This salary seems too good to be true?

Panacea Financial Contract Review
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doc1107

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MD or DO in anesthesiology, Pain Management, Family Practice, Internal Medicine, for nice clinic. See no more than 30-35 patients per day. Hours: 9-5 M-F.
Great staff in place and ready to go. Please send resume and call L**** **** to discuss further. . Send resume asap to **********************

2 Physician staff
1 PT, 1FT opening

$2K per day cash pay! Call asap


How is that possible? That just blows me away? I mean this isn't like expecting you to do any surgery or anything....
 
I agree. Do the math...If you see 35 patients a day, the clinic would have to pull in $57 per patient in order to cover your salary. Given a typical overhead of 50%, the actual charges for the clinic to break even would be $114 per patient which is more than is paid by medicare or anthem or most other carriers unless you are fraudulantly miscoding. There must be another angle to this: either the patients are cash pay pill mill patients, there is fraudulent billing, or there are some procedures expected or quid pro quo in order to make that much income for the physician.
 
gotta be cash pay pill mill. Don't think procedures are involved or the ad wouldn't include FP or IM docs
 
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considering that the average pill mill can generate 700-1k per patient visit, if they are offering you 2k/day then they are seriously taking advantage of you...
 
Perhaps demanding $6k a day would be in order given that the pill mill doctors probably last about the same length of time as a NFL linebacker...
 
Too good to be true. Run.
 
considering that the average pill mill can generate 700-1k per patient visit, if they are offering you 2k/day then they are seriously taking advantage of you...
Click to expand...

$700-$1000 is how much the patients have to pay for their visit at one of the pill mills?
I guess they have to get a really large oxy script to make a profit themselves........
 
Tenesma said:
considering that the average pill mill can generate 700-1k per patient visit, if they are offering you 2k/day then they are seriously taking advantage of you...
Click to expand...

from the pill mills i have seen, usually 250 for the initial visit, 150-200 for the subsequent, scheduled EVERY month. You probably have to pay cash for the required MRI at THEIR facility, or other shenanigens i have seen advertised.
 
it is usually 50-200$ for the visit/"exam", then another 50-200$ for "imaging", then another $100-500 for a TON of meds.... the clinics know that these meds are going to be re-sold, so they have no problem asking ( and getting) a higher price for these meds...
 
do they also make money off of UDS at every visit?
 
Tenesma said:
it is usually 50-200$ for the visit/"exam", then another 50-200$ for "imaging", then another $100-500 for a TON of meds.... the clinics know that these meds are going to be re-sold, so they have no problem asking ( and getting) a higher price for these meds...
Click to expand...


so, the "patient" does not get a prescription to fill at walgreens, but ends up buying the medication from the doctor, at a higher price? OR am I reading this wrong, and you mean a Rx for monster doses of dilaudid?
 
Interesting comment about buying the drugs from the doctor. I had a drug rep in the office selling compounded creams. As a jack-of-all trades and master of none, he also asked if I was interested in starting an in-house pharmacy. Then he pulls out some numbers from a pain doc in KY. The doc sees 800-900 patients per month (mon-fri, 9-5) and 95% of patients get prescriptions. He's netting over $325K/yr from drug sales. I declined.
 
the reason that they can charge for the pills is that some pharmacies don't fill the narcs any more... for example in Florida, with an out-of-state driver's license, the "wal-green"/conventional pharmacy will only honor 3 days worth of the prescription... in other states, those patients have been put on prescription monitoring program watch lists and are unable to fill at most pharmacies...

clearly, these pill mills are disgusting, but don't be misled: they are based on good business sense: it is all about supply and demand - and unfortunately, more people are going to die...

2-3 years ago I saw ads for docs (didn't have to have ANY pain training) for 10k/day seeing 50-100 narcotic patients per day...

a lot of the docs who were working for pill mills at the time were retiring/retired docs, who realized it was just a matter of time before the board of medicine/DEA would revoke their license... but heck: 10k/day for 1-2-3 years before the system catches up with them, is one way of filling up the retirement coffers... absolutely disgusting...
 
