Wow, this topic really took on a life of it's own! While there are a number of different ideas and points of view, it is refreshing to see how diverse the field is - in not just practice type but also political palate. I currently work in a rural setting and TRULY enjoy helping this patient population - I also TRULY enjoy the guaranteed salary that comes with it - Private Practice in a non-rural setting will be a financial and personal uphill battle not just due to reimbursement differences but also in patient population. I love working hard and helping underserved patients to make money, but if a new practice is going to survive it appears I have no choice but to carefully adjust my patient population to offset reimbursement changes. My patient population now did not have access to a local Pain doc until I opened my clinic, so it will be a change with a venture into private with a more affluent demographic.
I personally am postponing my practice start date to re-determine the best business model - opt out of MC/focus on more % of driving cash only/PI/WC vs ramp up volume asap. As previously mentioned, driving patients in by saying "Yes" to all patients will be great but in a year's time, I might be regretting that decision (not only due to smoke-smelling waiting rooms) @
hyperalgesia . And yes, a mandate on Medicaid will really be a game changer. I don't think it will come to this, but at this point who knows?! Luckily, we have done research on our local market demand for another pain doc...and while it is high now, the big concern is the slowish transition to single-payor. Long term viability is just too uncertain. We are currently trying to play with the numbers and see how best to utilize NP/PA into the equation to squeeze out every cent per patient interaction over time. Efficiency will be of utmost importance in all private practice settings and maximizing personnel cost/benefit will be paramount to keeping your head well above water.
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stim4u I did see the meet the press and I did speak one-on-one with one of the consultants helping implement the CoveredCalifornia launch - they essentially said the same thing, verbatim. The option to join another larger group would be great, but unfortunately defeats the purpose of my original goal of running my own private practice. But...I am in discussions with a large ortho group to potentially partner resources and develop a mutually beneficial partnership...in addition I am also in talk with a local smaller hospital to partner. Both of these are my best hedge against decreased reimbursement. Being quick and nimble is an absolute necessity now that the battlefield conditions have worsened.
Any of you hearing what current Med students are saying? I cannot imagine how many are switching to Engr, Dentistry, or Vet. Speaking of Veterinarians...wow, cash up front, endless amount of pet lovers - Our local guy is absolutely crushing it! Just got a bill for my cat. Had to do a double take.