SC and North Carolina Pain practices

[inspire004]

Planning to move close to costal areas due to family reasons, was surprised by the practice patterns, Charlotte is run by one group, FP and IM are hiring pain physicians to run the show. Not to mention PMR

any insights and advice is appreciated,

me just starting out of fellowship and working with IM guys with full staff and overhead covered seems like a long AT&T contract with premature termination fee

they have no idea on how to run pain practice and want there pain patients not referred to in house pain doc
they have a fluro room ready and cleared and waiting for pain MD to select a new fluro machine, would give full support with salary for first year and would want 40% after 1 st year although this is there initial proposal

waiting for them to send out a rough draft on what they want to offer

i was thinking of going on my own starting from scratch with this demand,


Are there any resource if i want to go on my own

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[PMR 4 MSK]

Planning to move close to costal areas due to family reasons, was surprised by the practice patterns, Charlotte is run by one group, FP and IM are hiring pain physicians to run the show. Not to mention PMR

any insights and advice is appreciated,

me just starting out of fellowship and working with IM guys with full staff and overhead covered seems like a long AT&T contract with premature termination fee

they have no idea on how to run pain practice and want there pain patients not referred to in house pain doc
they have a fluro room ready and cleared and waiting for pain MD to select a new fluro machine, would give full support with salary for first year and would want 40% after 1 st year although this is there initial proposal

waiting for them to send out a rough draft on what they want to offer

i was thinking of going on my own starting from scratch with this demand,


Are there any resource if i want to go on my own

Is it 40% and the rest is yours, with no overhead? Or they take 40%, then deduct rent, insurance, your share of employee salaries and benefits, etc?

If you go solo, be prepared to not take a paycheck for 6 months or more and be in debt beyond belief, if you can find a bank to finance you.

 

[bedrock]

very hard to go solo as fresh grad.

would recommend getting a decent job in the area you'd like to live (but without a non-compete, or very limited radius to non-compete), working for 2-3 years. This gives you the chance to
1-pay off loans and save money for your own practice
2-figure out the business side of things. There is so much you don't learn in residency/fellowship
3-really figure out how'd like your practice setup, (types of patients, work flow, and in particular how to be as efficient as possible in private practice.
4- get to know the local referrers and build relationships

#1 is particularly important, as currently banks are much more reluctant to lend. Yes,you're an MD, but you likely also have six figure loans, little collateral and no established revenue stream (for a new practice)

 

[inspire004]

my situation and clarifications

1. Can work for 6 mths with low pay
2. after 1 yr they want 40 % of collections
3. I dont need to pay for all the overheads from day one facility, billing, equipment, EMR , possible one nurse or PA or fluro tech which ever is best
4. how much capital do u really need to start up- just basic clinic
5. lot of pain franchises going on ,can we trust these chiropractor and CEO guys
6. how do one apply for loans, are there any special pre requisites for pain practices,I have no debts to pay
7 I need management tools like these anesthesia guys have revenue or practice management tool, team building for starters
8. Are there any good how to start pain practice literature/ workshops with ASA, ASIPP
9. thank you all for making this forum better place to learn

I thought this was interesting
abrham maslow
http://en.wikipedia.org/wiki/Maslow's_hierarchy_of_needs

 

[ParaVert]

Just stay out of my backyard 😉.

Charleston is flooded, Summerville is underserved to my understanding. Georgetown, Pawley's and Murrell's Inlet has strong competition. North Myrtle / Loris / Little River is underserved. Don't know about Holden Beach and northwards. Ask your SCS reps, they're often well informed about who is doing what where.

 

[emd123]

Just stay out of my backyard 😉.

Charleston is flooded, Summerville is underserved to my understanding. Georgetown, Pawley's and Murrell's Inlet has strong competition. North Myrtle / Loris / Little River is underserved. Don't know about Holden Beach and northwards. Ask your SCS reps, they're often well informed about who is doing what where.

Coastal SC, lots of competition from what I hear.

 

[hyperalgesia]

Every time I asked someone about Charleston or Myrtle Beach, they mentioned how underserved Columbia was.

 

[VA Hopeful Dr]

Every time I asked someone about Charleston or Myrtle Beach, they mentioned how underserved Columbia was.

Most of the rest of SC is "underserved", though having been here for some time I always wonder if that's true. My commercial insurance patients have no problem finding a pain doctor and my drug-seeking patients wouldn't last 10 minutes in a good pain practice.

 

[PMR 4 MSK]

my situation and clarifications


4. how much capital do u really need to start up- just basic clinic
5. lot of pain franchises going on ,can we trust these chiropractor and CEO guys
6. how do one apply for loans, are there any special pre requisites for pain practices,I have no debts to pay

4 - Probably $100K
5 - No
6 - Find a bank, talk to the loan officer, fill out the forms, wait for a reply

 

[bedrock]

1. Can work for 6 mths with low pay
2. after 1 yr they want 40 % of collections
3. I dont need to pay for all the overheads from day one facility, billing, equipment, EMR , possible one nurse or PA or fluro tech which ever is best

1- Charlotte isn't coastal, do you really mean coastal or just NC/SC? There are several pain groups. Talk to all of them even if they're not advertising an opening, they may be thinking about it and you might get paid a lot more. In the meantime apply for both NC and SC medical licenses.

BTW, how much exactly is the "low pay" for six months? No one makes partner money their first year, what are you expecting? First year guarantee of around 230-260K is average and not "low pay"

2-40% of collections (60% going to you) is AWESOME, and a great deal if-
a-It's truly 40% and they don't deduct other things like malpractice, health insurance, etc. Then it's simply average. If start deducting much more than that it may go below average.
b-you're doing procedures in office, and not at their ASC.

3-If you don't know what's best between nurse, PA, or fluoro tech, then you need real world experience, don't go out on your own yet. The answer is----------X-ray tech who's experienced/smart enough to also act as your MA/nurse. That plus a receptionist. Use a billing service when starting out, but you can't tell if the billing service is any good unless your fellowship taught you more about billing than mine did.

 

[bailey1491]

Coastal SC, lots of competition from what I hear.

I would agree that coastal SC is rather competitive. Myrtle Beach and the beaches just south are served by at least five pain docs that come to my mind. As for North Myrtle/Loris/Little River, this area is underserved at the moment but Loris Healthcare System(hospitals in Loris and North Myrtle Beach) have a contract agreement with Anesthetix, an anesthesia supercompany, to provide anesthesia and pain services for them. They are finishing, if not already finished, a Hospital based pain facility in North Myrtle. They are looking for pain docs willing to provide 50/50 pain/anesthesia services and are still hiring from what I hear. I know a pretty good bit of info on this having interviewed there a while back, so pm me if you want some more details.

Holden Beach and some other beaches south of Wilmington are served mostly by a hospital in Supply, NC which is operated by Norvant medical. They too have a hospital based pain clinic.

As for the chiropractor thing, you likely spoke with the same guy I had contacted a few months back. His business model sounded reasonable but I opted to look elsewhere.

Good luck with the search.

 

[PinchandBurn]

..... The answer is----------X-ray tech who's experienced/smart enough to also act as your MA/nurse. That plus a receptionist. ....

I am not biased here. But from what I've seen, this is very true.

 

[inspire004]

Any one working close to Charlotte. The big group here is AA former southeast. It's getting increasingly hard to find decent jobs around this area , any input from your group is appreciated. Gas works is too dry in these states. I am just cold calling groups to get some response. Is there any better way to connect and find jobs