How to Avoid the Pitfalls of Choosing a Practice Sigsbee W. Duck, M.D.
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Transcript of How to Avoid the Pitfalls of Choosing a Practice Sigsbee W. Duck, M.D.
Location, Location, Location…
Political trends specific to distinct geographical locations
Population Subset:
What types of patients do you want to see?
Average age of population at desired location?
What percent Medicare, Medicaid, uninsured, and third party payors?
Numbers, numbers, numbers…
Number of patients
Have to see more to maintain income
Defining Different “Types” of Practices
Practice Types
Solo
Multispecialty
Established Group practice
Hospital employee
Academics
Military
Practice Politics
Who is running the practice?
What is the hierarchy?Who is your boss?
Office managerCEOClinic DirectorEtc.
Who is getting the higher income…and why?
Who does the coding?Are you involved?
Benefits and ExpectationsWhat are the benefits and/or expectations of each scenario?
Salary and payment schedule?
What equipment do they have?Go look and know
What equipment will they purchase for you? When?Who chooses said equipment? Does it matter to you if they own equipment?
It should not come out of your overheadIf in a group practice: what is the buy in and how is it structured?
Guaranteed salary with or without payback?
Overhead:How much and why in both primary and secondary clinics?
Buy-ins and buy-outsWhat does your buy-in encompass?, i.e. surgery center, CT Scanner, Lab?Is the buy out capitalized?
Benefits and ExpectationsContinued…
Benefits:Time off
CME
Reimbursement for meetings and expenses
Tail coverage
Disability
Type
Policy owner
Beneficiary
Separate policy for stop-gap coverage
Paid with pre-tax versus post-tax dollars
RequirementsDays worked
Know your hours and days
Week-hours required
Practice mandated meeting requirements
Satellite clinics
Call Requirements
Pass the Boards…
The patient always comes first
What are my responsibilities?Productivity requirements?Who reviews your work?
Contract Specifics
Contract length
What happens after contract expires?Automatic contract renewalCan I become an employee and not a partner?
Get an attorney!Preferably a local attorney so he or she knows the particular state law ramifications
GET IT IN WRITING!
Non-Compete
Slow down plan or are you just put out to pasture…