Re: Practice overview? Where to begin

[Guest guest]

I think many of us have posted details about our practices. And feedback

on list, and off, hopefully has been helpful. I for one love reading

about how others have worked through issues, made decisions and keep

making improvements as they shape their lives and offices.

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

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> I haven't followed this listserv all that much although I've gotten all

> the emails for a long time, so I'm not too familiar with the " do's and

> don'ts " . Would it be acceptable for me to post some specific information

> about my practice in the hope of getting some good useful feedback?

>

> (These aren't the details I'm referring to.) Eight years ago I stopped

> doing everything hospital-related, including tons of ob; back then, it

> didn't matter what I did or didn't do, I still made plenty of money.

> When I stopped all of that during a seven-year period of burnout, I went

> from no interest in practice management and making a lot of money to no

> interest in practice management and making less than a beginning school

> teacher.

>

> Since then I have followed with interest the ideas put forth from this

> group with great interest. A couple years ago I was paying $94,000

> annually in salaries, down now to $65,000 in 2006, and the possibility

> of $40,000 or less for salaries this year.

>

> My lowest net was in 2005, up significantly last year, and expect to

> continue the upward trend this year. There's so much more I could be

> doing to increase my efficiency and bottom line, but it's hard to really

> know where to begin.

>

> Looking forward to some good feedback.

>

> Shirley Pigott MD

> texas

[Guest guest]

Shirley: You hit the nail on the head when you implied you made lot of money doing procedures like OB, but did not have time to manage the details of your practice. I have found the opposite is true as well, as you grow a low overhead ideal practice you have more time to cut overhead and see patients. It is encouraging to see efficiency take root in the new practice. However, I think at a certain point with the way RVU's are calculated E & M services start to become interchangeable. So long as you have the next service to provide and the correct amount of time, it becomes futile what to do next. Unless you can further harness technology or staff to provide increases in efficiency the next unit of productivity does not yield further income to the practice above another unit. Physicians trade low paying insurers for higher paying and revenue improves with the same # of RVU's. Others add acupuncture or

aesthetics. There is only so much attention to be paid to the bottom line. When I left large group practice my overhead dropped exponentially, my income as well. We need to start to focus on the top line with respect to efficiently attracting higher paying patients, higher reimbursement from insurers, while increasing patient centered care. I am looking to leverage my abilities, but unlike many industries, I have not found the economy of scale or compensation for my expertise to be lucrative in primary medicine. I wish you well in your endeavor. Shirley PigottMD wrote: I haven't followed this listserv all that much although I've gotten all the emails for a long time, so I'm not too familiar with the "do's and don'ts". Would it be acceptable for me to post some specific information about my practice in the hope of getting some good useful feedback? (These aren't the details I'm referring to.) Eight years ago I stopped doing everything hospital-related, including tons of ob; back then, it didn't matter what I did or didn't do, I still made plenty of money. When I stopped all of that during a seven-year period of burnout, I went from no interest in practice management and making a lot of money to no interest in practice management and making less than a beginning school teacher. Since then I have followed with interest the ideas put forth from this group with great

interest. A couple years ago I was paying $94,000 annually in salaries, down now to $65,000 in 2006, and the possibility of $40,000 or less for salaries this year.My lowest net was in 2005, up significantly last year, and expect to continue the upward trend this year. There's so much more I could be doing to increase my efficiency and bottom line, but it's hard to really know where to begin. Looking forward to some good feedback.Shirley Pigott MDtexas __________________________________________________

[Guest guest]

I have noticed that nothing I learned in Econ 101 seems to apply! SPOn 1/3/07, Egly <kevin_egly@...

> wrote:

Shirley: You

hit the nail on the head when you implied you made lot of money doing

procedures like OB, but did not have time to manage the details of your

practice. I have found the opposite is true as well, as you grow

a low overhead ideal practice you have more time to cut overhead

and see patients. It is encouraging to see efficiency take root in the

new practice. However, I think at a certain point with the way

RVU's are calculated E & M services start to become interchangeable.

So long as you have the next service to provide and the correct amount

of time, it becomes futile what to do next. Unless you can further

harness technology or staff to provide increases in efficiency the next

unit of productivity does not yield further income to the practice

above another unit. Physicians trade low paying insurers for

higher paying and revenue improves with the same # of RVU's.

Others add acupuncture or aesthetics. There is only so much

attention to be paid to the bottom line. When I left large group

practice my overhead dropped exponentially, my income as well. We

need to start to focus on the top line with respect to efficiently

attracting higher paying patients, higher reimbursement from insurers,

while increasing patient centered care. I am looking to leverage

my abilities, but unlike many industries, I have not found the economy

of scale or compensation for my expertise to be lucrative in primary

medicine. I wish you well in your endeavor. Shirley PigottMD <shirleypigottmd@

gmail.com> wrote: I

haven't followed this listserv all that much although I've gotten all

the emails for a long time, so I'm not too familiar with the " do's and

don'ts " . Would it be acceptable for me to post some specific

information about my practice in the hope of getting some good useful

feedback? (These aren't the details I'm referring to.)

Eight years ago I stopped doing everything hospital-related, including

tons of ob; back then, it didn't matter what I did or didn't do, I

still made plenty of money. When I stopped all of that during a

seven-year period of burnout, I went from no interest in practice

management and making a lot of money to no interest in practice

management and making less than a beginning school teacher. Since

then I have followed with interest the ideas put forth from this group

with great interest. A couple years ago I was paying $94,000

annually in salaries, down now to $65,000 in 2006, and the possibility

of $40,000 or less for salaries this year.My

lowest net was in 2005, up significantly last year, and expect to

continue the upward trend this year. There's so much more I could

be doing to increase my efficiency and bottom line, but it's hard to

really know where to begin. Looking forward to some good feedback.Shirley Pigott MDtexas __________________________________________________