So 15 psychiatrists? Or what do you mean? If you have 15 psychiatrists or NPs that you profit from you gotta be making 2M+ right?
in the millions would be nice. But no, I actually make a very average psychiatrist annual income with just a very light patient census--one year I had 130k only, in the past 1-3 years. Most years are 300k or 400k but they tend to correlate with me putting in more hours (some are 60 a week--PP has unpredictability). however, even with a light patient schedule, the job is still very full time like. I even still work on the weekends--partly because I'm a control freak with making sure each dime is accounted for, I have catastrophic thoughts of this clinic hemorrhaging in expenses. This thread actually brings out some interesting philosophical questions and brings in psychology to the picture.
In regards to the office, it's a combination of therapists, psychologists, psychiatrists. It grew quick because it pays well, I try to keep a good culture and a good lifestyle. I also try to recruit a good fit of patients. Only criteria is that you are committed to your treatment, to getting better, no other agendas. It takes commercial, medicare and medicaid. and it is evidence based, so the reputation is excellent and referral funnel fantastic. Always on the recruit because we can't keep up with the demand from motivated people.
At the same time, there are people who wonder how much I make and assume it's massive. Which brings in basic econ or even just math I wish people understood. Yes, the patient schedule looks low. But a larger practice has a lot to do to keep up with competition: marketing, keeping up with inflation, recruitment and retention of good people, grievances, liabilities (like getting entity coverage, updating documentation templates), optimizing revenue cycle and overhead cost, building up academic affiliations (I see that as a wise investment for promoting quality of care and ease of retention of good providers--some of which we train!). And I think owner presence is important. It's a place i believe in. And really try to balance my income and the culture of the place.
On the same token, it's possible with further growth, the income of the owner can grow quite a bit. But so far it has taken nearly 5 years of grueling work. The first three (one year of prep while working for an employer) was 80 hours a week. There's a lot of mental gymnastics. You need to know how to handle money, not get bullied by insurance companies, make sure services you pay for are actually doing their work (had to fire 3 SEO services before settling on mine--the SEO has been a golden goose), automating things and using software as much as possible to minimize need for hiring admin staff (performance too unreliable and very very expensive--easy way for a clinic to lose money), mastering my own recruiting abilities (recruiters are very expensive and you as the owner know what candidate profile fits needs of the clinic best), etc. Clinic started off as me in a small room. Did my own office work, billing, collections, rendered my own TMS and worked full time as a psychiatrist. I learned it all. And being a successful owner calls on even more than the massive skill set we have to acquire as a physician. So if down the road I make millions a year...the question is, if everyone else is treated quite well, where does one draw the line of what is deserved by the owner versus not? Anyone can walk away and start their own clinic. Few can make their own business succeed. It's economics. This doesn't happen too much, but I do pick up on resent from a few people. But if someone sets up a smart business model, invents a great device, are we in a place to tell them they don't deserve the rewards (assuming they're not running some sweat shop style culture)? I do keep tabs on what other places offer and what is mathematically feasible. As a matter of fact, had a meeting with a major attorney in healthcare, contract, and Stark Law well known in the country. I wanted to discuss if I should be concerned about compensating providers
too much because being able to offer competitive pay has been the draw here and I want to keep it going but don't want to be in some large scale violation. The good news: as a for profit Stark entity, he says there's no limit! But if you ever find yourself working for a non-profit, there is. Now if any one else was in the shoes of being a successful business owner, I think they too would feel like they've earned their keep. And if multiple employees asked for an agreement where your company was at a net loss per year, you'd also not feel the greatest about that. If anything for basic econ, it's an unsustainable model and can be contagious because if more start asking for that, it would just be a matter of time before you as the owner are not earning. I do feel like I've earned my keep and it takes a lot of work to keep the success going. I grew up in poverty, single parent household. My mother had a restaurant. Since 8 years of age, I worked full time. But this also gave me a ton of work experience in running a business so it worked out?
This place was started with goals for me to make more though. Because I knew it was not feasible in standard employer models and there was a vision I had for a healthcare setting too. I want more children and for complex reasons may need to prepare for a single parent household. I'd like three, am expecting right now. My parents don't have much savings or investments, they are older. I'm an only child and need to support them and for their increased needs. One of them is already terminal.
Wow, long answer. But I think what this thread highlights is, there are realities we need to work with. If we don't like something, we must pursue influencing some change and not demand it be served. And everyone has their own story, so we shouldn't assume too much? And at the end of the day, we are very fortunate. This thread when taking about whiners is most likely referencing people who truly objectively are whiners and I thin we all know this is not meant to be a generalization. . . cheers! lol
...wait...
