NPTim Posted September 8, 2017 Share Posted September 8, 2017 So I'm in day four of opening of my practice. Hemorrhaging money like russian aristocracy. im feeling like a Christian scientist with an appendicitis. Yeah, I don't care if someone who reads this is a CS, F. O. 1 Link to comment Share on other sites More sharing options...
holyjohnson Posted September 8, 2017 Share Posted September 8, 2017 22 minutes ago, NPTim said: So I'm in day four of opening of my practice. Hemorrhaging money like russian aristocracy. im feeling like a Christian scientist with an appendicitis. Yeah, I don't care if someone who reads this is a CS, F. O. you got the medical terms down,how hard can the rest really be? give it some time,take a breath a watched pot never boils. 1 Link to comment Share on other sites More sharing options...
NPTim Posted September 8, 2017 Author Share Posted September 8, 2017 Yeah, I told myself this. I read that I should shoot for adding 20-30 patients a month. But just my basic nut needs 50 patients out of the gate. People are polite and complimentary but no one seems to see any value what I am offering. Link to comment Share on other sites More sharing options...
NPTim Posted September 9, 2017 Author Share Posted September 9, 2017 So looking for a new EMR, the one I signed up for and am currently in the 'free trial' phase is a clunker, for me anyway. It's all about the free texting and I'm a 'hunt and pecker' yes I said it that way to give y'all the giggles, you're welcome. Anyway, had two presentations on two EMR's today. All ipad compatible. All use check boxes and templates. One integrates UpToDate when forming your plan based on the diagnosis. Like cough, it'll remind you that most coughs of short duration are viruses and to treat symptomatically, stuff like that, costs $299 per month for 100 visits then .80¢ per visit thereafter for the rest of the month. Then $399 for unlimited. Price is not locked so it could increase. the last one today was good, only it managed marketing and social media as well. No UpToDate intergration, but I already bought a 3 year subscription so, meh. I was warned about this company's by the first one that presented yesterday (more on that later) about price increases, borrowing from venture capitalists, and only video training. I asked about these specifically as those are deal breakers. The guy assured me it was live person training and the price, $225/ month was locked for as long as I'm with them, as are any non physician I bring on. If I bring on a physician, they double the price. This doubling of the price burns my ass a little. Almost universally, if MD or DO is after their name, they get soaked. It's like permission to steal.it irritates me, but not enough to pass up a deal. I like that I can send the patient's entire medical record electronically if the recipient has the same certification, and most EMRs do. It also works both ways. I like this. They all beat the **** out of the free writing EMR. I'm going to drop them. 1 Link to comment Share on other sites More sharing options...
Tahmail Posted September 12, 2017 Share Posted September 12, 2017 How are you promoting the practice? Link to comment Share on other sites More sharing options...
Tahmail Posted September 12, 2017 Share Posted September 12, 2017 On 9/8/2017 at 8:18 PM, NPTim said: People are polite and complimentary but no one seems to see any value what I am offering. Any referrals? What kind of practice? Link to comment Share on other sites More sharing options...
NPTim Posted September 12, 2017 Author Share Posted September 12, 2017 No referrals yet. Primary care, cash practice. No insurance accepted. Link to comment Share on other sites More sharing options...
Tahmail Posted September 13, 2017 Share Posted September 13, 2017 This will improve business 1 Link to comment Share on other sites More sharing options...
Tahmail Posted September 13, 2017 Share Posted September 13, 2017 13 hours ago, NPTim said: No referrals yet. Primary care, cash practice. No insurance accepted. Won't that be limiting since healthcare is required? 1 Link to comment Share on other sites More sharing options...
holyjohnson Posted September 14, 2017 Share Posted September 14, 2017 (edited) topless nurses on duty? BOGO swabing just brainstorming here. Edited September 14, 2017 by holyjohnson 1 Link to comment Share on other sites More sharing options...
NPTim Posted September 14, 2017 Author Share Posted September 14, 2017 On 9/12/2017 at 9:32 PM, Tahmail said: Won't that be limiting since healthcare is required? Limiting maybe, but more freeing. My niche is filling the void left by huge deductibles. Insurance now, with the exception of being horribly over priced, is just as it should be, the way it used to be. Insurance should be for hospitalization, not routine maintenance. im the routine maintenance. For $150/month, cheaper for volume or whole year, you get to be seen, as often as you NEED to be seen with no deductible or co-pay. Plus access to me 24/7/365, I answer the phone, text, emails, not someone else. No more 5-15 minute appointments, 30-60 minutes appointments. Plus, if you are admitted to the hospital within a 26 mile limit, I come visit you as 'a friend with medical knowledge' . Link to comment Share on other sites More sharing options...
