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deleted185747
I would like to open my own rehab hospital / center and was wondering if anyone knows how to go about this. I have no money, only medical school debt.
Please correct me if I am wrong- being a inpatient rehab director is not exactly the same as owning your own rehab hospital? However, I am sure there might be some positive similarities, can you please compare these two roles?There's always ads for hospitals looking for rehab floor directors - I used to do one, I was the only PM&R in town.
Please correct me if I am wrong- being a inpatient rehab director is not exactly the same as owning your own rehab hospital? However, I am sure there might be some positive similarities, can you please compare these two roles?
The appeal behind owning a rehab center is that you employ lots of people and make $ off each employee; basically getting paid for doing business and administrative stuff. Being a rehab director I think you are getting paid for your work setting medical protocol, hiring staff, etc.
How does the whole "self-referral" thing work? Are there seperate companies that are all under the same roof, owned by different people?
Thanks, this is helping me formulate what is feasable. An outpatient rehab center is more what I was interested in. I think a bigger building, bigger sign, more staff, and more patients would make it easier to get referrals from the community. I suppose I will start small and then expand once I show a profit for several years (in order to qualify for a large loan)
Maybe I'm naive and learned enough about the field yet, but I was thinking that physiatrists would be really well suited to open up their own rehab facility. The business could hire physical therapist's, which you (as a physiatrist) could refer to, and collect from further rehab. It could also have orthopod partners, which would mean even more in-house referrals both to and from the surgeons. If you're trained to do injections, you can offer those as well.
From some of the posts here, it sounds like this is an unusual situation. I don't understand why it would be because it fits with the physiatrists scope of practice in directing patient care from the onset of injury until the completion of surgery, rehab, or whatever procedure if necessary.
Maybe I'm naive and learned enough about the field yet, but I was thinking that physiatrists would be really well suited to open up their own rehab facility. The business could hire physical therapist's, which you (as a physiatrist) could refer to, and collect from further rehab. It could also have orthopod partners, which would mean even more in-house referrals both to and from the surgeons. If you're trained to do injections, you can offer those as well.
From some of the posts here, it sounds like this is an unusual situation. I don't understand why it would be because it fits with the physiatrists scope of practice in directing patient care from the onset of injury until the completion of surgery, rehab, or whatever procedure if necessary.
Do you find that working for a group of ortho's/neurosurg's works fine for you? I wouldn't mind if the benefits of this outweigh those of owning my own practice someday, but my biggest fear would be to work for a group of docs, be underpaid, overworked and find that leaving and starting anew would be even more of a headache than just doing it outright.
I ask this only because my father is in this situation, and if someone is gonna work me 70-80hrs a week until retirement, I'd rather do it owning my own practice and (hopefully!) getting paid better. Any insight would be greatly appreciated!
Do you find that working for a group of ortho's/neurosurg's works fine for you? I wouldn't mind if the benefits of this outweigh those of owning my own practice someday, but my biggest fear would be to work for a group of docs, be underpaid, overworked and find that leaving and starting anew would be even more of a headache than just doing it outright.
I ask this only because my father is in this situation, and if someone is gonna work me 70-80hrs a week until retirement, I'd rather do it owning my own practice and (hopefully!) getting paid better. Any insight would be greatly appreciated!
Meaning no disrespect, Dr. Tchoup, but don't you think your situation is somewhat unique, given the pre-existing relationship you had with the department prior to your joining them?It has worked fine for me. It didn't work for 2 other docs who came before me, and left. It wasn't a question of working for the surgeons, it was that they didn't want to work very hard, and I do.
The advantage of starting your first job under anyone else's practice, whether pain, surgery, or pmr is that you can watch all those examples I mentioned above play out, and the infinite other ones, and then decide if you want to go out on your own. Just practicing medicine for the first year is nerve-wracking enough.
Meaning no disrespect, Dr. Tchoup, but don't you think your situation is somewhat unique, given the pre-existing relationship you had with the department prior to your joining them?
