From: "brownbears74" <pfhcks@sbcglobal

From: "brownbears74" <pfhcks@sbcglobal.net>
Sender: Practiceimprovement1@yahoogroups.com
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Date: Thu, 07 Jul 2005 16:07:13 -0000
Subject: [Practiceimprovement1] Financial update
Reply-To: Practiceimprovement1@yahoogroups.com

Like most Americans, I guess I live too much month to month and
haven't tallied actual numbers, but things seem to be going well with
the small practice. I, like the peppered moth of England, have tried
to adapt to the current circumstances: I find my small practice (see
anywhere from 3-12/day) the most rewarding, and yet the most
challenging financially at times. I have a part time office assistant
who works very well for probably very little.

My supplement continues to come from a week or weekend of locum
tenens/moonlighting here and there, which is about 1/4-1/2 of my
monthly goal (gross: 11,000).

I also have a nice relationship with a local general surgeon who
*needs* (I'm not sure how much time I really save him) an
assist--averages about 2-3/week. The endearing quality to his office
nurse is that I can usually be very flexible to their time needs--for
me, a surgical assist is good revenue, whereas in a traditional
model--you might not even break even from the interruption in your
clinic schedule. I encourage you all to look into this is a suitable
situation exists.

My overhead runs very low I think, but there are always
fees/memberships, and little things here and there (probably runs
about 50-60k/year).

I don't know exactly where my salary is after taxes: but not too bad.
We recently were able to purchase a new minivan for our burgeoning
family--not something I would have thought possible in the first year
of practice. We are hoping to build on to our home soon as well.

I am currently negotiating with a small community to provide some
weekend coverage and phone backup (to their P.A.'s) in exchange for a
reasonable rate and health/dental--I'm sure just a short term solution
to our health care coverage struggles (reminder: we have a young son
with C.P. who helps us meet our deductible every year--currently on
COBRA), but will be well appreciated and could translate into about
40K plus income/year plus health/dental.

Quality of life: I think I'm getting very spoiled. After many long
initial nights in the office getting policies and procedures straight,
I now seldom devote more than one long night/week for billing/catch
up, and can usually get away during the week anytime necessary. I,
like others, take pride of ownership in the business and don't really
mind extra time here or there--I KNOW I WOULD HATE an under-educated
office manager trying to tell me how to do things better (translation:
pedal faster to churn out more money). I don't think I'd be
completely happy unless I won the lottery and could spend all of my
time at home with my family, but this is the next best thing. My wife
recently got to happily turn down a part time teaching job to continue
to stay at home with our 2 children (can you put a price tag on that?)

I continue to worry about inevitable coding audits--I see more 214's
than 213's with occasional -215's. I feel ethically very justified in
my coding--for crying out loud the CPT system is based on LEVEL OF
SERVICE, and our level of service demands proper (and likely higher)
coding.

We'll see how the future goes: I feel my practice is very "malleable"
at this point. I have closed out to new patients (around 500) now, as
we see how demand continues to be handled (I don't like my delays in
responding to labwork). We continue to trickle in new patients
(family members of existing or as favors to others).