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InvestingDoc

@InvestingDoc

1 month

State of current medicine in my area. Local PE backed urology group has a weight loss clinic run by a urologist Gastro PE backed group...most initial consults are done by a PA/NP now. Docs are mainly scoping Derm PE backed group. regular derm now done mostly by PA/NPs

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InvestingDoc

@InvestingDoc

5 years

@relatableafmd Disagree completely. You can have a respectful discussion about obesity or weight without making patients feel deflated. You're a doctor, it's okay to tell a patient they are obese...just show your fellow person respect in how to approach the convo.

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InvestingDoc

@InvestingDoc

2 months

Proud moment Today my primary care clinic that I started 5 years ago saw the most patients we have ever seen in one day as our third location continues to grow. 118 pts in one day. I'm as excited about hitting this mark as I was when I hit the 10 pt per day mark.

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InvestingDoc

@InvestingDoc

1 month

New patient no showed to their appointment yesterday, claims it was an emergency. We accommodate them with a visit today, 1 day after their no-show. They show up 35 min late today, no paperwork filled out We reschedule again 1 star review for not accommodating them better

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InvestingDoc

@InvestingDoc

4 months

@chrissyfarr I'm a PCP, my wait times went from 2 weeks pre pandemic, to now 4-5 months as half the other PCPs in a 5 mild radius retired or quit during the pandemic or with decreased pay

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InvestingDoc

@InvestingDoc

1 year

A MD turn down a job offer for our practice, because we have PAs and they did not agree with any MD supervision of APPs. I respect that she told us early what her non negotiables are. Better for both of us to go separate ways. Offer was 250k a year plus 10k in bonus guaranteed

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InvestingDoc

@InvestingDoc

4 months

One of my favorite derm group in town, they sold out to PE about 5 years ago. They recently let go of numerous dermatologist. Their model is now hiring NPs or APPs to do all the work that the docs were doing except for the mohs docs

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InvestingDoc

@InvestingDoc

1 month

@thats_bone I get that, but when my referrals for autoimmune hepatitis or chronic hep b with very high viral load are being seen by a potential new grad PA...that just rubs me the wrong way.

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InvestingDoc

@InvestingDoc

14 days

One of the hardest things about managing a private practice. The phones. We average about 300-500 phone calls a day in our office.

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InvestingDoc

@InvestingDoc

6 months

@sgremminger I'm not a pediatrician but in primary care, some patients will book as an annual checkup but it's way more. For example, last week I had one book is an annual checkup to check their cholesterol and then told me they were suicidal. That's why I was 60 minutes behind.

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InvestingDoc

@InvestingDoc

1 month

Today I decided to close my panel to taking new patients. My wait list is over 3 months long. Its time to focus on my established patients and shunt new patients to the other doctors in my group.

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InvestingDoc

@InvestingDoc

5 months

6 weeks ago I opened another location for my practice. I predicted in my business plan that it would take 5 months to turn a profit at this location, staffed by a doc. Week 6 done, and we are profitable! This has blown away my expectations and I hope this rapid growth continues.

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InvestingDoc

@InvestingDoc

1 month

how evil is united healthcare? My pt this morning with GBM, terminal brain cancer, United will only pay for 8 Zofran pills/month and make him pay $3 to get 30/month. Jesus. as if their billions of profit are not enough...making a terminal cancer pt pay $3 to not throw up daily

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InvestingDoc

@InvestingDoc

3 months

I'm the only doc in my family, and if we go off of net worth, size of business owned, number of hours I have as free time...then I'm by far the loser of the bunch compared to my other two brothers. They had a huge head start owning their business compared to me bc of med school

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InvestingDoc

@InvestingDoc

3 months

A surgeon called to say congrats on all our growth. His way of saying it. "Congrats on the third office, any idiot in primary care could open a successful location since no one is going into primary care anymore and there is a huge need" Umm...thanks bro? Never sending you a pt

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InvestingDoc

@InvestingDoc

5 years

@relatableafmd Agree to disagree. I don't treat obesity like voldemort's name but always treat with respect and usually just mention once during convo. You really so naive to think that us who mention obesity don't address the underlying issue?