I ask this only because my father is in this situation, and if someone is gonna work me 70-80hrs a week until retirement, I'd rather do it owning my own practice and (hopefully!) getting paid better. Any insight would be greatly appreciated!
Meaning no disrespect, Dr. Tchoup, but don't you think your situation is somewhat unique, given the pre-existing relationship you had with the department prior to your joining them?
Do you find that working for a group of ortho's/neurosurg's works fine for you? I wouldn't mind if the benefits of this outweigh those of owning my own practice someday, but my biggest fear would be to work for a group of docs, be underpaid, overworked and find that leaving and starting anew would be even more of a headache than just doing it outright.
I ask this only because my father is in this situation, and if someone is gonna work me 70-80hrs a week until retirement, I'd rather do it owning my own practice and (hopefully!) getting paid better. Any insight would be greatly appreciated!
However, from talking with the PT's in our office, most PT's and OT's are being trained to stay away from doctor-owned PT clinics. They are being pushed towards D.PT and D.OT (doctorate) and recommended to only join PT's or start their own clinic. We're having a hard time recruiting partly for this reason.
I think it would be great to see more physiatrists start owning equity in their facilities. Radiologists can become partners in imaging centers; surgeons in surgery centers and various specialty hospitals. Why shouldn't physiatrists own rehab hospitals, SNF's or LTACs? There are anti-kickback and Stark self-referral issues to deal with, but physicians can ethically and legally own facilities and use the services of those facilities under specified conditions.
The first place to start is determing whether your state is "certificate of need state." Then, line up the investors, by dirt, build something, jump through all the accreditation hoops. One interesting thing to keep your eye on is the HFAP program through the American Osteopathic Association. Only the Joint Comission and the AOA's HFAP have "deeming authority" for medicare accreditation of facilities. It's hold-over from the days when MD's wouldn't let DO's practice in their hospitals; so the DO's went off and created their own federally-approved hospital accreditation program giving the MD's the proverbial "Nanny-nanny-boo-boo!" Several smaller hospitals (regardless of whether DO's are on staff) still use the HFAP process because it tends to be less administratively burdensome and it's kind of finding a "second life" among "entrepreneurially-minded" physicians...
http://www.hfap.org/
I'm always amazed how thing change in the health care market when *physicians* start poning up their pennies and put skin in the game. Suddenly, "new efficiencies" are possible when before the standard answer was "no."
How many vascular surgeons do you see invested in asc's? or transplant? Very few. Because you get a vasculopath with potential limb loss, or organ transplant patients waiting for definitive care, and their length of stay wipes out any profit for the investors. I would venture to say the same for inpatient rehab. Can you predict LOS for one Rancho IV vs another, with all the variable in discharge?
why would PTs be averse to joining physician-owned clinics??
I would like to open my own rehab hospital / center and was wondering if anyone knows how to go about this. I have no money, only medical school debt.
It's the schools pressuring it - part of the indepence thing - wanting PT's to see pt's without MD orders - just another push in that direction, I believe.
This is mainly to PMR 4 MSK, but anyone with solid information, please reply.
I know POPTS or Physician Owned Physical Therapy Services has been a hot topic (at least in some states) recently. I can see where there could be a conflict for say and ortho who owns a in-house (or outside) rehab center. However, I don't understand why it would create anymore potential for increased services than an in-house x-ray, lab, massage therapist, etc would create.
From what you know on this topic, could a PMR doc still employ a PT, as long as you technically didn't "refer" to the PT and only had the PT perform services under the MD? Is there any conflict with this?
I hate to talk money in here, but I would like to ask practicing PMR docs a question on billing as well (sorry I am asking a million questions in one post). From whatever state you are in, what is the range (I know I can look up codes and reimbursements) of payment you recieve for injections, by area.. ie, shoulder, hip, knee, elbow, spine. In addition, what are the ranges of payment on EMG/NCV and do you bill the global (professional and technical components of the procedure)?
Last question (at least for today), can Family/Internal medicine physicians bill AND get paid for EMG/NCV's and joint injections from most private carriers? If so, are they getting paid less, not as often, etc?
Thank you all in advance for answers to any of these questions!
JW