How realistic is spurning insurance? (related to article)

[Silent Cool]

Hey,

I found this article recently on SDN:
http://www.aafp.org/fpm/2007/0600/p...ss=http://www.aafp.org/fpm/2007/0600/p19.html

how realistic is setting up a practice like this? It sounds like a good idea. Why don't more FM/IM docs do this?

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[deleted87716]

Why don't more FM/IM docs do this?

Aside from the fact that most doctors aren't entrepreneurs, the article itself says:

Drawbacks
As with any model of health care, ours has some potential drawbacks. One is working with insured patients who need out-of-network referrals. This can be a hassle when services require prior approval from an in-network primary care provider. For some patients, the co-pay may be higher for an out-of-network provider or the coverage may be less, and this is the biggest reason for patient attrition, though attrition has been very low.

A second challenge is trying to absorb staff turnover or illness with a small staff. We have addressed this by having many well-trained volunteers available to step in when needed. These volunteers are usually pre-med students from local universities who want to gain experience in a clinical setting. Typically we have two to three students per semester volunteering who can stand in if needed.

 

[Silent Cool]

Aside from the fact that most doctors aren't entrepreneurs, the article itself says:

Blue, if you were to operate a practice like the one in the article, would you likely earn more money? Anyone can be an entrepreneur.

Cabinbuilder--have you seen this? Because you work locums, I'm curious if you have considered something like this and what your reasons would be for doing or not doing it.

 

[deleted87716]

Blue, if you were to operate a practice like the one in the article, would you likely earn more money?

Based on the conversations I've had with folks who have gone that route, no.

 

[Silent Cool]

Based on the conversations I've had with folks who have gone that route, no.

So then we're talking under 200K?

 

[deleted87716]

So then we're talking under 200K?

No, you should be able to do better than that once you've built up your practice.

From the article:

The net practice profit (my income) is $62 per patient I see. We break even by seeing four patients per day, which yields $328. When you multiply that by 245 clinic days per year, it adds up to about $80,000, which is a bit more than our annual overhead. I provide about 3,500 to 4,000 patient visits per year, and our nurse practitioner provides about 2,500.

$62 profit per patient visit times 3,500 to 4,000 visits = $217,000 to $248,000 per year take-home.

 

[Silent Cool]

No, you should be able to do better than that once you've built up your practice.

From the article:



$62 profit per patient visit times 3,500 to 4,000 visits = $217,000 to $248,000 per year take-home.

So you're taking home closer to 300K as an FP?

 

[deleted87716]

So you're taking home closer to 300K as an FP?

I'm bound by a confidentiality agreement, so I can't be specific about my income. Here are some recent stats, however. More than one-third of FPs earn >$200K.

http://www.medscape.com/features/sl...amilymedicine?src=wnl_edit_specol&uac=45494DJ