40-50 patients a day. How?

[agolden1]

In my first year of attendinghood looking to move jobs.

Group I'm considering with fairly high overhead costs. Current pain docs seeing 40-50 patients a day on clinic days with encounters 15 minutes with double bookings for procedural followup. No opioid management. In spite of asking, did not have the opportunity to shadow in clinic.

I feel like this forum has led me to believe most docs seeing 20-30 a day or so. For those pushing above 40 patients daily (particularly in the 40-60 range).... how? What systems do you have in place do be able to accomplish this? How do you not burn out? Seeing about 20 a day currently, but also slowed down a bit by a substantial amount of opioid so I'm not sure if cleaving this out would speed things up significantly.

Perhaps because I'm a bit fresh and haven't had the chance to see someone move at this speed this just seems like an overwhelming amount of clinic hustle, but I was not sure if I was just being a whiny millennial....

Understand some people may not want to post publicly on this subject so I'm open to messages as well.

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[nopain1234]

Some ball hard

 

[Orin]

In my first year of attendinghood looking to move jobs.

Group I'm considering with fairly high overhead costs. Current pain docs seeing 40-50 patients a day on clinic days with encounters 15 minutes with double bookings for procedural followup. No opioid management. In spite of asking, did not have the opportunity to shadow in clinic.

I feel like this forum has led me to believe most docs seeing 20-30 a day or so. For those pushing above 40 patients daily (particularly in the 40-60 range).... how? What systems do you have in place do be able to accomplish this? How do you not burn out? Seeing about 20 a day currently, but also slowed down a bit by a substantial amount of opioid so I'm not sure if cleaving this out would speed things up significantly.

Perhaps because I'm a bit fresh and haven't had the chance to see someone move at this speed this just seems like an overwhelming amount of clinic hustle, but I was not sure if I was just being a whiny millennial....

Understand some people may not want to post publicly on this subject so I'm open to messages as well.

Teams - You'll rely on your MA/RN/etc to get the HPI blurb, verify meds, do any questionnaires, queue up refills/etc. They'll pull up the scans/notes in case you haven't already looked at them in the morning before clinic.
Templates - They'll plug it into a template allowing you to focus on the PE/details you need for clinical decision making. Note/plan done in the room before you go to the next.
Targeted - You'll skip the 5 minute discussion about their kids, constipation, hair loss, etc to focus on whether you can help them with your plan.
Teams - You'll hand off to your team to circle back for patient education/followup/etc while you get to churning on the next one.

And that might get you to 30 if you've got good people and weeded out the trouble patients. You'll probably lie about the rest when hiring new people to scare off the lazy.

 

[callmeanesthesia]

My non-op sports partners both see about that many per day. I only manage about 25. I have a hard time getting below 30 minute new/15 minute f/u despite everything I’ve done to increase efficiency. No opioids. Before going into room my scribe/MA rooms patient, takes HPI while I review the referral packet and imaging. Then I talk to patient, do PE, discuss recs. Circle orders/dx/charges on a paper slip and give to scribe/MA to enter. She completes the note. If something complicated I’ll use dragon dictation to add to assessment/plan before closing. Meanwhile, second scribe/MA is rooming the next one. Not sure how to get faster. OTOH I don’t take notes home.

 

[runfastnow]

Sweet spot for me is 25. I hate seeing more than 30 in a day. If I have to see 30+ then I cut substantially patient education and either leave it up to my RN or to a patient handout and then end up wasting time on procedure days explaining what we are doing.

Most efficient I could imagine would be 1-2 minute confirming HPI (and having to be a jerk cutting people off all the time which I hate doing), 1-2 minute showing patient their imaging, 1-2 minute doing an exam, 3-5 minute of "do you want PT/meds or an ESI/RF/SCS?" with minimal/no education or discussion of the procedure itself.