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InvestingDoc

@InvestingDoc

2 months

Just entered into negotiations with United healthcare to renegotiate our contract. Wish me luck bros haha We will see how much of a raise I can argue for now that we have 20,000+ patients.

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InvestingDoc

@InvestingDoc

11 months

Now all the big GI groups in my town have been bought out and under one management company. Interesting that they still have different names, the illusion of choice but behind it is all a huge private equity conglomerate.

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InvestingDoc

@InvestingDoc

1 year

@AlokPatelMD This raises the importance of financial education. 170k is total compensation. That includes PTO, health care benefits, 401k match. Comparing salary to total compensation is not apples to apples. However, yes peds is very underpaid

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InvestingDoc

@InvestingDoc

7 years

First person I've read about who has received loan forgiveness :)

From the StudentLoans community on Reddit: I received PSLF Forgiveness!

Explore this post and more from the StudentLoans community

www.reddit.com

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InvestingDoc

@InvestingDoc

5 months

Why are doctors leaving medicine? A patient filed a complaint that I required a visit for a handicap placard evaluation and now I have to write a letter defending myself for requiring a visit

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InvestingDoc

@InvestingDoc

27 days

A GI doctor came to introduce themselves to my office. They boasted about being a part of a "physician owned private practice" bro, your group is owned by private equity, Provident Healthcare Partners. The docs who hired you sold out to PE years ago...

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InvestingDoc

@InvestingDoc

6 years

After 6-8 months of hard work, my private practice opened 3 days ago and we've had 9 patients for our first "week." Not to bad for having the website up only a week before opening our doors. I'm excited about the business going forward :)

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InvestingDoc

@InvestingDoc

2 months

Just heard back from United healthcare on our rate negotiation talk. Our contract says we need to negotiate at least 90 days or more prior to renewal of our contract. We are between 60 and 90 days out from renewal. Can't negotiate until next year. Total BS

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InvestingDoc

@InvestingDoc

4 years

@danielleofri Ooof. I forwarded this article to all my colleagues / residents in training as an example of how to never act like the author in this story. Thanks for sharing.

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InvestingDoc

@InvestingDoc

2 months

The bigger we get, the more interest we have in people joining us. Currently talking to an endo who wants to join us, psych, and 2 other doctors who want to open another location in our area under our umbrella rather than starting from scratch. If you build it, they will come

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InvestingDoc

@InvestingDoc

1 year

Today I learned that to advertise on Doximity, the minimum you can spend is $26,400 to try to hire a new physician. Insane

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InvestingDoc

@InvestingDoc

1 year

@ABIMcert Imagine working for this organization. Do you think every employee of this org goes home knowing how much they are hated by every physician? Or you think they are just deep in denial?

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InvestingDoc

@InvestingDoc

3 months

Last year we started doing executive wellness exams. $1,000 per hr for the exam / visit. This week alone I have 9 of them on my schedule.

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InvestingDoc

@InvestingDoc

7 years

My friend today asked if 22% return on his 401k was good... All the people who graduated residency or fellowship last year, paid into their retirement portfolio and see 20% returns are most likely in for a rude awaking if they think this is the norm....

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InvestingDoc

@InvestingDoc

6 months

@gabrieldane @Medscape Ortho, plastics and urology make way more than that in private practice

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InvestingDoc

@InvestingDoc

2 months

I get reported for accepting a $15 jimmy johns lunch from pharma companies and worry about stark law in my practice...and this $200 million dollar PE startup is out here giving kickbacks for Medicare patients to sign up for their CCM program with paid ads. Lol wild

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InvestingDoc

@InvestingDoc

1 year

For those of you who own your own business or practice, what was your moment that pushed you to start? Mine was when I overheard the head of my hospitalist group talk about how new grads like me will work for pennies while he collects all the big dollars I bill for.

