses... and great quality p4p, and low er/uc utilisation If I feel they need a referral I call the referral docs office and request it, no further office visit needed. When you do this, you're asking that other Dr. to do uncompensated work. I would be quite reluctant to do this and in addition ,.the definition I use for referral is that the patient needs care that I cannot provide and I need to send them on. I'm glad to hear this works for you but I don't think that this is replicable --certifying that a referral is needed without having seen the patient? I would be uncomfortable with that. To be honestrSwitch to: Text-Only, Daily Digest • Unsubscribe • Terms of Use. -- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org-- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com-- PATIENTS-please remember that email may not be entirely secure, and that Email is part of the medical record and is placed into your chart ( be careful what you say!)Email is best used for appointment making and brief questionsEmail replies can be expected within 24 hours-Please CALL if the matter is more urgent . MD ph fax impcenter.org