 

[GoBeers]

40-50 pure shady opioid clinic i suspect is very possible. just walk in with script and walk out.
40-50 non-opioid clinic is impossible. to have a non-opioid practice, you have to really educate patient and explain their disease course, expectation, and the benefits of every alternative non-opioid therapy and have them buy in.

even with MAs and templates setting everything up, the only way I can possibly see 40-50 non-opioid patients each and every day is 1) have an MA explain the nuts and bolts of therapies aka procedures or 2) have scribe write all your assessment and plans or 3) you take notes home with you. I can see up to 28-30 patients (with about 6 new patients) (roughly 50-60% opioid practice) and finish notes by end of clinic.

 

[Agast]

Do those busy clinics take a lunch break?

Ophthalmology can see like 80 patients in a day…very little time spent actually talking to the patient, and if the patient doesn’t understand what’s going on they are SOL

You can do busy pain clinic if you write zero prescriptions as that will decrease follow up calls and questions.

 

[agolden1]

40-50 pure shady opioid clinic i suspect is very possible. just walk in with script and walk out.
40-50 non-opioid clinic is impossible. to have a non-opioid practice, you have to really educate patient and explain their disease course, expectation, and the benefits of every alternative non-opioid therapy and have them buy in.

even with MAs and templates setting everything up, the only way I can possibly see 40-50 non-opioid patients each and every day is 1) have an MA explain the nuts and bolts of therapies aka procedures or 2) have scribe write all your assessment and plans or 3) you take notes home with you. I can see up to 28-30 patients (with about 6 new patients) (roughly 50-60% opioid practice) and finish notes by end of clinic.

Practice is non opioid.
1) MA explains procedures - Don't think this happens
2) No scribe, just dictations
3) Seems like some charting over lunch at up to an hour at days end before going home.

Maybe scrimping on explaining the procedures is part of whats going in which isn't really fair to patients either...

 

[forchinet121]

Do those busy clinics take a lunch break?

Ophthalmology can see like 80 patients in a day…very little time spent actually talking to the patient, and if the patient doesn’t understand what’s going on they are SOL

You can do busy pain clinic if you write zero prescriptions as that will decrease follow up calls and questions.

Lol I don’t think anyone sees 80 a day, the most efficient retina sees 60 most optho seems much less than that. The retina guys literally just look in your eyeball for 5 minutes with no chit chat.

 

[jsaul]

I know a pain doc in a ortho group near me that sees 40 to 50. It's a mix of everything including opioids. He does not take notes home to complete.

Seeing 40 to 50 happens and happens a lot.

I couldn't do it but others do and they do it and don't look burnt out to me

 

[Agast]

Lol I don’t think anyone sees 80 a day, the most efficient retina sees 60 most optho seems much less than that. The retina guys literally just look in your eyeball for 5 minutes with no chit chat.

Well, to quote another doctor group I belong to

“
When I applied for fellowship (vitreoretinal surgery), there was one practice where physicians all saw >100 patients a day. So, I would vote private practice ophthalmology/specifically retina as the winner here.

Also, in my current practice, I can easily do 60 eye injections in a HALF day (afternoon) in our injection clinic and still leave well before 5”

 

[TIVAndy]

Well, to quote another doctor group I belong to

“
When I applied for fellowship (vitreoretinal surgery), there was one practice where physicians all saw >100 patients a day. So, I would vote private practice ophthalmology/specifically retina as the winner here.

Also, in my current practice, I can easily do 60 eye injections in a HALF day (afternoon) in our injection clinic and still leave well before 5”

injection of an eye is much quicker than an epidural.

 

[GoBeers]

Practice is non opioid.
1) MA explains procedures - Don't think this happens
2) No scribe, just dictations
3) Seems like some charting over lunch at up to an hour at days end before going home.

Maybe scrimping on explaining the procedures is part of whats going in which isn't really fair to patients either...

I suppose I can stop all the small talk and friendly chit chat (yes they can drag on a bit). But I feel like this is one of the important ways to really gain trust and be seen positively. Or maybe I can be a lot shorter on my discussions regarding treatment or explanation of pathology.