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InvestingDoc

@InvestingDoc

1 year

@jareddashevsky We text all pts for appointment confirmation. Just pulled my clinic stats. Less than 35% of people less than 40 confirm via automated text. That's why we also call those who don't answer via text.

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InvestingDoc

@InvestingDoc

6 months

Today I made "phase 2 official" I will soon go to 3 days in the clinic and 2 days focused on admin time, growth, and other outside projects. My business partner and I have agreed to focus on growth and with that, I can't see 20 pts 5 days a week and have rapid growth of the biz

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InvestingDoc

@InvestingDoc

15 days

Certificate of occupancy for new location setup for tomorrow Electricity switched over today Internet will be set up Thursday Sign goes on the front door and on the marquee on Friday Mover setup for Saturday We open our new location on Monday.

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InvestingDoc

@InvestingDoc

1 month

I feel like I've reached a good level in my business. I took a week long vacation two weeks ago. I saw 0 change in the amount of dollars that we have received or billed for my business even with me gone for a whole week.

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InvestingDoc

@InvestingDoc

4 months

Primary care is the face and often acts as the punching bag of all the frustrations that patients have with health care. Biggest complaint. Pts thinking annual exam is a free visit to bring all their problems to and we are scamming them asking for copay

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InvestingDoc

@InvestingDoc

1 month

Sometimes an employee relationship turns toxic. One of my new PAs is now telling others that its BS that I get a full day "off" from patient care to run the business without any pt visits. They are demanding = time off to go home and hang out with their dog I wish I was kidding.

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InvestingDoc

@InvestingDoc

2 months

@DrBruggeman Its been crazy to see all the local private practice docs quit, retire, or sell out to large groups in the 5 years since I started my practice. We are one of the only independent primary care groups left in town.

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InvestingDoc

@InvestingDoc

1 month

@B_Madden4 But I can't own any part of a pharmacy or hospital as a doctor lol. The system is so rigged

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InvestingDoc

@InvestingDoc

5 months

@ToddZywicki So my patient who had a seizure in clinic today leading me to be 45 min behind bc we had to stabilize them and call 911 is me not being considerate of other patients time lmao. Get real bro

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InvestingDoc

@InvestingDoc

5 years

@JuliaNEM33 I don't let it get me down when people talk like this. It is a window into their viewpoints and I feel sorry for them to feel this way. Makes me wonder if they also look down at my father who is a metal worker or my brother who is a welder. I'm happy and that's all that matters

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InvestingDoc

@InvestingDoc

1 month

@RRoopani I usually respond generic bs. BUT This one I flamed & called them out that they didn't show yesterday and showed up 30 minutes late today to try to accommodate them for a new patient visit and I'm sorry this did not meet your expectations. Good luck finding a new doc.

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InvestingDoc

@InvestingDoc

1 year

Owning a clinic can be wild. Dealing with a patient who refusing to see us unless we sign a notarized paper that his medical record will never be stored on any Chinese server or go through a Chinese server. our EMR uses AWS, I have no idea where their servers go through

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InvestingDoc

@InvestingDoc

11 months

My 9am new patient just fired me bc we refused to see him right when he walked in and requested that he call and get his insurance info. He: showed up late lost his wallet lost his insurance info refused to call his wife to get his insurance info Refused to fill out paperwork

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InvestingDoc

@InvestingDoc

2 months

To think I built it with no loans, no debt, and it's amazing to have a business where we can help 118 peoples lives in one day. I'm so excited to keep growing, at an even faster rate in the future with our new branding and website coming next month.

