Re: Re: financial viability

[Guest guest]

So, in short: a moderately high volume coupled with office efficiency seems to

be the formula to IMP success. Unfortunately, it seems there is still no

substitute for relative volume of patients. Efficiency only takes us so far

and then there has to be some volume. 30 pt's/day? Maybe not, but it sounds

like 15 - 20/day is the sweet spot if you want to make a decent living. Super

low volumes just can not equate to anywhere near an average income, unless you

live in a very unique microcosym practice environment like Pamela Wible in

Oregon (ie, 99.9 percentile reimbursement rates vs the rest of us, super low

malpractice rates, very motivated & unique patients).

>

>

> Date: 2007/01/01 Mon PM 01:12:32 EST

> To:

> Subject: Re: financial viability

>

> Sorry for the delay in answering this. I was waiting to close out the

> books on 2006 to give you an accurate answer.

> My opinions on keys to financial success,

> 1. Keep overhead low but spend what you need to make money

> 2. See enough patients. In solo-solo model Gordon's initial plan was

> to see 60 patients per week, in a 1 staff per doctor model you need

> to see about 80-85/wk

> 3. Code very accurately and make sure you don't miss procedure codes

> and codes such as specimen prep which some insurances pay.

> 4. Constantly improve your efficiency. You will never be able to see

> the patients you need if you are not very efficient.

> 5. Get good contracts or dump that insurance. I had a range from

> below medicare rates to 140% above Medicare. I am in the process of

> becoming nonparticipating in my bottom 3 payors.

>

> In Chicago it is very difficult for primary care to make a living. I

> know 5 docs who have either gone out of business or moved to another

> state in the last 18 months. My malpractice is $30,000/yr, my 1/2

> time partner pays 18,000/yr. Rents and staff costs are very high. (My

> MA makes $15/hr,my LPN makes $20/hr)

> In my 2nd full year in practice I payed myself $146,000 which does

> not include retirement or health insurance ( we get that through my

> wife) I paid $12,000 for repayment of my startup loan. My budget for

> next year is for me to make $30,000 more. My volume has only reached

> the 80/wk level in the last 2 months. Medicare pays $90 for a 99214.

> I average $108/visit. I tend to bill about 70% 14's and the rest 13's

> with some 5's thrown in I do a moderate amount of skin procedures in

> my office such as mole removals which pay well. We do a lot of

> pediatrics. The shots raise both my collections and my overhead a

> lot. We also bill some insurances for labs and have the lab bill us.

> This also inflates both our collections and overhead.

> My overhead right now is higher than most of you at 50%

>

> Larry Lindeman MD

>

>

>

> > So Larry

> > your practice is such a good example to learn from

> > You have a micropractice as it is small, and you make a good

> > salary mostly ? I guess becasue you can do the volume which you

> > can do becasue of staff?

> > Is that correct?

> > Or do you also in addtion live in a place where the reimbursemetn

> > situation is good- like we hear from Orregon and I think

> > Washington also?

> > Successful practices are such a hard- to- predict combo of all

> > this stuff.

> >

> > Do you know w hat your overhead is byplease?

> > And please which tasks are done by other than docotrs?-Billing,

> > scheduling how about comunicating test results ordering

> > supplies etc?

> >

> > Finally Dr Successful, Do you know and are you willing to

> > share you average charges per patietn and or average reimbursment

> > per patietn? Tahnks!

> >

> >

> >

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