I used to roll my eyes whenever a patient would tell me " I saw neurology or rheumatology or surgeon and... they didn't tell me anything about my diagnosis or how to treat it or what to expect." A part of me could easily see that to be true because there are some lousy physicians out here. I've always tried to make it a point to clearly get my thoughts across because I would hate to be a patient and be left in the dust like that. But maybe I'm giving patients too much credit and they simply just don't care to remember or understand.

Please tell us how you end up doing 50 non-opioid patients a day. I'd be very curious to learn.

 

[RoloTomassi]

Practice is non opioid.
1) MA explains procedures - Don't think this happens
2) No scribe, just dictations
3) Seems like some charting over lunch at up to an hour at days end before going home.

Maybe scrimping on explaining the procedures is part of whats going in which isn't really fair to patients either...

In addition, I would imagine:

-at least 8a-5p, maybe earlier/later?
-don't view images, just read reports
-don't show patients images, don't use models
-very focused or no exam
-brief notes, probably bill 3s

All in all, subpar doctoring but not impossible. 50/day is ~10 min/visit. I do 15 min/visit of any type. ~25/day is pretty tiring.

 

[agolden1]

Please tell us how you end up doing 50 non-opioid patients a day. I'd be very curious to learn.

To be honest, I’m not fully sold on this volume of patients. Again, part of the reason for the post was to see if a bunch of people would jump on and say “oh it’s not that bad and there’s a bunch of us out here doing this. Here’s how.”

Which, at least here, does not seem to be the case so far….

 

[SSdoc33]

it can be done using an orthopedic model. it is hard to do using a "pain" model.

ill sometimes see 40 patients a day. thats too much. usually 12-15 shots and 15 or so clinic patient is where i max out.

if you bill mostly level 4's and do our bread and butter stuff, that should be plenty. i will say that if you can cut out all opioids, you will be able to see a lot more patients and feel a lot less burnt out. call me an a-hole, but it leads to a much more fulfilling professional life

 

[agolden1]

it can be done using an orthopedic model. it is hard to do using a "pain" model.

ill sometimes see 40 patients a day. thats too much. usually 12-15 shots and 15 or so clinic patient is where i max out.

if you bill mostly level 4's and do our bread and butter stuff, that should be plenty. i will say that if you can cut out all opioids, you will be able to see a lot more patients and feel a lot less burnt out. call me an a-hole, but it leads to a much more fulfilling professional life

Job is an orthopedic setup. 30 procedures or so on procedure days, 40 clinic visits. Do you ever have straight clinic days where you are seeing 40-50 patients or do you always intersperse procedures?

 

[SSdoc33]

Job is an orthopedic setup. 30 procedures or so on procedure days, 40 clinic visits. Do you ever have straight clinic days where you are seeing 40-50 patients or do you always intersperse procedures?

the most efficient way to do it is to do all procedures or all clinic.

on my full procedure day ill do around 25 shots. on my full clinic day ill see 30 patients 8-2 and work straight thru lunch (10-13 new patients).

most days i split, procedures and clinic

 

[GoBeers]

it can be done using an orthopedic model. it is hard to do using a "pain" model.

ill sometimes see 40 patients a day. thats too much. usually 12-15 shots and 15 or so clinic patient is where i max out.

if you bill mostly level 4's and do our bread and butter stuff, that should be plenty. i will say that if you can cut out all opioids, you will be able to see a lot more patients and feel a lot less burnt out. call me an a-hole, but it leads to a much more fulfilling professional life

if your clinic is already known as non-opioid practice, then I suppose all the patients coming in know that expectation and therefore are mentally ready to accept all other modalities. they probably already have insight and realistic expectations, in which case one doesnt have to "waste time" trying to convince that other alternative therapies are reasonable.

 

[kstarm]

There are a lot of things that can be done to improve efficiency but it boils down to off loading as much of the visit as possible to other people and trying to limit your interaction with the patient as much as possible. If you see 50 people for 10min a piece you are already at over 8 hours of work. If you have every injection following up with you in 4 weeks to tell you that they feel better you can probably see lots of people that way. I personally can't practice this way, and see lots of people who were dissatisfied with this model at their previous "pain" i.e injection clinic. But the bar for sleeping at night is different for everyone and you might be more comfortable with a similar model.