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InvestingDoc

@InvestingDoc

7 years

After 2 months of working straight, a day off feels so good. I'm so glad the rain stopped so we could enjoy dinner outside on the patio. I wont be signing up for that many shifts in a row in a very long time...if ever... But it feels good to have paid off my med student loans:)

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InvestingDoc

@InvestingDoc

1 year

@healthcareandy Hospitals want to divert attention from their massive payments

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InvestingDoc

@InvestingDoc

5 months

A patient just told me that the private equity backed urology group in town has started up a cash pay compound Ozempic service through their urology practice. Wild to see

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InvestingDoc

@InvestingDoc

5 months

@B_Madden4 Last year they were wonderful to deal with, this year they are a nightmare. Can't get any answers, deny tons of legit claims. We stopped taking them last month due to so many issues with them. Glad they are making money though lol.

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InvestingDoc

@InvestingDoc

6 days

I got notified that our billboard went up today. New website for my business goes live Sunday. New booking platform goes live next Friday to make self-booking easier.

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InvestingDoc

@InvestingDoc

1 year

@doctorORbust Kikuchi disease, it was a crazy case. I freaked her out prepping her for a possible cancer diagnosis. She was very relieved to find out it was not cancer when the path came back

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InvestingDoc

@InvestingDoc

11 months

3 job offers we put out in the past week for new docs to join us in my practice. All great candidates that I would be happy to work along side with. 2 to start ASAP. The other one to start start 3rd quarter after graduation 2024.

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InvestingDoc

@InvestingDoc

6 years

I Hate reviews. One star review from a new pt who needed a referral to surgeon. On the way out asks for Ambien. I pull up prescription monitoring. 195 Norco pills, 60 vallium pills, and 20 Librium pills filled this month Called him out, no meds given, he left one star review

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InvestingDoc

@InvestingDoc

11 months

Always audit your medical practice. 6 employees work for us from home. 5 are great working full 8 hour days. One of them is averaging 3 hours a day logged into their computer. Several days, they didn't even log in once.

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InvestingDoc

@InvestingDoc

7 years

I'm all about the side hustle in medicine but this might be a bit much!

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InvestingDoc

@InvestingDoc

1 year

@blondemedSJW So if I am having a bad day and have the flu, you're saying that gives the the right to tell my wife fuck you? That certainly is a take that Chris Brown would approve

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InvestingDoc

@InvestingDoc

9 months

We spent $240k on growth this month prepping to open two new clinics. Wild to think that 5 years ago I was worried about spending 4k a month on rent for my office.

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InvestingDoc

@InvestingDoc

2 months

@NNkinsi Sounds about right. Our competition in the area we just expanded to has 5 docs, 4 are not taking new pts and the one who is...first available is 4 months from now

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InvestingDoc

@InvestingDoc

7 months

Growing a practice. How to reach 300% growth goal in one year? 1. Open new locations 2. Work your butt off, seeing 20+ pts a day 3. Work late doing admin work For those of you who have emailed me for consulting work, I'll be back at it soon. Right now have to focus on growth.

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InvestingDoc

@InvestingDoc

3 months

@drmoneymatters The NPs I used to supervise left my group and used this group to find a supervising physician. They told me they are paying some psychiatrist in Dallas $400 a month to be the medical director of their primary care practice and that's it. $400 a month....that's it

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InvestingDoc

@InvestingDoc

5 months

@jareddashevsky One Medical unless amazon keeps dumping money into it. We have been getting so many patients from them because they have so much turn over in providers in their offices.

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InvestingDoc

@InvestingDoc

3 months

@HealthcareREguy I wanna see what $950 a foot gets you. We spend $550 and it's a grade a amazing new build in Austin TX (not a cheap place)

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InvestingDoc

@InvestingDoc

4 months

Seeing a patient today who called in last year to tell us that they are terminating care with our office because we "suck" Here today begging to come back bc other offices were "so much worse than ours" Haha I guess thats a complement.

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InvestingDoc

@InvestingDoc

1 year

@blondemedSJW Here is a good example that you can have a confident option and be wrong at the same time. Anyone verbally abused me or my staff, that's an automatic termination.

