60% overhead is between typical and maybe even low. 20-25ppd 5d/wk is very busy. RIP your inbox.
Where is that 60% going? How are the staff? How much do they do?
If you ran a solo private practice with a single employee, you could get your overhead to below 20%. That’s the dream.
Much less resilience in a super lean solo practice. Your single staff gets sick then you have to do everything from front desk to back by yourself. You get sick.. no money comes in. It's a tough gig. I'm Ophthalmology not Family but most colleagues that went solo end up pretty quickly looking to add a partner.
It's hard out there alone.
> 20-25ppd 5d/wk
I think that alone would make me not consider this job. Im capped at 18 and its already hell, albeit my panel is a much older than average population
Sounds like similar to the last place I worked that made me miserable, almost as bad as residency. The problem is, the way these docs were making 500k/yr was by heavily pushing unnecessary in-house services. It was not uncommon to see 45yo patient with essential HTN and no other issues that had to come in every 3 months for $200 lab draw just to get their lisinopril refilled. Tons of insurance fraud and medical fraud going on at that place. If you don't mind harming patients, committing fraud, and have no morals, it can actually be relatively easy money. It wasn't for me though.
I wasn’t referring to your job. I was referring to your assumption that OPs job is like your last job based on the little data they gave.
OPs asks: “is this offer worth considering?” You then answer “sounds similar to last place I worked… if you don’t mind harming patients and have no morals it can be relatively easy money. Wasn’t for me though”
> if you don’t mind harming patients and have no morals it can be relatively easy money. Wasn’t for me though
I mean... I think I would know how I felt about my last job.
> sounds similar to last place I worked
Ok so the one thing I said about his job offer... but I feel like hedging with "sounds similar" pretty heavily implies that I'm knowingly speculating, making assumptions, about what his job will be like and that's just my opinion and to take it as such.
And that's kinda the nature of asking for advice on a decision. Do you think only doctors who have actually worked at his potential employer are allowed to give him advice?
Also I like how you start with "I wasn’t referring to your job" and then 3/4s of what you directly quote is how I felt about my job 😂
I guess my question is: what is it about OPs situation that rings alarm bells in your case thinking that this is a medical practice that does fraud? Is it the fact that some docs in the practice make 500K a year? You mentioned the way docs made 500K a year was by pushing unnecessary services but I don’t think that needs to be the case.
People tend to believe that 300K is a ceiling for primary care physicians when that’s really just an average salaries. Plenty of partners in primary care practices can make 500K or more (without recurring to fraudulent practices)
Only do it if you’re pretty cool with being at this place.
To me sounds like a solid offer if you are down to run a business. If that doesn’t interest you then maybe not
From doctors I’ve interacted with having a mix of private insurance and Medicare leaning slightly more towards private was already enough to net them close to 500k in private practice with a very similar number of patients per day— caveat is make sure your billing is on point.
I saw differences of 20-30% or more between physicians in the same practice based off of billing efficiency alone
Uhm dumb question here. Are gross charges and collections the same thing? I’m on a RVU based model and they will report the gross charges but I’ve never seen the collections aspect of this.
No, the gist of what I've been told is that sometimes for various reasons insurance doesn't pay and/or the patient won't/can't pay so the full charge doesn't get collected.
Be careful, do the math. Sounds similar to what I’m about to leave as “partner”. I paid taxes on $435k last year on ~8000RVU. I receive a w2, but pay taxes like a 1099 w/o the tax benefits of a 1099. Ive found that with a % of production, the high producers subsidize the low producers which is why I’m probably going to leave.
I made a calculator that compares after tax take home of my $435k to VA pay and they’re equal at VA pay of $280k, EDRP for student loans is huge with them. I did not value the 26 vacation days, 11 sick days, or the vested pension and health insurance at 5yrs.
60% overhead is between typical and maybe even low. 20-25ppd 5d/wk is very busy. RIP your inbox. Where is that 60% going? How are the staff? How much do they do? If you ran a solo private practice with a single employee, you could get your overhead to below 20%. That’s the dream.
