Primary care docs making more than 300k?

[Whatsyourname]

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Curious on time and tested methods certain docs use to bring in the big bucks. Sure it's all to help people in the end of the day, but comments about good out pt procedures, ways to take M&M pts and still make a decent living

Hospitalist/moonlighting methods to make bank also appreciated

 

[Trogghunter]

Hire a bunch of techs/MAs, do xrays/screening exams/labs/minor procedures in office, have students rotate through and have them write your notes so that you just review/sign them and can see 40 patients a day and work 8-5. I've seen this done many times and have been the student writing the notes. Gotta appreciate a good business model. That's how you make 350k plus as family practice.

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[sluggs]

You can also do a high volume of private-pay narc addicts who will slip you $ under the table for narc scrips and also you can try the Medicaid mill phony bill model!

 

[Bostonredsox]

Hire a bunch of techs/MAs, do xrays/screening exams/labs/minor procedures in office, have students rotate through and have them write your notes so that you just review/sign them and can see 40 patients a day and work 8-5. I've seen this done many times and have been the student writing the notes. Gotta appreciate a good business model. That's how you make 350k plus as family practice.

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not sure about outpatient, but you cant bill an inpatient note writted by a med student, atleast in my state. An attending can just cosign a residents note, or the NPs, but they have to write their own if all they have is a student.

 

[gutonc]

not sure about outpatient, but you cant bill an inpatient note writted by a med student, atleast in my state. An attending can just cosign a residents note, or the NPs, but they have to write their own if all they have is a student.

You can't bill a student note. But you can bill the living s**t out of a "scribe" note. It doesn't take a rocket scientist to get from point A to point B.

 

[Whatsyourname]

How about making good money with a hospitalist model? Any experiences?

 

[gutonc]

How about making good money with a hospitalist model? Any experiences?

Do your own procedures, pick up extra shifts.

 

[CDI]

Let IMGs rotate with you in return for LORs.

Charge $1500/month if you can let them do in-patient to. Theres doctors who do this and take on 10 IMGs at a time. $15k/month = $$

 

[gutonc]

Let IMGs rotate with you in return for LORs.

Charge $1500/month if you can let them do in-patient to. Theres doctors who do this and take on 10 IMGs at a time. $15k/month = $$

I was actually going to suggest insurance fraud, but this sounds like a slightly less illegal, more lucrative plan.

 

[CDI]

I was actually going to suggest insurance fraud, but this sounds like a slightly less illegal, more lucrative plan.

Completely legal. The IMGs actually have to get their own insurance as well. Its $1500 for the rotation...the LOR is implied and how you gain a rep amongst IMGs to sign up in the future.

 

[Trogghunter]

Maybe get some gigs doing malpractice consultation/legal review. I know someone that bills 500/hr and bills like a lawyer. Always on the physicians side. He said that in 20 years, his analysis has never led to a physician found guilty. Gets a case or two a month.

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[NRAI2001]

You can also do a high volume of private-pay narc addicts who will slip you $ under the table for narc scrips and also you can try the Medicaid mill phony bill model!

Every thread has atleast one idiot mentioning illegal activities to make more money.. Like its some hilarious joke. There are way too many people that would take it literally and are more than ready enough to generalize it to all docs and how they re just out to make money.. 🙁

 

[Bostonredsox]

Every thread has atleast one idiot mentioning illegal activities to make more money.. Like its some hilarious joke. There are way too many people that would take it literally and are more than ready enough to generalize it to all docs and how they re just out to make money.. 🙁

you mean he was joking? sh**....I guess I should stop selling my prescription pads for a flat fee wired to an off shore account....

 

[NewYorkDoctors]

Get a very good client base who are willing to be in and out in 5 minutes or less with the doctor.

(It helps if you have someone who has medical experience, aka nurse, PA, non-practicing physician who can take care of a lot of the "prep" work for you so the patient can get pampered from the door inward so all they really need the doctor for is a prescription... and a client base is selective for you... and a network of physicians in their own private alliance unfettered by a hospital system)


I've seen a doctor working 9-5 like this (obviously finishing charts after work, but with most of it done by the staff already) and 7 days a week and really raking in the dough... the other specialists with procedures who have assembly lined and maximized the patient experience this way make even more... think 7 figures.

 

[DIce3]

Stop thinking about the money.
Focus on being the absolute best general internist possible.
The money will come...

25 patients per day in the office at 15 minutes average per patient
5 days per week
48 weeks per year
Call $50 an average net (take home) for each visit

$50x25x5x48=$300,000

Work harder.. make more. Work less.. make less. No scams, midlevels, ancillaries, or procedures are needed.

 

[CDI]

Stop thinking about the money.
Focus on being the absolute best general internist possible.
The money will come...

25 patients per day in the office at 15 minutes average per patient
5 days per week
48 weeks per year
Call $50 an average net (take home) for each visit

$50x25x5x48=$300,000

Work harder.. make more. Work less.. make less. No scams, midlevels, ancillaries, or procedures are needed.

Unrealistic. Just learn some extra skills. A cosmetic procedure, a knee injection, USG course, ECG...extra cash.

 

[DIce3]

Unrealistic. Just learn some extra skills. A cosmetic procedure, a knee injection, USG course, ECG...extra cash.

My practice is realistic and straightforward. I respectfully disagree.

Internists do not typically "learn US" as that takes way too many hours to come close to mastering. Taking an US course then reading an ultrasound is a sure ticket to a malpractice case for a missed reading. Instead, the machine is rented in a time share but the reading is farmed out to a real radiologist for US or cardiologist for echo. The purchase of the machine + overhead of the space + technician overhead is really impossible in primary care outside of a >10 man internal medicine group.