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InvestingDoc

@InvestingDoc

2 months

@doclauravater Are you seriously asking why mandatory wellness modules for residents and fellows in training are hated? Lol tell me you sold your soul to corporate medicine without saying it out loud.

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InvestingDoc

@InvestingDoc

2 months

@Kev_In_Med I feel like a boomer. When I was in med school we literally couldn't pass our OBGYN rotation until we caught 5 births that were signed off by an attending.

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InvestingDoc

@InvestingDoc

7 years

Great article by a doctor who overcame several obstacles including a divorce via @TexasMonthly

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InvestingDoc

@InvestingDoc

3 months

Does anyone else feel like 98% of the time, SNRIs just don't work for chronic fatigue or any time of pain syndromes? My success rate is insanely low with any SNRI for anxiety/depression/pain/etc.

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InvestingDoc

@InvestingDoc

6 months

Anyone else think it's sketchy that you can't view disclosures of conflict of interest for any board members or leads of the AMA org until AFTER you are a paying member? What's up with that?

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InvestingDoc

@InvestingDoc

4 years

@MVGutierrezMD @BCM_Alumni @bcmhouston @BCM_PMandR @marklewismd @ETSshow Also went to BCM and got the same letter with Mr.

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InvestingDoc

@InvestingDoc

3 months

@michaelcsiah We all started somewhere. I'm not sure publicly shaming an intern who is there to learn is the best public post, but you do you I guess.

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InvestingDoc

@InvestingDoc

7 months

Hardest part of the job. We interviewed a physician assistant who interviewed amazing. First week on the job, it's a disaster. They struggled to see 10 patients total in one week. Best way to say it's not a good fit?

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InvestingDoc

@InvestingDoc

1 month

@dmorris345 I think you are 100% right. I can't remember when I sent a patient to a GI doc here in town and they actually saw the GI doctor for the first visit. The APPs are first line of contact for everything.

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InvestingDoc

@InvestingDoc

7 months

With the change healthcare outage what was offered to us since we cannot submit any claims or get paid? A loan from United healthcare of course with interest.

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InvestingDoc

@InvestingDoc

3 months

For those of you who are reddit fans, I created a new subreddit for those of us in private practice. Come join and consider contributing to the conversation.

r/PrivatePracticeDocs

PrivatePracticsDocs is a place to share knowledge with each other about owning or starting a private practice.

www.reddit.com

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InvestingDoc

@InvestingDoc

1 year

I emailed my lawyer a 112 word email. 4 days later got a 28 word response. This is how doctors should be billing too. #MedTwitter For the record, I am very happy with my lawyer.

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InvestingDoc

@InvestingDoc

10 months

On track to add two new locations to our private practice in the next 4 months. I'm super excited about the growth potential, all done without any loans or outside investment

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InvestingDoc

@InvestingDoc

3 months

@BowTied_MD Younger owns a metal fabrication company, welding company...heavy metal business. Older started an oil and gas company with this friends while working at PWC. They later sold it for 5.4 billion and he retired at 28. He now owns some car dealerships to stay busy.

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InvestingDoc

@InvestingDoc

3 months

I've consulted with probably almost 100 people now who are starting up a clinic or growing their practice. One of the biggest but easiest mistakes to correct that I see is adding this to your website:

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InvestingDoc

@InvestingDoc

11 months

I've been coding my own website, self taught ( python, JavaScript, react) from udemy classes. Problem is I don't have time to make significant progress. Those in healthcare who started a tech based company, did you find a cofounder or just hire out to complete coding the idea?

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InvestingDoc

@InvestingDoc

3 months

There is a society or association group for everything in medicine. AMA... TMA... AAFP... Etc There is no society or association for physicians who own their own practice... Why is that or did I just miss it?

