From: Jean Antonucci <jantonucci@fchn.org>
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Date: Mon, 5 Jun 2006 11:39:45 -0400
Subject: [Practiceimprovement1] 1 yr report
Reply-To: Practiceimprovement1@yahoogroups.com

HI  Having a slow monday   so I thought I would post  how I turned out at
one year
Have posted this to the  radical and confident and  optimistic bunch at
Practice Improevement 1 and the  more oppressed-seeming  people at aafp's
pracice management list serv.Neither bunch seems any more wealthy than the
other...

I  have finished 12 months I work entirely by myslef  no staff though I
outsource billing
Two rooms one an office/exam room  andone  an exam room Share watiitng room
and  bath and med refrig/counter space.
I  opened for about $9,000 No loans though I ran up  a Mastercard balance.
Laptop and all  in one and a small  printer for scripts
Open access
no hospital work
MUch  Nursinghome skilled care and some chronic care work
house calls.
good reminder  system(tickler) via the laptop- Constant internet access for
patient  handouts   and instant answers  via  up- to- date and md
consult(get both free through hospital membership staff dues)

for extra income  precept  and reveiw  charts for disability Will be doing
also soon some independent medical examiner work for the same company I
reveiw disability charts for- they  pay  great

Lap top makes reports/registries easy though I am not sure  yet that i USE
the cheap little emr to the best of its  abilitties
It has  taken  using an emr 1 yr to see what things I want it to do and
what it cannot do.

no email with patients  yet or virtual visits  though considering it

practice ordinary standard medical care  nothing much alternative  in a
rural  middle to low income setting heavy on medicare
EVERYONE also has  maine care- medicaid  but to survive I  limit it to about
10% of my practice About 25 % of the state is on it..

On call 24/7- use my homephone and ellphone  Have a collegaue in his pwn
practice who will cover if I really  go AWAY but Have  taken the lap top
with me on long summer weekends and check in twice a day. Painless.

Take medicare  and maine care and indemnity bluecross i have NO  other
affiliations or in -networks  contracts with any insurances. I balance bill.
In this year  2 people have  not paid me as of now That is a few were
written off and then later paid etc.

What everyone wants to know is MONEY.OK!
I began to make  about 60,000 a year from the practice at about 5 mo  Now
for the last 3 months I make 64,000 . From  t hat I pay my health insurance-
have HSA , disability  taxes etc of course.etc. 

My schedule is  about 3/4 full daily . Well today is about half- an
unusually slow day . Have  451 patients . I guess about 400 are active. If
64,000 is 75% then  when the scedhule is full I can expect over 80,000
yearly income . That was my goal(becasue I can live  quite   well on that ,
as I have worked  like a dog and paid off my school loans and I live
nicely but I have cheap habits.Who goes out to eat?? We have few
restauarnts!! etc  I can always supplement  with precepting at the residency
MORE  if I want to give up days off. I work very long hrs  about 11 in the
office  4 dyas a week and i do some   work  at home  so i try NOT to work
too many days a month precepting. But i can and have)

BUT  my  business plan says that at a max of 12 people a day  once the
maine care IS really limited (early on of course medicaid just fills up a
new practice)  with an assumtption of $60.00 rec'd per patient at 4 days a
week   I can earn about 103,000/yr


When I  first posted that I was going to  do this  on aafp  practice
managemnt i got a "Jean! why would you do this??" and  some other  private
" I bet  you can  I crunched the numbers  you will have  lower costs which
will be good for self pay folks"

So  .I am happy . I am hoping I take good care of patients . I have had many
other  jobs in medicine and this is the only thing to do at all ever.
I would Never practice the "old" way agian. And at one yr   I support
myslef  though not fabulously butadequaltey  WITHOUT TAKING INSURANCE
wihtout  doing conciegre  boutigue  alternative  herby   or even osteopathic
manipulations ( I amNOT disrespecting any of these I am describing my
situation)  and it is onely 1 yr and there is only UP to go!
happy to answer any questions
Jean