 

[Ferrismonk]

Here's my 2 cents:

1. It IS possible, but you WILL burn out at that pace if you really care about your patients.
2. During fellowship, my attending and I would see 60+ patients each day. I saw most then he followed behind me. The only way this was possible is by outsourcing all non-physician stuff (all the intake questions, effect of blocks, new things, etc), eliminating most of the non-productive talking, and not trying to convince patients to do things they don't want to do. Offer what you suggest and leave. We wrote down the basics and our PE on paper then my attending did the dictations after hours. This was before required EMR, meaningful use, data mining charts, etc.

I currently see max 24 patients a day, less if new patients or longer procedures. My schedule is 8-11:30, lunch until 1, patients again 1-3:30. Usually leave around 4:30 and don't take anything home with me. I still make money just fine.

 

[geauxg8rs]

If you aren’t allowed to shadow I wouldn’t consider it. That’s just me. Cause I would want access to the books and billing, etc. if they won’t let you see the first then won’t let you see the more important stuff

 

[bedrock]

In my first year of attendinghood looking to move jobs.

Group I'm considering with fairly high overhead costs. Current pain docs seeing 40-50 patients a day on clinic days with encounters 15 minutes with double bookings for procedural followup. No opioid management. In spite of asking, did not have the opportunity to shadow in clinic.

I feel like this forum has led me to believe most docs seeing 20-30 a day or so. For those pushing above 40 patients daily (particularly in the 40-60 range).... how? What systems do you have in place do be able to accomplish this? How do you not burn out? Seeing about 20 a day currently, but also slowed down a bit by a substantial amount of opioid so I'm not sure if cleaving this out would speed things up significantly.

Perhaps because I'm a bit fresh and haven't had the chance to see someone move at this speed this just seems like an overwhelming amount of clinic hustle, but I was not sure if I was just being a whiny millennial....

Understand some people may not want to post publicly on this subject so I'm open to messages as well.

Agree that them not allowing you to shadow for a day is a red flag.

 

[SSdoc33]

just be aware: you can still provide good care and move quickly. and still be a sh$tty doc but spend an hour with each patient. if you are good and know what you are doing, you can move

 

[agolden1]

Here's my 2 cents:

1. It IS possible, but you WILL burn out at that pace if you really care about your patients.
2. During fellowship, my attending and I would see 60+ patients each day. I saw most then he followed behind me. The only way this was possible is by outsourcing all non-physician stuff (all the intake questions, effect of blocks, new things, etc), eliminating most of the non-productive talking, and not trying to convince patients to do things they don't want to do. Offer what you suggest and leave. We wrote down the basics and our PE on paper then my attending did the dictations after hours. This was before required EMR, meaningful use, data mining charts, etc.

I currently see max 24 patients a day, less if new patients or longer procedures. My schedule is 8-11:30, lunch until 1, patients again 1-3:30. Usually leave around 4:30 and don't take anything home with me. I still make money just fine.

Thanks for the detailed response and appreciate the insight from someone who has been there.

 

[agolden1]

just be aware: you can still provide good care and move quickly. and still be a sh$tty doc but spend an hour with each patient. if you are good and know what you are doing, you can move

Rarely black or white. More likely shades of grey like most things in our field it seems like.

 

[PainDoc2025]

For someone seeing 40-50 patients, whats their typical gross income? Are these typically the people in the 90th percentile MGMA salaries?

 

[MitchLevi]

For someone seeing 40-50 patients, whats their typical gross income? Are these typically the people in the 90th percentile MGMA salaries?

99th

 

[agolden1]

For someone seeing 40-50 patients, whats their typical gross income? Are these typically the people in the 90th percentile MGMA salaries?

Gross wasn't really discussed. Because of the very high overhead nature of the orthopedic group and the fact that all procedures with them are done at ASC, salaries were definitely top quartile once established and the physician was receiving a chunk of the ASC profits.

