Re: financial viability

[Guest guest]

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 money2. 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/wk3. 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 MDSo Larryyour practice is such a good example to learn fromYou 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!

[Guest guest]

no ,...delighted you would take the time at all to write this

Although circumtances of reimbursment malpractice etc differ from location

to location, one lession I am taking from you , from a nancy g remark,

from Lynn Ho , is that 2-3 yrs may be the marturation time for these small

practices.

I see that that is prob gonna be truw for me.

tahnk you so much Hope to meet you at aafp in oct.

Thanks.

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!