I order one or two EKGs per day, with a slight margin on the TC and $10 on the PC. I would say there is only slight justification in favor of an EKG machine.

Doing cosmetic work is likely worth the expense, but doing these procedures will forever tarnish one's reputation as the doctor's doctor. Depends on where one wants to stand in the community.

 

[CDI]

My practice is realistic and straightforward. I respectfully disagree.

Internists do not typically "learn US" as that takes way too many hours to come close to mastering. Taking an US course then reading an ultrasound is a sure ticket to a malpractice case for a missed reading. Instead, the machine is rented in a time share but the reading is farmed out to a real radiologist for US or cardiologist for echo. The purchase of the machine + overhead of the space + technician overhead is really impossible in primary care outside of a >10 man internal medicine group.

I order one or two EKGs per day, with a slight margin on the TC and $10 on the PC. I would say there is only slight justification in favor of an EKG machine.

Doing cosmetic work is likely worth the expense, but doing these procedures will forever tarnish one's reputation as the doctor's doctor. Depends on where one wants to stand in the community.

So without any of that you're able to clear $300k in your solo practice? I find that hard to believe.

 

[michaelrack]

Stop thinking about the money.
Focus on being the absolute best general internist possible.
The money will come...

25 patients per day in the office at 15 minutes average per patient
5 days per week
48 weeks per year
Call $50 an average net (take home) for each visit

$50x25x5x48=$300,000

Work harder.. make more. Work less.. make less. No scams, midlevels, ancillaries, or procedures are needed.

It would be hard to replicate the average $50 net per visit- the only way I could see to do it is an extremely low overhead and/or a no-medicare practice.

 

[path or no path]

My practice is realistic and straightforward. I respectfully disagree.

Internists do not typically "learn US" as that takes way too many hours to come close to mastering. Taking an US course then reading an ultrasound is a sure ticket to a malpractice case for a missed reading. Instead, the machine is rented in a time share but the reading is farmed out to a real radiologist for US or cardiologist for echo. The purchase of the machine + overhead of the space + technician overhead is really impossible in primary care outside of a >10 man internal medicine group.

I order one or two EKGs per day, with a slight margin on the TC and $10 on the PC. I would say there is only slight justification in favor of an EKG machine.

Doing cosmetic work is likely worth the expense, but doing these procedures will forever tarnish one's reputation as the doctor's doctor. Depends on where one wants to stand in the community.

A little self-righteous, wouldn't you say? What is wrong with providing quality service that your patients demand. By the same standard, 99% of derms and plastic surgeons reputation is tarnished

 

[xenotype]

By the same standard, 99% of derms and plastic surgeons reputation is tarnished

Well, it sort of is. When someone asks if there is a doctor in the house, about the last choice is going to be one of those two. The billboards you see in anywhere, USA that have an internist or FM doc advertising cosmetic procedures just look so sleazy. No way around it. I can imagine having it as a part of your practice, but not one that you advertise or focus on because you start to look like a hotel that offers hourly rates.

 

[michaelrack]

Well, it sort of is. When someone asks if there is a doctor in the house, about the last choice is going to be one of those two. The billboards you see in anywhere, USA that have an internist or FM doc advertising cosmetic procedures just look so sleazy. No way around it. I can imagine having it as a part of your practice, but not one that you advertise or focus on because you start to look like a hotel that offers hourly rates.

A good reputation doesn't pay the bills. I feel bad for primary care docs, and understand if they do something like cosmetic work (although in my area it is "Low T"/weight loss/Lipo injections/B12 injections)

 

[link2swim06]

One internist I know did the following:

He has zero office staff. Scheduling is done through an online website. He does everything from measuring vitals to administering shots himself.

To be part of his practice it is $300 per person at the start of the year for every patient.

You offer appointments which are more than double the length and extras like additional nutrition/exercise counseling. Also he more flexible about appointment times.

Assuming you have a 1,000 patients you make $300,000 cash on Jan. 1st. Plus all maybe another ~$150K throughout the year. You only pay rent for the office, minimal overhead costs, and insurance.

Regardless he clears just less than $500K for 40 hours a week.

 

[Postictal Raiden]

One internist I know did the following:

He has zero office staff. Scheduling is done through an online website. He does everything from measuring vitals to administering shots himself.

To be part of his practice it is $300 per person at the start of the year for every patient.

You offer appointments which are more than double the length and extras like additional nutrition/exercise counseling. Also he more flexible about appointment times.

Assuming you have a 1,000 patients you make $300,000 cash on Jan. 1st. Plus all maybe another ~$150K throughout the year. You only pay rent for the office, minimal overhead costs, and insurance.

Regardless he clears just less than $500K for 40 hours a week.

Wouldn't increasing the annual fee to $1000 and decreasing the patient panel to 300 be more feasible?

 

[CDI]

Wouldn't increasing the annual fee to $1000 and decreasing the patient panel to 300 be more feasible?

Regional variability. You play to your market.

 

[Medstart108]

Hire a bunch of techs/MAs, do xrays/screening exams/labs/minor procedures in office, have students rotate through and have them write your notes so that you just review/sign them and can see 40 patients a day and work 8-5. I've seen this done many times and have been the student writing the notes. Gotta appreciate a good business model. That's how you make 350k plus as family practice.

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Haha thats exactly what my PI does. A bunch of techs, hires a bunch of fellows to see patients, has some unlicensed IMGs do some histories, write up notes and then just review them. What a good life.