However, there are others on this forum who have posted about being able to hit a similar percentile in hospital employed and private practice with in office C-arm without having to hit the 40-60 patient mark.

I think in this scenario, part of the reason you have to see such a volume of patients is because of the high overhead and the reimbursement from ASC.

Still, its hard to find the unicorn practice of "high, but not too high patient volume with in office C-arm and equal partnership track in a town near you!" But it's worth keeping on looking.

 

[Ferrismonk]

For someone seeing 40-50 patients, whats their typical gross income? Are these typically the people in the 90th percentile MGMA salaries?

Likely, but not 100%. It really does depend on payor mix, professional fee only or not, percentage of OVs to procedures, etc.

 

[MitchLevi]

If you're seeing 40-50 pts per day in an ortho clinic...Not a traditional pain clinic...An ortho clinic.

You're 99th percentile.

The vast majority of pts will be procedural candidates, and there will be less fibro and other BS diagnoses leading nowhere.

 

[jqueb29]

Gross wasn't really discussed. Because of the very high overhead nature of the orthopedic group and the fact that all procedures with them are done at ASC, salaries were definitely top quartile once established and the physician was receiving a chunk of the ASC profits.

However, there are others on this forum who have posted about being able to hit a similar percentile in hospital employed and private practice with in office C-arm without having to hit the 40-60 patient mark.

I think in this scenario, part of the reason you have to see such a volume of patients is because of the high overhead and the reimbursement from ASC.

Still, its hard to find the unicorn practice of "high, but not too high patient volume with in office C-arm and equal partnership track in a town near you!" But it's worth keeping on looking.

If I hit those numbers (40-50 pt per day) at my HOPD job, that's about $1.2 million

 

[jsaul]

I just saw 35 today. 830 am to 430pm. 1hr lunch. Mix of clinic and procedures. This is not the norm for me but it was doable.

 

[MitchLevi]

Sorry, but mixing procedures and clinic doesn't count IMO.

If you're of the ability to burn through 40-50 pain pts in a clinic, you're different. Last week I did 41 in a day. Procedures AM and clinic afternoon. Not hard.

That isn't the same as 45 clinic pts.

 

[Agast]

^ok retina bot…….

 

[geauxg8rs]

^ok retina bot…….

I guess it’s easy to see that many eye patients when all of the notes are exactly the same. Lol

 

[forchinet121]

Bro why did this guy just roast us like 10 times in a row we get it you make bank damn….

 

[MitchLevi]

What was the point of any of that?

 

[Pain Applicant1]

As a vitreoretinal surgeon with over 20 years private prectice experience in Chicago metro, you clearly need to do more homework about retina practices. Without the need for refractions and with the use of 2 scribes per physician, a successful retina practice can certainly see 30-40 pateints per half day. For a half-day clinic of 3 hours, we schedule 12 patients per hour, ending 3.5 hours after start time.
35 pts per half day, 8 half-days per week for clinic, 1 or 2 half days for surgery: $220-$240/pt visit including ancillary testing, drawings, injections, lasers, etc = $225K/month for clinics for 3.5 wks/mo + $800-$1200K/surgery x 15 surg/mo=$15K/mo=$240K/mo billings=$2.88 million/yr with about 6-7 wks vacation/yr. Depending on profitabiliy of practice with injectable med costs/rebates, profit margins for successful retina practices are 45-55%= $1.44 million/yr take home. And yes, I have averaged this amount for about 15 years as partner of a busy, successful, metro practice.
Patient volumes and standards of care can be confirmed with Medicare database for traditional Medicare, but now does not include Medicare advantage plans (nor private insurance). These numbers are well within standard of care, with some very busy vitreoretinal partners close to $1.75 to $2 million take home in past 5-10 yrs. With decreasing reimbursements, avg take-home pay for partners will continue to slowly drop as costs increase.

If you want to know why PE is interested in retina & oncology practices, it is because they are better able to manage costs (primarily employee costs) and, of course, they take drug rebates paid to practices for themselves. If drug rebates disappear, they will soon drop/sell/flip such practices after reducing costs since their profit margins will drop (or they will have to significantly cut physician reimbursement).

