From: "John Brady, MD" <drbrady@thevillagedoctor

From: "John Brady, MD" <drbrady@thevillagedoctor.hrcoxmail.com>
Sender: Practiceimprovement1@yahoogroups.com
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Date: Tue, 4 Oct 2005 19:21:26 -0400
Subject: RE: [Practiceimprovement1] selling new doctors on this
Reply-To: Practiceimprovement1@yahoogroups.com

I agree we need to sell this financially as well. I am currently taking a salary of 112,000 as I continue to pay off loans. However, after the loans are paid in full, and the practice grows a bit more, I hope to make between 150,000-160,000 a year seeing 15-18 patients a day. The issue for residents to understand is that although they want to make the big bucks once they come out, they may never be in a better financial spot to try this than coming out of residency. The reality is that once you have decided that seeing 40 patients a day is not sustainable, you have already bought a bigger house, had children, and have a new car. It is one thing to have loans hanging over your head but be used to living off $35,000-40,000 a year. It is entirely different to be loan free but then drop from a salary of 150,000 to a salary of 100,000 (or less). Interestingly, I guess this goes back to the idea of delayed gratification. Perhaps we should at least warn the residents if they accept a wonderful position with the local hospital owned group to keep living modestly and save as much as possible so if and when they decide to make the leap, it won’t hurt as bad financially.

John

-----Original Message-----
From: Practiceimprovement1@yahoogroups.com [mailto:Practiceimprovement1@yahoogroups.com] On Behalf Of David Brock DO
Sent: Tuesday, October 04, 2005 12:17 PM
To: Practiceimprovement1@yahoogroups.com
Subject: [Practiceimprovement1] selling new doctors on this

A few members here have mentioned recently that they have recently or will soon discuss the “Ideal Practice” concept with residents. Since I’m only 18 months out of residency I can tell you what I would have needed to hear at graduation time to “sell” me on these new ideas. Yes, the idea of being happier & having a less hectic professional life is very enticing. However, residents will also want to know if that happiness & serenity can be found while still making at least close to what an average family practitioner currently makes (~$150,000 per recent MGMA survey I believe). New residents won’t want to hear that, on the hand you can be much happier & provide better care to your patients, but oh by the way you have to accept that you may only make $60,000/year. Most residents graduate these days with at least $125,000 in student loans, many have a lot more than that. So, I realize that throwing actual salary numbers around on the list may be sort of taboo, but those are the things new doctors want to know before they choose a practice style & setting. The key question: is it possible to see significantly less than the average of ~ 25 pts/day, work less than the average of ~58hrs/wk, spend more time with each pt, run a leaner low overhead practice (with very little staff) AND still make anywhere close to $150,000/year? Or, do you just have to accept that the trade-off of having an “Ideal Practice” is that you will make somewhat less than you could in a traditional high volume/high overhead practice?

David

Sender: Practiceimprovement1@yahoogroups.com
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Date: Tue, 4 Oct 2005 18:24:57 -0700 (PDT)
Subject: Re: [Practiceimprovement1] selling new doctors on this
Reply-To: Practiceimprovement1@yahoogroups.com

David:

My goal is 80-120% of MGMA. I think with time I will get close. Also, I have to add in the professional perks not given in my former practice as follows: disability and life insurance, salary deduction and corporate match to $41000 individual 401K, home office with high speed internet to connect to office for benefit of corporation, health reimbursement account family medical and dental coverage 100% pretax dollars, high dollar deductible heath insurance kicks in at $20,000 cost $1200, flexible schedule, more time with patients, more time with family, no more student loans (forgiven on recruitment), and professional autonomy and business autonomy to sink or swim on my own. This sure beats 20-30 patients a day, call every 6th night, every 6th week in the hospital rounding on 14-26 patients. We are collecting about $100/per patient visit without significant ancillary income from laboratory. we are 15 months away from goal of self sustaining low overhead practice. We are paying the bills and a sustaining income, but we would like to see more consistently 60 patients a week instead of 25 to 45.

Kevin