The Smart FP

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

bustbones26

Senior Member
15+ Year Member
20+ Year Member
Joined
Jul 26, 2003
Messages
981
Reaction score
51
I posted the same thing on another thread on this forum, but I'd like to share it with others too.

I wish I had a copy of an article I recently read, but I'll tell you all about it.

There was this FP that was unhappy with working in a big FP group. So he decided to go solo. This article was amazing, let me give you the low down on how this guy ran his solo practice.

First, he found one of his doctor colleagues that had office space and rented an exam room from his friend. The exam room he rented was large anought to set up his desk and office as well as exam table, etc.

When his patients arrived, his friends receptionist would tell the doc via intercom that his patient had arrived. He would then come out, greet the patient himself, and take them back to the exam room.

He had no appointments. Patients just walked in when they needed to be seen. He stated in this article that he could spend an entire hour with the patient if he wanted. In this hour, he could also do more so that his billing codes were of a higher level.

When the patient left, he did all of the charting and billing procedures himself. He had no secretary, no office manager, no billing agent, he did it all himself. If he needed a chaperone for say a gyn exam, he would go out front and ask one of his friends office staff to chaperone.

He never was on call for hours on end. He handed out his cell phone number to his patients and warned them to use it judiciously. He said that at the most, he may have received a phone call in the middle of the night about 3 times per month. Oh he also did no obstetrics as well.

By doing all of the above, he limited his practice to a small number of patients and physically worked part time. At the end of the article he broke down the numbers, remember before he went solo he used to be in a big FP group.

By breaking down the numbers he showed that he made more money in his solo practice limited to 1500 patients working half of the hours, than he did when he was in a big FP group that had thousand upon thousands of patients and we was overworked. He showed that he made 150K from seeing his 1500 patients and that every penny of it, other than paying the rent for his exam room went directly into his pocket. In addition, with his extra time, he also worked as a consultant for an HMO. All together, his article basically showed that he physically worked part-time as an FP and was raking in more cash than any of his colleagues and was not getting overworked.

When I read this article, I was amazed. I actually thought that if I became ANY kind of primary care doc, I would run my practice this way. The only thing different, is this guy had the priveliege of having a doctor friend rent and exam room and borrow office staff occassionaly to chaperone a sensitive exam.

I wish I could find this article for you all to read! I can't even remember which journal/magazine it was in. But it just goes to show, if you are a smart business manager and are good at handling money, you can have alucrative practice in any specialty.

Members don't see this ad.
 
i think it sounds like an awesome idea. i would love to have a small practice out of my house, that way i could still be around my kids. this gives me hope that it is possible!
 
Members don't see this ad :)
Ok, this will probably ruffle a few feathers, and I'll admit that I haven't read the entire article, but from the graph showing his "actual" revenue/expenses at "50% capacity" it looks like an exemplary study showing why this won't work.

He's bringing in ~$4K/mo and spending ~$1.5K/mo. That's $30K/yr (assuming no vacation) at 50% capacity. Even if he doubled his revenue and kept his expenses constant (can't happen), he's only pulling in $78K/yr. Is that enough scratch to make it in Rochester, N.Y.? Hope he doesn't have any loans.

I'm thinking that cleaning houses might work out a little better for him. We pay our housecleaners (team of 2) $75/visit for ~1.5hrs of work. They don't need any telephones, office space, charts, insurance, accounting, etc. Just some comet and windex, and a 1984 T-bird to get here. 6 hrs of work/day would give them $78K/yr. And they didn't go through college, med school, & residency. Just something for him to consider...

By the way, does malpractice insurance really only cost $100/mo?
 
There are more articles by the same author in FPM since those original two. The first contains questions from other doctors about his practice model, and the second is an article on avoiding burnout using the same general practice principles.

http://www.aafp.org/fpm/20020500/39answ.html
http://www.aafp.org/fpm/20030900/51crea.html

I think he raises several good points. His model probably wouldn't work for everyone, but the principles (fewer auxiliary staff, therefore lower overhead) I think are solid.
 
Top