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[dsharrah25]

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Thinking about signing contract for this job – would you take it? Any red flags? Anything you’d want to clarify?

Model is eat what you kill/office based/you are your own boss under an umbrella group
Take home is ~$400/pt. mostly medicare.
Avg is 23-25 pts per day
Overhead is ~115k (max)/mo (must pay this regardless)
~8-4:30 daily M-F
Vacation up to you, at your own $ risk

BUT – it takes about 2-2.5 yr to get there, during which you are an employee of this group:
Salary ~$250k
Plus small productivity bonus, varies
Some vacation
You start out in deficit since partners pay for your overhead + salary + you start with zero pts; you become partner when you break even then are profitable for 4 consecutive months

 

[Agast]

Overhead is $115k a month? Is there a typo somewhere?

 

[Gnarvin]

Well, a couple things don’t add up. First, if you are personally responsible for paying $115k per month in overhead, that means you would need to bring in gross over $1.3 million per year which is a lot just to break even.

Also, I have no idea how they came up with the “take home” of $400 per patient per visit. Unless you are only doing procedures, and only highly reimbursed ones. I could be wrong though.

 

[geauxg8rs]

Overhead is $115k a month? Is there a typo somewhere?

Come work for me. I only charge 100k /month overhead. Save 15k right there!

 

[Agast]

Come work for me. I only charge 100k /month overhead. Save 15k right there!

Lemme take up a second job and I think I can afford it!

 

[gdub25]

This job sounds in line with what we see in my practice. Overhead of 115k a month with only seeing 25 patients per day sounds like it could be trimmed down to me but I just depends on how efficient the place runs.

 

[dsharrah25]

Overhead is $115k a month? Is there a typo somewhere?

No, I haven't asked what all goes in the overhead, but it ranges from 110-115k/mo.

Well, a couple things don’t add up. First, if you are personally responsible for paying $115k per month in overhead, that means you would need to bring in gross over $1.3 million per year which is a lot just to break even.

Also, I have no idea how they came up with the “take home” of $400 per patient per visit. Unless you are only doing procedures, and only highly reimbursed ones. I could be wrong though.

$400 comes from taking total collected/total # pts from all providers under the group, averaged

 

[pmrmd]

100k monthly overhead is incredible to me. That is an outrageous and unreachable number for one person in a new job. No way would I sign up for that.

 

[clubdeac]

There's no way you individually can cover 115k overhead per month in private practice. I was there 5 years ago and was charged about 60-65k per month which came out to approximately 750k per year. My second year there I billed 2 million. They collected 1 million of that and I took home $250k. It was very depressing. Good luck!

 

[Agast]

I don’t understand these overhead figures. Mine is like $35k a month. I have 3 MAs and 1.5 insurance staff plus shared front desk/back desk/schedulers. And we get portioned out to the last drop.

 

[au bon pain]

$400 comes from taking total collected/total # pts from all providers under the group, averaged

Still can't wrap my mind around this. Are they doing a new patient visit-->series of 3-->RFA--> a trial or mild...on every geriatric w/o office visits in between? Otherwise it's tough to see how you get to that $ with medicare. On the other hand, I'm not that bright. Is this possible without being an assembly line?

 

[nvrsumr]

I have seen similar set up in ortho spine practices and docs owe money to the group when they are fired/leave.

 

[callmeanesthesia]

That’s a lot of overhead, and a suspiciously large average per patient visit. I’m in an Ortho group with 2 in office fluoro rooms, on site X-ray and MRI, and I have 2 MAs, a scribe, and a PA. Also have the full management structure that comes with a 12 physician practice. My overhead including my PA is less than $100k/month. I would suspect there is a large “officer salary” going to senior partners there. I think my average amount billed per patient visit (billed mine you, not collected) is in the $3-400 range.

 

[BobBarker]

The take home per patient is way too high. The overhead is way too high. It doesn’t make any sense.

 

[BobBarker]

I read it again. I think this is the craziest thing I have ever read on this forum. I did a ESI on a patient with Cigna and I got $340 last week. That is a good payor.

