Family medicine income with only Medicare patients

[Ineedhopenow]

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How much would a family practitioner in private practice make if s/he only saw Medicare patients, saw patients 8 hours per day for 5 days a week? Let's say this physician worked 52 weeks a year (no vacations).*

Please don't include overhead costs.

 

[deleted87716]

Please don't include overhead costs.

Kinda hard to answer the question, in that case. We'd also have to make some assumptions about coding accuracy. And, who works 52 weeks a year...?

You can look up Medicare's fees yourself here: http://www.cms.gov/apps/physician-fee-schedule/

Pick a state, as fees vary. Conservatively, I'd assume an even mix of 99213 and 99214 for outpatient visits. 99212, 99215 and new patient visits won't happen often enough to really worry them about for the purposes of an exercise like this. Realistically, someone treating exclusively adults >65 y/o would probably be seeing at least 75% 99214. You could make additional money seeing patients for Medicare's preventive services visits. These actually reimburse fairly well. Calculating only physician-generated E&M charges is also ignoring any in-office procedures which could be accomplished during the visit and billed using modifier 25, nurse-only visits (99211) for education, vaccinations, INR monitoring, etc.

20-25 patients is probably a good average for an 8-hour day.

 

[NotFromHere]

If you did nursing home work, which varies in availability by region, but in some areas is in very high need, you would be able to collect 80% of medicare for all patients, and 100% for some of the patients with coinsurance. Your overhead costs would be about 10-20% as you would not need to rent an office or hire staff to answer phones and put people in rooms, etc. There are people doing very well in this line of work, though it is not for everyone. It is a way to start out in practice if you need cash flow to start, and enjoy interacting with older people. Some people make a career out of this and become medical directors, and do hospice management as well. If you do hospice for a period of time, you will be eligible to write the board exam which can open more doors to you. Most nursing home patients are in need of high quality compassionate care and this is not always available to them.

 

[ghost dog]

How much would a family practitioner in private practice make if s/he only saw Medicare patients, saw patients 8 hours per day for 5 days a week? Let's say this physician worked 52 weeks a year (no vacations).*

Please don't include overhead costs.

Why wouldn't overhead costs be considered?

Medical students and residents need more business acumen. This needs to be taught in med school, or at least in residency. Honestly: "Business 101" could be taught in less than a day.

I could have saved a nice little bundle if I had opened up my practice at the beginning instead of working for someone else. The greedy idiot I worked for ( a doctor / clinic manager ) was the worst.

This person thought it was reasonable to clean patient washrooms once a week.

 

[JustPlainBill]

Really difficult to answer the post as BD pointed out -- More about clinic flow and level of visit than numbers.....If you do strictly Geri Medicare and do it right, you can get away with about 8 patients per half day as 99214's or so I'm told. And if you've never seen 8 Geri patients back to back, it takes some work, especially when they dump their Wal-mart bag full of medications onto the exam room counter and then want to spend 2 minutes per pill bottle, peering at them and wanting to discuss what they do and why they're taking them....good luck with that. Throw in a language barrier and you'll get dwell times in the 60minute range, easy.

Good medicine is hard to do well at the primary care level. That's why no one wants to go into it. It's hard work, you have to be efficient and know your stuff. Not everyone can do it.

Personally - I'm probably going to work for a Doc-in-the-Box for a year or two to get my feet on the ground and get some real-world (i.e. non-academia nut residency) experience. I may continue that to allow me to do what I'm passionate about -- those people who have insurance but work hourly jobs and lose money every time they come to the doctor.....i'm planning on keeping odd hours just for them...plus the local GIs and their families.