Successful, established retina practices understand this and will sell to the benefit of older partners. Only practices that care about new hires or maintaining their practices will resist the siren call of PE.

As a vitreoretinal surgeon with over 20 years private prectice experience in Chicago metro, you clearly need to do more homework about retina practices. Without the need for refractions and with the use of 2 scribes per physician, a successful retina practice can certainly see 30-40 pateints per half day. For a half-day clinic of 3 hours, we schedule 12 patients per hour, ending 3.5 hours after start time.
35 pts per half day, 8 half-days per week for clinic, 1 or 2 half days for surgery: $220-$240/pt visit including ancillary testing, drawings, injections, lasers, etc = $225K/month for clinics for 3.5 wks/mo + $800-$1200K/surgery x 15 surg/mo=$15K/mo=$240K/mo billings=$2.88 million/yr with about 6-7 wks vacation/yr. Depending on profitabiliy of practice with injectable med costs/rebates, profit margins for successful retina practices are 45-55%= $1.44 million/yr take home. And yes, I have averaged this amount for about 15 years as partner of a busy, successful, metro practice.
Patient volumes and standards of care can be confirmed with Medicare database for traditional Medicare, but now does not include Medicare advantage plans (nor private insurance). These numbers are well within standard of care, with some very busy vitreoretinal partners close to $1.75 to $2 million take home in past 5-10 yrs. With decreasing reimbursements, avg take-home pay for partners will continue to slowly drop as costs increase.

If you want to know why PE is interested in retina & oncology practices, it is because they are better able to manage costs (primarily employee costs) and, of course, they take drug rebates paid to practices for themselves. If drug rebates disappear, they will soon drop/sell/flip such practices after reducing costs since their profit margins will drop (or they will have to significantly cut physician reimbursement).

Successful, established retina practices understand this and will sell to the benefit of older partners. Only practices that care about new hires or maintaining their practices will resist the siren call of PE.

As a vitreoretinal surgeon with over 20 years private prectice experience in Chicago metro, you clearly need to do more homework about retina practices. Without the need for refractions and with the use of 2 scribes per physician, a successful retina practice can certainly see 30-40 pateints per half day. For a half-day clinic of 3 hours, we schedule 12 patients per hour, ending 3.5 hours after start time.
35 pts per half day, 8 half-days per week for clinic, 1 or 2 half days for surgery: $220-$240/pt visit including ancillary testing, drawings, injections, lasers, etc = $225K/month for clinics for 3.5 wks/mo + $800-$1200K/surgery x 15 surg/mo=$15K/mo=$240K/mo billings=$2.88 million/yr with about 6-7 wks vacation/yr. Depending on profitabiliy of practice with injectable med costs/rebates, profit margins for successful retina practices are 45-55%= $1.44 million/yr take home. And yes, I have averaged this amount for about 15 years as partner of a busy, successful, metro practice.
Patient volumes and standards of care can be confirmed with Medicare database for traditional Medicare, but now does not include Medicare advantage plans (nor private insurance). These numbers are well within standard of care, with some very busy vitreoretinal partners close to $1.75 to $2 million take home in past 5-10 yrs. With decreasing reimbursements, avg take-home pay for partners will continue to slowly drop as costs increase.

If you want to know why PE is interested in retina & oncology practices, it is because they are better able to manage costs (primarily employee costs) and, of course, they take drug rebates paid to practices for themselves. If drug rebates disappear, they will soon drop/sell/flip such practices after reducing costs since their profit margins will drop (or they will have to significantly cut physician reimbursement).

Successful, established retina practices understand this and will sell to the benefit of older partners. Only practices that care about new hires or maintaining their practices will resist the siren call of PE.

