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How to Avoid the Pitfalls of Choosing a Practice

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?

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How to Avoid the Pitfalls of Choosing a Practice

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  1. How to Avoid the Pitfalls of Choosing a Practice Sigsbee W. Duck, M.D.

  2. 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

  3. Defining Different “Types” of Practices • Practice Types • Solo • Multispecialty • Established Group practice • Hospital employee • Academics • Military

  4. Practice Politics • Who is running the practice? • What is the hierarchy? • Who is your boss? • Office manager • CEO • Clinic Director • Etc. • Who is getting the higher income…and why? • Who does the coding? • Are you involved?

  5. Benefits and Expectations • What 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 overhead • If 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-outs • What does your buy-in encompass?, i.e. surgery center, CT Scanner, Lab? • Is the buy out capitalized?

  6. 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

  7. Requirements • Days 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?

  8. Contract Specifics • Contract length • What happens after contract expires? • Automatic contract renewal • Can 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…

  9. The Fear of the Unknown • Healthcare reform… • How will new changes affect you? Your practice?

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