Design of new practice?

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specepic

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Sorry to be carpet bombing the threads lately.....

This group I'm joining is an existing ortho (2) + PM&R (1) + 2 ortho PAs. I'm being brought on as the Pain/Pm&r to start a Pain program and offer more spine services. There may be a 'pain rehab center' spearheaded by psych that I'll help with.

They are building me an attached suite in the building and I can pretty much spec things soup to nuts. I will be doing flouro of course (at the hosp across the parking lot), prob some scs trials, likely not pumps (infrastructure prob won't be adequate), MSK U/S, EMG, consults (in/out pt.). The downside is I'm running solo out of fellowship with no one to 'hold my hand'. The upside is autonomy and control of my practice.

Any sage words from the vets out there starting with what I can call myself (practice name) to attract the pts I want and help avoid the scum. Any other tips in general?

For those wondering the practice type is a hybrid of hospital employ and private practice. The 'partners' get paid on billed RVU's by the hosp but get the $ generated by the PAs as well having a PSP and some other perks. Basically it sounds like in exchange for the hosp getting facility fees they get a decent $/RVU and don't have to worry if pts don't/can't pay.

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Sorry to be carpet bombing the threads lately.....

This group I'm joining is an existing ortho (2) + PM&R (1) + 2 ortho PAs. I'm being brought on as the Pain/Pm&r to start a Pain program and offer more spine services. There may be a 'pain rehab center' spearheaded by psych that I'll help with.

They are building me an attached suite in the building and I can pretty much spec things soup to nuts. I will be doing flouro of course (at the hosp across the parking lot), prob some scs trials, likely not pumps (infrastructure prob won't be adequate), MSK U/S, EMG, consults (in/out pt.). The downside is I'm running solo out of fellowship with no one to 'hold my hand'. The upside is autonomy and control of my practice.

Any sage words from the vets out there starting with what I can call myself (practice name) to attract the pts I want and help avoid the scum. Any other tips in general?

For those wondering the practice type is a hybrid of hospital employ and private practice. The 'partners' get paid on billed RVU's by the hosp but get the $ generated by the PAs as well having a PSP and some other perks. Basically it sounds like in exchange for the hosp getting facility fees they get a decent $/RVU and don't have to worry if pts don't/can't pay.

dont bite of more than you can chew. doing all that you say: spine, pain, emgs, consults, inpatient (lord knows why you'd want to do this. make sure you dont get stuck round on ACLs, traumas, and hips from the orthopods), msk u/s is next to impossible. most of us do a bit of this and a bit of that, but generally not everything you have up there. trying to fit it all in is a recipe for burnout.

also, be prepared to more at a snails pace if you are doing you cases in a hospital. unless you have some good infrastructure, you won be moving too fast.
 
dont bite of more than you can chew. doing all that you say: spine, pain, emgs, consults, inpatient (lord knows why you'd want to do this. make sure you dont get stuck round on ACLs, traumas, and hips from the orthopods), msk u/s is next to impossible. most of us do a bit of this and a bit of that, but generally not everything you have up there. trying to fit it all in is a recipe for burnout.

also, be prepared to more at a snails pace if you are doing you cases in a hospital. unless you have some good infrastructure, you won be moving too fast.


I hear you. I should also qualify the fact that this is like a 35 bed hospital so outpatient>>>>>>>inpatient. They've never had a pain doc other than one contracted to come in 2 days a week for procedures only. Most of my time will be procedures in hosp and clinic visits across the street. The EMG load for geographic area is low and presently entirely handled by the current PM&R (who is staying) and the one Neurologist.

For those holding fire on commenting wondering if I'm coming to their backyard this practice is in rural northern New England.
 
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This group I'm joining is an existing ortho (2) + PM&R (1) + 2 ortho PAs.

...

The downside is I'm running solo out of fellowship with no one to 'hold my hand'.


Are you joining a group, or going solo?
 
If you are building, why not get your own fluoro? It'll pay for itself and turn a profit quickly.

"Pain Management" as title gets the point across, and people understand it. But, as you imply, also can attract an unsavory element. One way around that is not taking self-referrals, but then you lose word-of-mouth referrals. Another is simply screening the hell out of all who present for opioid assesment - get records, do full H&P, use SOAPP-R and UDS, and don't prescribe opioids on the first visit.
 
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