As a vitreoretinal surgeon with over 20 years private prectice experience in Chicago metro, you clearly need to do more homework about retina practices. Without the need for refractions and with the use of 2 scribes per physician, a successful retina practice can certainly see 30-40 pateints per half day. For a half-day clinic of 3 hours, we schedule 12 patients per hour, ending 3.5 hours after start time.
35 pts per half day, 8 half-days per week for clinic, 1 or 2 half days for surgery: $220-$240/pt visit including ancillary testing, drawings, injections, lasers, etc = $225K/month for clinics for 3.5 wks/mo + $800-$1200K/surgery x 15 surg/mo=$15K/mo=$240K/mo billings=$2.88 million/yr with about 6-7 wks vacation/yr. Depending on profitabiliy of practice with injectable med costs/rebates, profit margins for successful retina practices are 45-55%= $1.44 million/yr take home. And yes, I have averaged this amount for about 15 years as partner of a busy, successful, metro practice.
Patient volumes and standards of care can be confirmed with Medicare database for traditional Medicare, but now does not include Medicare advantage plans (nor private insurance). These numbers are well within standard of care, with some very busy vitreoretinal partners close to $1.75 to $2 million take home in past 5-10 yrs. With decreasing reimbursements, avg take-home pay for partners will continue to slowly drop as costs increase.

If you want to know why PE is interested in retina & oncology practices, it is because they are better able to manage costs (primarily employee costs) and, of course, they take drug rebates paid to practices for themselves. If drug rebates disappear, they will soon drop/sell/flip such practices after reducing costs since their profit margins will drop (or they will have to significantly cut physician reimbursement).

Successful, established retina practices understand this and will sell to the benefit of older partners. Only practices that care about new hires or maintaining their practices will resist the siren call of PE.

As a vitreoretinal surgeon with over 20 years private prectice experience in Chicago metro, you clearly need to do more homework about retina practices. Without the need for refractions and with the use of 2 scribes per physician, a successful retina practice can certainly see 30-40 pateints per half day. For a half-day clinic of 3 hours, we schedule 12 patients per hour, ending 3.5 hours after start time.
35 pts per half day, 8 half-days per week for clinic, 1 or 2 half days for surgery: $220-$240/pt visit including ancillary testing, drawings, injections, lasers, etc = $225K/month for clinics for 3.5 wks/mo + $800-$1200K/surgery x 15 surg/mo=$15K/mo=$240K/mo billings=$2.88 million/yr with about 6-7 wks vacation/yr. Depending on profitabiliy of practice with injectable med costs/rebates, profit margins for successful retina practices are 45-55%= $1.44 million/yr take home. And yes, I have averaged this amount for about 15 years as partner of a busy, successful, metro practice.
Patient volumes and standards of care can be confirmed with Medicare database for traditional Medicare, but now does not include Medicare advantage plans (nor private insurance). These numbers are well within standard of care, with some very busy vitreoretinal partners close to $1.75 to $2 million take home in past 5-10 yrs. With decreasing reimbursements, avg take-home pay for partners will continue to slowly drop as costs increase.

If you want to know why PE is interested in retina & oncology practices, it is because they are better able to manage costs (primarily employee costs) and, of course, they take drug rebates paid to practices for themselves. If drug rebates disappear, they will soon drop/sell/flip such practices after reducing costs since their profit margins will drop (or they will have to significantly cut physician reimbursement).

Successful, established retina practices understand this and will sell to the benefit of older partners. Only practices that care about new hires or maintaining their practices will resist the siren call of PE.

I love this guy!!! My man!

 

[deleted131481]

Each of the five times I read his post I felt just a little bit more underpaid...