 

[dsharrah25]

There's no way you individually can cover 115k overhead per month in private practice. I was there 5 years ago and was charged about 60-65k per month which came out to approximately 750k per year. My second year there I billed 2 million. They collected 1 million of that and I took home $250k. It was very depressing. Good luck!

if you decide to leave prior to becoming partner, then yes you do owe them

 

[dsharrah25]

so it sounds like most here are hesitant to take the job?

If the #s presented are accurate, how would you rate the job from one to ten, ten being more desirable?

 

[Agast]

so it sounds like most here are hesitant to take the job?

If the #s presented are accurate, how would you rate the job from one to ten, ten being more desirable?

I would rate it a -2/10. If they are taking home $400 on Medicare patients in a single encounter there’s probably some fraud involved.

 

[Laryngospasm]

Sounds like a long road to profitability and a short road to getting taken advantage of.

 

[geauxg8rs]

I read it again. I think this is the craziest thing I have ever read on this forum. I did a ESI on a patient with Cigna and I got $340 last week. That is a good payor.

340??? I wish for that!!

 

[SommeRiver]

Terrible job IMO.

Overhead is laughable.

 

[The Last Ankibender]

250k salary, go back to anesthesia for that salary. Overheard is absurdly high

 

[The Last Ankibender]

Thinking about signing contract for this job – would you take it? Any red flags? Anything you’d want to clarify?

Model is eat what you kill/office based/you are your own boss under an umbrella group
Take home is ~$400/pt. mostly medicare.
Avg is 23-25 pts per day
Overhead is ~115k (max)/mo (must pay this regardless)
~8-4:30 daily M-F
Vacation up to you, at your own $ risk

BUT – it takes about 2-2.5 yr to get there, during which you are an employee of this group:
Salary ~$250k
Plus small productivity bonus, varies
Some vacation
You start out in deficit since partners pay for your overhead + salary + you start with zero pts; you become partner when you break even then are profitable for 4 consecutive months

Also breaking even will be hard. You need to make back the 1.3million a year in overheard and your salary so around 1.5million. and you say it takes 2.5year so around 3million to break even. They are robbing you

 

[Laryngospasm]

They forgot to tell you the overhead includes the new hatteras sport fish down in the keys lol

 

[BobBarker]

What kind of group is this? Well-established? All pain trained? Ortho?

 

[Vie221]

Thinking about signing contract for this job – would you take it? Any red flags? Anything you’d want to clarify?

Model is eat what you kill/office based/you are your own boss under an umbrella group
Take home is ~$400/pt. mostly medicare.
Avg is 23-25 pts per day
Overhead is ~115k (max)/mo (must pay this regardless)
~8-4:30 daily M-F
Vacation up to you, at your own $ risk

BUT – it takes about 2-2.5 yr to get there, during which you are an employee of this group:
Salary ~$250k
Plus small productivity bonus, varies
Some vacation
You start out in deficit since partners pay for your overhead + salary + you start with zero pts; you become partner when you break even then are profitable for 4 consecutive months

Agreed that the risk on overhead is high. In an office based practice, your overhead should be around 60 percent of gross collections. To generate your 250k per year, you would need to generate 1.55 mil. That's a big number that even 23-25 procedures a day on medicare will likely not cover.

 

[Nodolor]

Agreed that the risk on overhead is high. In an office based practice, your overhead should be around 60 percent of gross collections. To generate your 250k per year, you would need to generate 1.55 mil. That's a big number that even 23-25 procedures a day on medicare will likely not cover.

says who?

we are like 35%

 

[PainRehabMD]

$400/patient take home on mostly Medicare? What in the world are they doing with their patients?

 

[Laryngospasm]

Rfa every day on every patient

 

[geauxg8rs]

Rfa every day on every patient

And stim on Sunday

 

[deleted131481]

says who?

we are like 35%

60% probably an average. Pretty sure we are 125%.

 

[Nodolor]

60% probably an average. Pretty sure we are 125%.

Overhead 125% of Gross collections?

 

[deleted131481]

Overhead 125% of Gross collections?

I should have used purple font. Just joking- meant our hospital/academic practice is rather inefficient.