He means "George Russell, M.D." --- Rockwell was the painter; Russell was the doctor he used as his subject.
Posted on 02/24/2007 7:27:27 AM PST by shrinkermd
Primary-care doctors -- family physicians, general practitioners, pediatricians and obstetricians -- address patients' health comprehensively and usually over a long period of time, aiming to catch problems early on. Their numbers have dropped by half in the past decade, according to a series of surveys by the American Academy of Family Physicians.
...So in early 2001, Dr. Moore took a risky step. He borrowed about $15,000 to start a solo medical practice in a tiny space with no nurse, receptionist or waiting room. He bought computer software to help him track patients' appointments, illnesses and medications, and to process insurance claims.
Patients at his "micropractice" can call or email to get appointments the same day. Visits last 30 minutes. Dr. Moore can be reached day or night on his cellphone. To refill a prescription, he walks "zero feet," he says, and taps a few keys on his laptop. "I was able to build a Norman Rockwell practice with a 21st-century information-technology backbone," he says.
Dr. Moore belongs to a small but growing number of physicians converting to high-tech, low-overhead practices to try to preserve a disappearing style of care often provided by lone family doctors. They are working to counter a sustained decline in primary-care medicine, long the mainstay of the U.S. health system.
(Excerpt) Read more at online.wsj.com ...
He means "George Russell, M.D." --- Rockwell was the painter; Russell was the doctor he used as his subject.
Rockwell has become a synonym for an idyllic, "all american", mom and apple pie kind of life. And people who use the analogy, don't snicker as if it never existed. What's left of it is disappearing fast.
Sorry, but the GPs are doomed by the preposterously bad Medicare/Medicaid reimbursements, out-of-control shakedown payments to the shyster racket (oops I meant liabilty insurance premiums to the distinguished John Edwards wing of the democrat party), and the nurse practitioner industry.
Figure 2000 billable hours, plus other charges he can add (like prescription or if the visit is less than 30 minutes he can squeeze in more patients).
What do you imagine the overhead is on those 4000 visits?
And how many non-billable hours do you imagine each billable hour requires?
Society has decided, acting through its government, to break the doctors.
The pediatricians and family doctors, being as a class somewhat naive and trusting, are being broken first.
Meanwhile, we cannot produce plastic surgeons fast enough to meet the demand for boob jobs.
The only satisfaction I take in this is that the People are finally getting what they want.
Hope they're happy.
How does he deal with all the insurance paperwork?
The doctor does it or outsources the insurance work by computer.
I am going to the same GP who saw me as a baby 50 years ago. He has 1 nurse to assist in the office. No appointments, just walk in... first come - first serve.
He will not deal with insurance, period. He dosen't want the hassle. You pay your bill and he gives a reciept that you can submit for reimbersment.
He says he will stay in practice until he dies. I dread when that happens.
I can tell you from personal experience that the overhead not including employees will run about $10,000 a month if you watch your pennies and lease used equipment. If you want a nice space, new equipment and good software, the overhead would be close to that $200,000/yr figure. If you worked 60 hrs per week, you could make a little money.
For a standard clinic with staff, billing support, transcription overhead is over $500,000. If you are employed with a profit sharing plan, the usual figure for breakeven is given at about $1,000.000 per year.
That'll just about coverage his malpractice premiums.
There's good news and bad news. When I turned 60 last fall I picked-up TRICARE for retired military reservists. My monthly medical insurance premium went from $600 (I'm self-employed) to $19. That's the good news. In going TRICARE I had to switch to a new primary care physician. I had my first annual physical under TRICARE last month. Excluding taking blood and urine for the lab, my entire physical lasted eight minutes, during six of which the doctor read lab results from his PC. That's the bad news.
ping
If it's not too much trouble could someone email me this article as I don't get the WSJ...
He doesn't have any of that overhead. He is just one person in an office. No receptionist, etc.
From the article.
I know, all too well, that no self-employed person works only 2000 hours per year.
But I am assuming that he can bill 2000 hours, and figure another 500-1000 hours a year for typing stuff into the computer. That equates to a 60-hour work week, which is typical for doctors, lawyers who are partner or partner-track, and other self-employed folks.
I laud this as it is a start back to normalcy in medicine.
His overhead without the employees is going to be between 120,000 and 200,000.
Just transcription is going to be about 15,000. Rent is going tobe about 30,000-100,000. Office management software will be about 20,000. Basic X-ray will be about 30,000. Malpractice varies but for a basic FP about 10,000. Medical offices usually use special garbage collection for the red bags. Janitorial service. General liability/business insurance. Phones, lights, water. Upkeep of equipment. Maintaining basic medical and office supplies. Security system.
"Just a person in an office" does not mean no overhead.
When I was in private practice I cleared less than ten cents on the billed dollar. Things are worse now and I can see how this could be a survival strategy for a few motivated docs, but they will work their tails off for a very modest income.
I left private practice ten years ago. I was briefly tempted to return last year until I crunched the numbers.
Nope. I see 32 patients daily, take call at the hospital,have hospital patients and Nursing home patients and do OB and I do not clear anywhere near 200,000 a year. The reason. The LOW pay by Medicare and Medicaid and those who walk out of the office and never pay or even stop to turn in their charge sheet.
he has a tiny space, say $1000 per month including phone and Internet access; plus $100/month for his cell phone.
General liability is about $350 per year; an unknown amount of malpractice is on top of that.
So his cost before malpractice insurance is say $15K . He doesn't run his own pharmacy, will be doing his own transcription, and presumably his own bills.
The article claims that all his startup costs including software to run his practice is $15K. It seems he will be collecting payment at time of service and will not be working for Medicare/Medicaid.
Look at my post above.
Medical equipment is EXPENSIVE. I learned when working in third world countries, I was not trained to take care of patients without the tools of the traid.
Office space is expensive. If the landlord knows you are running a medical practice, your rent will be much more than $1000.
Unless you are running a cash clinic, the software required just to submit the bill is very expensive. If you are lucky, you can find something that you can use that will let you track appointments, labs, dictations, ect. But that kind of software is by lease only. They will customize the software to your needs but that is very expensive. Ten years ago, the software we used cost us about $20,000 per year per office and that was a discount price.
After you have managed to turn a profit, you still have self employment taxes and benefit expenses that are just painful.
Most people are not aware of the cost to do business, all business, not just medical. A business is a labor of love, most people could do better working for someone else. And that is just how the government wants it.
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