Private Practice in Progress

[TerraceHouse]

Sushi, do you meet pts primarily in-person or tele? Just curious.

---

Members don't see this ad.

 

[Sushirolls]

Consults are in person. Unless they are calling from my old office location and would be suitable for 100% tele.
After seen for the initial consult, its up to the patient to decide future visits for in office or tele. *unless controlled substances, I'll require certain frequency of in office visits. I'd say about 60% opt for tele, 40% prefer in office.

 

[clozareal]

Is the Payroll for wages, taxes, and SEP-IRA for your assistant? That together is about 18% of your gross revenue, so pretty big overhead cost.

 

[Sushirolls]

Yes, those are for the assistant. It is a big piece of the overhead. However, with this being an insurance based practice the amount of work done, its worth every penny. With out that work, I couldn't do it all. Simply impossible. I'm always fortunate her skills are on the upper end of customer service, and she's dependable, and likes the part time nature to current work hours.

If I were say, at ~200 patients and having ~16 clinical hours per week of work, that could in theory equal Gross of ~283K and the overhead would be very similar to that current ~50k mark. So here on up, growth is money in pocket. I just need to get away from this inflection point on the graph of fixed costs. It is a glaring light on why, if doing insurance, people shouldn't think of a light part time practice but focus on a moderate to full time level of practice if doing insurance based, because of the fixed overhead.

I could possibly stop paying monthly website maintenance of $100/month and pocket 1200 more per year, but then if website goes down, I have to figure that out. So as tempting as that is for a low lying fruit, I'll likely not strike it.

 

[finalpsychyear]

Your obviously improving year over year esp with the decrease in overhead.

Would you ever consider consolidating your practice into 1-2 days and supplement it with another job till your practice fills up fully?

 

[Sushirolls]

Those thoughts cross my mind at times.
New rural location just made such options geographically farther; and as I'm the more active parent for kid stuff I can't flip the switch for work-a-holic. Fully capable of doing that, but with me being more the 'soccer mom' I have less possible work time, and need to optimize it, which leaves me right where I am.

Get more patients up to volume "Full"
Then cut out medicare and lower paying insurance
Get back to full.
Re-evaluate what to do. Build office? Go for building equity? Expand to bring on psychologists? Make no changes and just dump money into farming to leave medicine as fast as possible?

 

[Jules A]

This looks good especially for essentially starting over in new state. Personally I wouldn’t sell myself short and would instead look at it as $71.8 in my pocket. The tax deferred in SEP plus growth will be in your pocket one day.

 

[clozareal]

I could possibly stop paying monthly website maintenance of $100/month and pocket 1200 more per year, but then if website goes down, I have to figure that out. So as tempting as that is for a low lying fruit, I'll likely not strike it.

That's pretty pricey. What goes into that $100/mo? I pay $20/mo for my website through Wordpress (now transferred to SquareSpace) and it's never gone down.

 

[octopuszebra]

I guess it depends on what you are doing with your website. If it's just a basic HTML website, you don't need to pay that much money. I use Github Pages (with Github Pro) and Namecheap. It costs $48/year for Github Pro (which is necessary to keep your repository private) and $16/year for the domain name on Namecheap.

I just edit the HTML files myself when I want to make a change. This is very easy with the ability to view the changes yourself (because it is HTML, so you can just open the file locally in your browser before you drag it to Github pages to upload it) and the new LLMs. Maybe I'm missing something, but I don't see why it is necessary to pay more than this.

If you're doing something complicated like a patient portal, that's a different story.

 

[Sushirolls]

Minor update. Q2 this year was new record high for the life of this practice for Gross Income and Net Income.
Hope the trend continues up.

Still mulling over canceling the website maintanence cost.