 

[Pain Applicant1]

As a vitreoretinal surgeon with over 20 years private prectice experience in Chicago metro, you clearly need to do more homework about retina practices. Without the need for refractions and with the use of 2 scribes per physician, a successful retina practice can certainly see 30-40 pateints per half day. For a half-day clinic of 3 hours, we schedule 12 patients per hour, ending 3.5 hours after start time.
35 pts per half day, 8 half-days per week for clinic, 1 or 2 half days for surgery: $220-$240/pt visit including ancillary testing, drawings, injections, lasers, etc = $225K/month for clinics for 3.5 wks/mo + $800-$1200K/surgery x 15 surg/mo=$15K/mo=$240K/mo billings=$2.88 million/yr with about 6-7 wks vacation/yr. Depending on profitabiliy of practice with injectable med costs/rebates, profit margins for successful retina practices are 45-55%= $1.44 million/yr take home. And yes, I have averaged this amount for about 15 years as partner of a busy, successful, metro practice.
Patient volumes and standards of care can be confirmed with Medicare database for traditional Medicare, but now does not include Medicare advantage plans (nor private insurance). These numbers are well within standard of care, with some very busy vitreoretinal partners close to $1.75 to $2 million take home in past 5-10 yrs. With decreasing reimbursements, avg take-home pay for partners will continue to slowly drop as costs increase.

If you want to know why PE is interested in retina & oncology practices, it is because they are better able to manage costs (primarily employee costs) and, of course, they take drug rebates paid to practices for themselves. If drug rebates disappear, they will soon drop/sell/flip such practices after reducing costs since their profit margins will drop (or they will have to significantly cut physician reimbursement).

Successful, established retina practices understand this and will sell to the benefit of older partners. Only practices that care about new hires or maintaining their practices will resist the siren call of PE.

For the sacred love of all things holy, please continue to post in here and gain access to the physicians only forum. I will be forever in your debt. 😂


"...the only people for me are the mad ones, the ones who are mad to live, mad to talk, mad to be saved, desirous of everything at the same time, the ones who never yawn or say a commonplace thing, but burn, burn, burn like fabulous yellow roman candles exploding like spiders across the stars and in the middle you see the blue centerlight pop and everybody goes “Awww!" -Jack Kerouac, On the Road

 

[lobelsteve]

What was the point of any of that?

Already reported. Determining if a bot/spam or guy in the wrong forum.

 

[Pain Applicant1]

Damn, I knew it was too good to be true. Ah well, back to the mundane I guess...

 

[Agast]

Damn, I knew it was too good to be true. Ah well, back to the mundane I guess...

Well, if you looked at their post history they spammed the heck out of the ophthalmology forum and then probably latched on to the search word in this thread.

I’ve always wondered what kind of person ends up wooing the bots on online dating sites, I guess I know now 😉

 

[Pain Applicant1]

Well, if you looked at their post history they spammed the heck out of the ophthalmology forum and then probably latched on to the search word in this thread.

I’ve always wondered what kind of person ends up wooing the bots on online dating sites, I guess I know now 😉

Bot or not, I would've loved to have it in the forums, or at the very least, the creator of the bot. What kind of person would waste his time creating a bot to prove his point on SDN? I'll tell you - the type of guy I'd like to have many conversations with.

 

[clubdeac]

I love this guy!!! My man!

this is actually nauseating. Makes retina look like as big a scam as being a real estate agent following Covid. In medicine, money should never be THAT easy

 

[Pain Applicant1]

this is actually nauseating. Makes retina look like as big a scam as being a real estate agent following Covid. In medicine, money should never be THAT easy

I don't care about the money and I barely know what the retina is anymore at this point it's been so long.

I like the fact that someone felt the urge to write that whole thing out and post it all over the place in order to prove his point. This dude is on a rampage to have to prove something for some reason. Must be a weird, interesting fellow. A guy that would spice things up around here. Programming guy, if you're out there, please continue to post in here!!!

 

[Pain Applicant1]

this is actually nauseating. Makes retina look like as big a scam as being a real estate agent following Covid. In medicine, money should never be THAT easy

Interesting analogy btw. What'd you mean by the RE agent COVID relationship?

I think the whole agent broker setup in general is a scam also.

 

[Agast]

I don’t think seeing 80 patients a day is “easy” money. That sounds exhausting.

 

[jsaul]

i haven't met a dermatologist that does not see less than 50 per day, they get worried when there is less than 50 on the schedule

I know one particular spine surgeon that sees 60 patients per day in his office day. He laughed at me when I told him I usually see 20 to 25