Family Practice–Hours & Volume

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  • #93060
    theweebeetheweebee
    Participant

    Hello Everyone,

    I’m curious to know:

    1. How many hours a week do you see patients
    2. How many hours a week total in the office (patients plus paperwork, phone calls, etc–when do you get in and when do you go home)
    3. How many patients do you see a day
    4. Is your office in the red or black
    5. Do you moonlight or have a second job

    I work like a dog from 9 to 7 (no breaks–I feel guilty if I go to the bathroom), seeing only 19-22 patients a day (mix of Level 3, 4, preventive visits, a few procedures), and not quite covering my overhead and paltry salary (much much less than the national average for FP’s). My colleagues see 25-28 per day and covering their overhead and much higher salaries. I’m trying to figure out what I’m doing wrong, and how be more efficient so I can see more patients. Am three years out of residency (always tended to be poky–I let patients have the time they need, I don’t cut them off if they have an “Oh by the way”–I address all their issues at that visit. I’ve had too many get mad when I tried to put it off to another visit, and I’m too new and it’s too competetive here to anger any patient. At least I then tend to have more level 4 visits than average, but then I tend to run behind), and am nine months into my current position (took over for a retired doc). Any advice?

    #93062
    TayoTayo
    Participant

    Are your contracts different. Where they might have a higher return rate?

    Do you know if your getting a nice portion of your money every month?

    These are a couple of the reasons why you might not see the money your working for like you should. Have them pull your Accounts Recievable report should be a simple printing take it home basically your looking for how many of your accounts are over 90days and still open. This might help. Then sometimes if you have change your contract in a while with insurance companies your getting a lower rate? Sometimes you might have to many patient of a certain insurance that pays slow and you need a few more in with other carriers. With the new Hippa rules you might start seeing more anyway if you file electronic because most claims that are will be filed that way will mostly be paid in at least 30days. So, take a look and some of those things.
    Thats my 2cents.

    #93064
    maggie52maggie52
    Participant

    weebee: so does this mean you are self-employed, but use the hospital/ other entity to do your billing? SOunds like a cop-out, but being employed makes you more money, a guaranteed paycheck and often a bonus…sounds like you code pretty well…but if you are that thorough then maybe a couple of level 5’s thrown in wouldn’t hurt…procedures,procedures ( I do EGD and colons $$$$ so my #’s always look fabulous even though a scope is over in 20 minutes!)Buy some liquid nitrogen and starting burning everything in sight! Injection are biggies (esp multiple trigger points.)

    Employed…
    office officially 8-5 (but really 730-600) see 25-35 people if doing walkins; 18 if scheduled…
    DO just hospitalist stuff one week of each month..
    Used to moonlight 75$/hr but not here…

    DO you have a mentor locally? He/she could enlighten you on the local scene and help you out.

    #93065
    theweebeetheweebee
    Participant

    I’d be curious to know from Dr.Heidi, and anyone else, how exactly you get paid by RVU’s. My colleagues at the office used to deliver, but found it was taking 65% of their time for 5% of their revenue, so they stopped.

    Although I get a salary, they still keep track of my charges and receipts, as well as expenses. Once I am a partner, I get paid by whatever is left of my receipts after my overhead (like any other private practice). At the rate I’m going, I’d be getting about $3000/month, before taxes. I think we have one more nurse than we need, and at least 1 and 1/2 too many front office staff, but the two docs who’s practice it is won’t hear of cutting any staff back (but then complain about our overhead).

    I worry too because not only can I not seem to handle more than 22 patients/day, many days I don’t even have 22 patients booked. I don’t understand it–I replaced a doc who was seeing 26-32 patients per day–I don’t know where all those patients went! Some left the practice, some switched to the other docs in the practice, but not that many. I’ve been there 10 months already, and my numbers aren’t picking up.

    Any suggestions on these issues?

    #93067
    maggie52maggie52
    Participant

    Each employer has a formula ( if they use RVU)…so if I create 5000 RVU ( sort of an average in US) they assign $30.00 per RVUnit. WE had such a wide disparity in people’s production , the formula i worked on required giving people a base ( let’s say 50,000) and then assigning a much lower dollar value per RVU.
    Too few pt’s? Hmmm..strange…a female should’ve attracted quite a crowd if you were marketed correctly….did they put an article or ad in the paper? Could you take some walk-ins? Take spillover from the other busier guys? Is there a manager you coudl speak with to see where the #s are failing?
    Glad your income went up when you went production!

    #93068
    FPmommyto2FPmommyto2
    Participant

    Hi there – I’m new here 🙂

    I’m 3 years out of residency, and work 3 full days, 2 half days per week. I usually get to the office at 8:45 and leave between 5:30 and 7. Patients are scheduled 9-12 and 2-2:40. I usually see about 18 per day. I’d hate it if I had to see more. I go earlier if I have to round, but that involves lots of daycare and hubby juggling.

    I’m totally self-employed. We have 4 docs in the office, and we pay overhead together – based on percentage of billing. So, if I bill 20% of the office’s charges this month, I’ll pay 20% of this month’s overhead.

    We’re definitely in the black, though not every month. I think we’re staffed way below national average We have 9 FTE’s for 4 docs. We don’t have an office manager and do all the personnel stuff ourselves.

    I think our billing is pretty efficient – our biller is like a bulldog and stays on top of everything. I’ve heard lots of stories like yours from my “employed” friends…

    Overall, however, my income is cruddy. Seeing more patient would help some, but its HMO land and seeing more HMO patients only costs me money. Our area is reimbursed at medicare’s rural rates, though I live in the area with something like the 6th highest cost of living in the country.

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