Practice Management
How to start your own cash-pay medical practice
You wish to spend more time with patients while giving high-quality care. You’re tired of dealing with health plans’ red tape. Maybe a colleague boasted that he could charge $300 to $400 per consult out of pocket. To which you say, “You know what, I can do that too!” We don’t blame you. However, when starting our cash-pay clinic, we juggled several elements during the transition. We distilled that planning …
Physicians have a blind spot that makes them prone to fraud charges
Unlike almost every other industrialized nation on Earth, independent American physicians running their own clinics must all be entrepreneurs. Unlike all other businesses, however, there are special rules related to the business side of U.S. medical practice. These are exemplified by the Stark laws. Aptly named, these strict provisions forbid doctors from engaging in what is called physician self-referral.
Doctors are required to avoid referring patients to entities in which they …
Innovation doesn’t have to be flashy to make a big impact
Labor shortages have become a pressing concern across the health care sector, with the nurse staffing crisis looming large over hospitals and health systems nationwide.
A report from the Massachusetts Health Policy Commission illuminated the severity of the workforce challenges, revealing a doubling of vacancy rates for registered nurses in the state’s hospitals from 2019 to 2022. Despite concerted efforts, the problem persists, with health systems still resorting to costly pandemic …
The tiniest ray of hope for reasonable physician compensation?
When you have been reviewing physician employment agreements for nearly four decades, you tend to get a little jaded about the possibility of ever seeing reasonable compensation for physicians. Although I am continually preaching to the choir about the need for reasonable physician compensation, I rarely see something that gives me encouragement that physicians may someday be paid appropriately for everything they do.
However, recently I have reviewed several agreements titled …
Integrating clinical expertise with business acumen for private practice success
I often find that many doctors come to me with doubts and are grappling with the idea that they don’t know how to manage the business aspects of their private practice. However, in working with them, most come to the realization that the truth is that the skills required to run a successful medical practice are not as foreign as they may think. In fact, they are deeply rooted in …
Is the health care system broken or designed this way? [PODCAST]
Health care administrators: a call for equal transparency and accountability
While physicians are constantly being asked to prove their value with a growing constellation of metrics, health care administrators seem to have escaped a similarly high degree of transparency and accountability about the value of their specific roles. What I mean is that physicians are certainly not equally informed by objective measures of the performance of their administrators. Given the remarkable growth in the health care administrator to physician ratio …
How to manage employee turnover in your practice [PODCAST]
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Join Amy Vertrees, a general surgeon, as she shares her journey navigating workplace dynamics in the medical field. From identifying early signs of toxicity to fostering open communication and embracing change, Amy provides …
How doctors can use the Augusta Rule to save on taxes
Do you own a home? If so, you have an opportunity to generate tax-free income using the “Augusta Rule.” Named after its original scenario where residents of Augusta, Georgia, rent out their homes during the annual Masters golf tournament, this rule offers a valuable opportunity to earn tax-free income and deductions you don’t have to pay for by renting out your personal residence or vacation home.
Let’s dive into the Augusta …
Legal risks for doctors and compliance solutions [PODCAST]
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In this episode, family physician and author of Burden of Pain: A Physician’s Journey through the Opioid Epidemic, Jay K. Joshi, with his extensive experience defending physicians, illuminates the pressing need for compliance …
The credentialing scavenger hunt: Navigating hospital credentials
If you are a physician planning to move to a new hospital or take a contract job in another state, prepare yourself for the daunting process of credentialing. As a pediatric emergency physician who frequently provides locum coverage, I’m intimately familiar with the cumbersome, repetitive, and costly scavenger hunt that accompanies credentialing at each new hospital. This process must be endured every time, at every hospital, with no sharing of …
How physician groups can beat private equity
As a society, we should all be concerned about the increasing rate at which private equity firms are acquiring physician groups. Over the last decade, private equity firms have invested nearly $1 trillion in approximately 8,000 health care deals, encompassing a wide spectrum of medical services, from fertility clinics to neonatal care, primary care to cardiology, hospices, and everything in between.
The consequence? Health care has shifted towards a profit-driven model …
Healthy hierarchy for patient safety, experience, and staff wellbeing
The hierarchy must be healthy to achieve critical outcomes in patient safety, patient experience, workforce health and wellbeing, and cost-effectiveness.
In a healthy hierarchy, staff must have the right skills, education, and experience to direct and carry out clinical and care-related tasks. Clear lines of communication, roles and responsibilities, policies and protocols, and scope of practice are all important. We can think of such things in terms of the structure. We …
5 strategies for private practice success in 2024
It is not news that private practices are struggling to thrive. Challenges such as decreasing reimbursements, higher cost of service delivery, attracting and retaining great staff, and increasing administrative burden are closing practices daily. While many of these systemic challenges are outside our direct control, there are actions we can take immediately to increase our probability of success.
Adopt the attitude of an entrepreneur. Physicians frequently tell me they run practices, …
How rookie doctors crush their first contract
There are few things in a doctor’s life more exciting and overwhelming at the same time than finding your first job out of training and *gulp* negotiating your first employment contract. For many people, not just doctors, talking about how much money you’ll make can feel incredibly uncomfortable. You might feel overwhelmed or anxious about the process, making you want to sign the first contract that’s put in front of …
Micro-corporations and employment lite contracts [PODCAST]
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We delve into the world of alternative career paths for physicians with Tod Stillson, a seasoned family physician and entrepreneur. Discover how chance encounters can lead to transformative career decisions as we explore …
A proven way to crush burnout and financial loss of your private medical practice
Unfortunately, the widespread financial opinions and advice to private medical practice physicians suffering from inadequate practice income today are dominated by a tsunami of experts outside of the medical profession. This includes the administrators and medical education scholars who are in the perfect position not only to diagnose the core problem but also to correct the core cause. So, why haven’t they done it?
Over the last two decades of increasing …
Dismantling the mythical dichotomy of physician career options
In our journey as physicians, the traditional narrative often presents a seemingly binary decision: you must choose between seeking employment within a hospital or health care institution or venturing into the challenges of establishing a private practice. However, this oversimplified dichotomy fails to capture the evolving landscape of health care entrepreneurship, particularly the emergence of a third, less conventional path – that of the single-member professional micro-corporation.
The myth of the …
Physician autonomy with self-employment [PODCAST]
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Join Tod Stillson, a family physician and entrepreneur, as we explore the often-overlooked world of physician contracts. Discover the hidden menu of business-to-business contracts in the medical industry and learn how transitioning to …
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