can u do fp and spend 30 mins per pt?

[whorubigman]

i would love to do family medicine for the rest of my life, if i just pay attention to what I personally like regardless of what others may think of me.

based on my family medicine rotations and other family medicine opportunities, i can't help but be discouraged by the HMO's influence on the way family practice physicians practice medicine, i.e., having to spend less and less time per pt just to make the ends meet...

am i getting a skewed view, or is this what I should expect to be doing for the rest of my life, i.e., spending 5 mins or less actually talking to each pt...

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[bmickelsen]

whorubigman
As I've said before you can do whatever you want in FP depening on what your objectives are, but to answer you question here is some very simplified math.

30 min appointments
9 hour days
18 appointments a day
$100 a visit
18 times $100
1,800 a day
5 Days a week
5 times 1,8000
$9,000 a week
$9,000 times 4
$36,000 a month
$36,000 times 12
$432,000 a year

This is not meant to be perfectly reflective of real life, but it just shows that you really can make of FP what you want.

Most FPs could cover all their costs and still make a decent living pulling in $432,000 a year before taxes.

And yes my methods where crude, I didn't talk about if you get reimbursed for the whole $100. So don't take it all to literally but it just gives you something to think about

 

[doc05]

not realistic. overhead would knock off 70-80% of that figure; then there's taxes after that. plus there's still paperwork, reviewing lab results/consultant reports/returning phone calls/reading journals etc. you won't be doing 9 hours/day, more like 10-12 hrs/day.

oh and you won't be getting $100/visit for an established patient -- at least not from an HMO.

 

[whorubigman]

not realistic. overhead would knock off 70-80% of that figure; then there's taxes after that. plus there's still paperwork, reviewing lab results/consultant reports/returning phone calls/reading journals etc. you won't be doing 9 hours/day, more like 10-12 hrs/day.

oh and you won't be getting $100/visit for an established patient -- at least not from an HMO.

Which reflects what's actually going on among FPs? The first answer or the second? I'm really curious.

 

[dr.smurf]

actually bmickelsen is not far off and as he indicated it was a crude example. im an fp resident and we get practice mgmt and coding/billing lectures periodically. the avg fp office overhead is 60% NOT 70-80%. and EHR's are actually reducing the overhead even lower as you get rid of the paper pushers in the office. oh and the labs, phone calls, etc....those are taken care of, triaged, screened, etc. by the nurse. and if your nurse is good at what he/she does then you may never see those labs or messages. you must rely on your ancillary office staff to do what they are hired and trained to do so you can concentrate on pt care. $100 office visits on average is possible in some areas. established pts commonly are coded 99213 and 99214's which are usually $80 and $100 respectively based on complexity of medical history. you will also have PE's in there which are usually $150. the money and reimbursement in FP comes from procedures and office diagnostics (ekgs, spirometer, xray, etc.) and you should get comfortable with them. im lucky our residency has an attending that is basically a surgeon in the office. this guy is great and knows how to do almost every office procedure there is from colps to casting to removing lipomas in the office. we rotate with him for a month and learn a lot and how to code. bottom line... learn how to code and code right!! too many fp's and internists under code and it skews the average and makes reimbursements lower than they should be.