Tenesma said:
the reason that they can charge for the pills is that some pharmacies don't fill the narcs any more... for example in Florida, with an out-of-state driver's license, the "wal-green"/conventional pharmacy will only honor 3 days worth of the prescription... in other states, those patients have been put on prescription monitoring program watch lists and are unable to fill at most pharmacies...

clearly, these pill mills are disgusting, but don't be misled: they are based on good business sense: it is all about supply and demand - and unfortunately, more people are going to die...

2-3 years ago I saw ads for docs (didn't have to have ANY pain training) for 10k/day seeing 50-100 narcotic patients per day...

a lot of the docs who were working for pill mills at the time were retiring/retired docs, who realized it was just a matter of time before the board of medicine/DEA would revoke their license... but heck: 10k/day for 1-2-3 years before the system catches up with them, is one way of filling up the retirement coffers... absolutely disgusting...
Click to expand...

Those folks playing that game as docs these days are getting caught up in the forfeiture and jail program. So it is over. Minimum is loss of license. I think we will see 5-10 yrs for MD's who have crossed the line.
 
Tenesma said:
the reason that they can charge for the pills is that some pharmacies don't fill the narcs any more... for example in Florida, with an out-of-state driver's license, the "wal-green"/conventional pharmacy will only honor 3 days worth of the prescription... in other states, those patients have been put on prescription monitoring program watch lists and are unable to fill at most pharmacies...
Click to expand...

Pharmacists I worked with told me the same thing. Also, some of these patients, docs and clinics are barred from the local pharmacies just because of their reputation. This allows the pill mills to jack up the cash price.

I wish I were convinced it is a winding down phenomenon but I'm not. The thing is, the busts I heard about had nothing to do with the practice of medicine being inappropriate. They were related to tax fraud. Like they caught some guy leaving the clinic with a duffle bag with $50k in cash and I believe are prosecuting on tax fraud charges.

Also, my understanding is that the moratorium on new pain clinics was heavily lobbied for by the existing pain clinics to keep out the competition. It's a travesty. I would prefer narcs just be legalized than to watch this charade unfold.
 
Ok thanks for all the answers. I was sure something was fishy...

BUt what if you were a legit doctor? I guess the clinic would fire you or 2k a day isn't enough to be caught up in a potential mess..
 
They get young and naive, or old/retired and don't-care-any-more docs who want fast cash, and I mean cash.

Here's how I picture it End of the day, you get an envelope with 20 $100 bills. Guido in the back office hands it to you with a smile and says "see you tomorrow doc, you're doing great!" His cash-counting machine is already at $40K for the day and he has more to go through.

You see 4 patients/hour. All the paperwork is done for you. You walk in, do a cursory exam, fill in some boxes, and then fill out the prescription forms. "Patient" goes back to the front office, where meds are dispensed, final bills are paid.

2 months later, Feds come in, arrest everyone. Guido claims it was all you. You wrote every prescription, saw every patient. He is just the "office manager" and has no medical training or knowledge. He laughs as you get thrown under the bus. Then he opens a new clinic across town, hires a new stooge to write prescriptions. Rinse and repeat.
 
Have you guys ever read these pill mill "notes?"
they are hilarious! The only items in the meds section is oxycodone 15,30 and oxycontin (80 or 60). There is no room for non oxy. The plan every month was "rf meds, Fu in one mo."

Just make a couple of check marks and sign at bottom.
 
doc1107 said:
Ok thanks for all the answers. I was sure something was fishy...

BUt what if you were a legit doctor? I guess the clinic would fire you or 2k a day isn't enough to be caught up in a potential mess..
Click to expand...

A legit doc wouldn't last a day in the clinic. This is for someone who is willing to put money above his professional integrity. I don't think you'd be fired because they tend to be all "production" based. If you don't write the scripts, you don't get the money, period.
 
The owner of the clinic has much less to lose than you would. Now here in Florida at least they are requiring any pain clinics to be owned by doctors. If not you have much stricter requirements to meet. My colleagues have been inspected here in FL and since the states are in tough economic times, they are losing funding. So they are funding themselves with $5000 fines for each discrepancy and $1500 just for the inspection. I unregistered as a pain clinic a few months ago.
 
what a waste......the database is a waste, 400 LEO's to shut down a few clinics is a waste. I dont understand it. The DOH can shut down anyone they want. They dont need all this BS unless it is political.
 
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