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InvestingDoc

@InvestingDoc

1 year

Am I reading this correctly? In the setting of record inflation Medicare wants to give us yet again another 3% pay cut for 2024?

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InvestingDoc

@InvestingDoc

2 months

My x feed is full of "SMB" people, which post wonderful content. This got me thinking, is there such a thing as SMB healthcare for x?

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InvestingDoc

@InvestingDoc

2 years

@RealEstateRahul How is each oral surgeon brining in almost 4 mil in revenue per year? That's an insanely high number. With 55% overhead like you mentioned, they were making 2 mil per year per doc? Seems suspiciously high

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InvestingDoc

@InvestingDoc

2 months

The best revenge is success. One of my previous pts asked to come back to see me as her doc. I had to politely decline. 3 years ago when we had 1 location and about 5k pts, she told me "everyone's talking about how downhill your practice has gone" Now, 3 locations, 20k pts

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InvestingDoc

@InvestingDoc

6 months

I love all my pts, but when a patient threatens me that we are losing them as a patient if we don't refill their Xanax without any follow up appointment, I think it is not exactly the threat they think it is.

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InvestingDoc

@InvestingDoc

3 months

Day 1 for the new clinic (3rd location) is almost done. We booked 18 for the day, 16 showed. Not bad for first day of our new location. The whole week is almost booked out already :)

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InvestingDoc

@InvestingDoc

3 months

Lots of moving parts. A new website soon 1 New location next week 1 New MD joining next month 1 New PA joining next month Starting the hunt for location number four next month No PE ownership, no loans. Private practice is possible but don't get me wrong. Sacrifices did happen

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InvestingDoc

@InvestingDoc

10 months

I was talking with my older brother this past weekend and realized that now 7 years out of residency and I am making more in a month than I made in an entire year as a resident.

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InvestingDoc

@InvestingDoc

2 months

For those of you who own your own practice. How often do you field complaints about your practice? I wonder if I'm too open to feedback. 5% of my visits, the pt complains about something with my business. 99% of the time it's not my fault. I didn't pick your insurance or RX costs

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InvestingDoc

@InvestingDoc

5 years

@LaurenKuwikMD I should put a MD vanity plate on my wife's 02 Chevy Cobalt that is half gold half rust. #primarycarelife

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InvestingDoc

@InvestingDoc

1 year

@neilsheadpoint Our PAs sit side by with me and I go over every case. Then again, they are seeing essentially our urgent care visits. same day add on for UTIs, flu, covid, stitches removal etc.

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InvestingDoc

@InvestingDoc

4 years

@MVGutierrezMD @JakeEgghead taqueria datapoint for life

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InvestingDoc

@InvestingDoc

5 months

Patients with any online ADHD group switching to our in office primary care. Almost 14% of these pts at our clinic who had virtual ADHD NP, on initial intake fail urine drug screen. Wild. Less than 1% for pts who come from brick and mortar providers fail their uds in our clinic

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InvestingDoc

@InvestingDoc

3 months

In the process of forming an IPA (Independent Provider’s Association) for my area since we don't have one. Has anyone gone down this road before that I can chat with? I have my lawyer, but I'm looking to connect with other doctors who have formed an IPA before.

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InvestingDoc

@InvestingDoc

2 months

I'm visiting New Jersey with my wife since she's from central NJ and having to wait for an attendant to come out and pump my gas feels antiquated like going to a doctor's office and filling out all your history and meds on a paper intake form.

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InvestingDoc

@InvestingDoc

6 months

Just learned that the primary care practice near me that went from zero locations to six locations in 3 months got 95 million for their series a. It will be interesting to see what happens with that group.

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InvestingDoc

@InvestingDoc

5 months

Clue number one that your patient has a lot of money and health anxiety. During today's visit he told me he bought his own ultrasound machine off eBay to check his lymph nodes in his neck. Despite seeing 3 ENTs and 3 scans from radiology saying everything is normal.

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