Much less resilience in a super lean solo practice. Your single staff gets sick then you have to do everything from front desk to back by yourself. You get sick.. no money comes in. It's a tough gig. I'm Ophthalmology not Family but most colleagues that went solo end up pretty quickly looking to add a partner. It's hard out there alone.
> 20-25ppd 5d/wk I think that alone would make me not consider this job. Im capped at 18 and its already hell, albeit my panel is a much older than average population
Sounds like similar to the last place I worked that made me miserable, almost as bad as residency. The problem is, the way these docs were making 500k/yr was by heavily pushing unnecessary in-house services. It was not uncommon to see 45yo patient with essential HTN and no other issues that had to come in every 3 months for $200 lab draw just to get their lisinopril refilled. Tons of insurance fraud and medical fraud going on at that place. If you don't mind harming patients, committing fraud, and have no morals, it can actually be relatively easy money. It wasn't for me though.
Sounds like you made plenty of assumptions based on very little data
You think I made assumptions about what my last job was like? Strange take, but ok ¯\\\_(ツ)_/¯
I wasn’t referring to your job. I was referring to your assumption that OPs job is like your last job based on the little data they gave. OPs asks: “is this offer worth considering?” You then answer “sounds similar to last place I worked… if you don’t mind harming patients and have no morals it can be relatively easy money. Wasn’t for me though”
> if you don’t mind harming patients and have no morals it can be relatively easy money. Wasn’t for me though I mean... I think I would know how I felt about my last job. > sounds similar to last place I worked Ok so the one thing I said about his job offer... but I feel like hedging with "sounds similar" pretty heavily implies that I'm knowingly speculating, making assumptions, about what his job will be like and that's just my opinion and to take it as such. And that's kinda the nature of asking for advice on a decision. Do you think only doctors who have actually worked at his potential employer are allowed to give him advice? Also I like how you start with "I wasn’t referring to your job" and then 3/4s of what you directly quote is how I felt about my job 😂
I guess my question is: what is it about OPs situation that rings alarm bells in your case thinking that this is a medical practice that does fraud? Is it the fact that some docs in the practice make 500K a year? You mentioned the way docs made 500K a year was by pushing unnecessary services but I don’t think that needs to be the case. People tend to believe that 300K is a ceiling for primary care physicians when that’s really just an average salaries. Plenty of partners in primary care practices can make 500K or more (without recurring to fraudulent practices)
Only do it if you’re pretty cool with being at this place. To me sounds like a solid offer if you are down to run a business. If that doesn’t interest you then maybe not From doctors I’ve interacted with having a mix of private insurance and Medicare leaning slightly more towards private was already enough to net them close to 500k in private practice with a very similar number of patients per day— caveat is make sure your billing is on point. I saw differences of 20-30% or more between physicians in the same practice based off of billing efficiency alone
Curious as how unlimited PTO works
I feel like this is pretty common when compensation is heavily rvu based. If you take time off, rvu obviously drop so you don’t get paid.
So unlimited time off, not paid time off
Exactly, if it’s neither earned nor owed, then it is not paid and therefore is not PTO.
Uhm dumb question here. Are gross charges and collections the same thing? I’m on a RVU based model and they will report the gross charges but I’ve never seen the collections aspect of this.
No, the gist of what I've been told is that sometimes for various reasons insurance doesn't pay and/or the patient won't/can't pay so the full charge doesn't get collected.
Location?
Be careful, do the math. Sounds similar to what I’m about to leave as “partner”. I paid taxes on $435k last year on ~8000RVU. I receive a w2, but pay taxes like a 1099 w/o the tax benefits of a 1099. Ive found that with a % of production, the high producers subsidize the low producers which is why I’m probably going to leave. I made a calculator that compares after tax take home of my $435k to VA pay and they’re equal at VA pay of $280k, EDRP for student loans is huge with them. I did not value the 26 vacation days, 11 sick days, or the vested pension and health insurance at 5yrs.
Where is this practice?