NPTim Posted September 21, 2017 Author Share Posted September 21, 2017 Day 21, still no patients. Maybe I should open as a pain clinic. No, **** no! ! The headache is just not worth the money. I would fill up quickly I bet. But still, no way. Still, it would get the cash flowing quicker. I wonder if it could be done without having to deal with insurance? Link to comment Share on other sites More sharing options...
NPTim Posted September 23, 2017 Author Share Posted September 23, 2017 New website. bestcaredpc.com keep in mind I’m new to making a website and it will get better over time, but it’s a start. Link to comment Share on other sites More sharing options...
tadbart Posted September 25, 2017 Share Posted September 25, 2017 Tim, you might not be far off on the pain clinic thing, at least to get the cash flow going. Dude, I dug ditches and carried concrete blocks to pay for EMT school. Maybe something distasteful now, with inflowing cash, will lead to getting everything set up. Concierge medicine is a niche. Whether it's soccer moms or pillbillies doesn't really matter. I think? 1 Link to comment Share on other sites More sharing options...
NPTim Posted October 1, 2017 Author Share Posted October 1, 2017 Further adventures in opening a new practice. I just dissolved my association with the chiro. This was a $5000 lesson, that sucked hard. The potential new place is 2 miles from home instead of 18, so I can literally walk to work. First floor office/cave. There is a chiro in the suite and he has a decent personality. We spoke for a bit after I looked at the place. Less than half the rent I’m paying now. When I wrote to the chiro I’m presently associated with, he offered to cut the rent in half, no soap. The kid has the personality of Sheldon cooper from Big Bang theory, kind of looks like him as well actually. He is not happy, but neither am I at present. I drove a couple of blocks north on Main Street in Mesa, and 12 or so west and there seemed to be a 75% vacancy rate along the route and I started to worry and feel I had made a huge mistake to venture into Mesa. this will cost me $1000 stupid tax. I will recover from it, but **** I could use the money. Link to comment Share on other sites More sharing options...
NPTim Posted October 1, 2017 Author Share Posted October 1, 2017 On 9/24/2017 at 10:56 PM, tadbart said: Tim, you might not be far off on the pain clinic thing, at least to get the cash flow going. Dude, I dug ditches and carried concrete blocks to pay for EMT school. Maybe something distasteful now, with inflowing cash, will lead to getting everything set up. Concierge medicine is a niche. Whether it's soccer moms or pillbillies doesn't really matter. I think? Yeah, no. You’ll see. It’s not worth the hassle and it will only get worse through regulation. I will consider working corrections again though. I didn’t think I would ever get that desperate, I’m nearly there though. i thought about getting out on a street corner or freeway on ramp with a sign, ‘ Will diagnose for rent’ with my lab coat and stethoscope on. That ought to get the news crews out. Not something one sees everyday. Hey free advertising, at the price of dignity though. Maybe not. Link to comment Share on other sites More sharing options...
tadbart Posted October 2, 2017 Share Posted October 2, 2017 I recently saw a job posting for an NP at Federal Pen Florence, Colorado. Pay was a dismal 85k, and Florence is out in the sticks. Not encouraging, for sure. Tough out these bad times, amigo. It'll turn around. 1 Link to comment Share on other sites More sharing options...
NPTim Posted October 8, 2017 Author Share Posted October 8, 2017 So I found a new space to set up shop. It has a lot of benefits. But one of the drawbacks is the lease. Now leases are usually one sided, I get this and so does my lawyer. But this is ridiculous. I have to take out insurance and name them as primary beneficiary of the policy. i am responsible for rent if the place should suffer total loss. So it burns down in the first month, I still have to pay them rent for the remaining 11 months. They have dozens of clauses that say they are responsible for nothing. They can terminate for any reason or no reason while I can not. I am responsible for their legal fees if say I get robbed and call them in as witness. my lawyer is advising me to not sign it. That is what I am paying her for, so I better listen. Shame too. I really liked the space. Well, it’s in God’s hands now. If it was meant to be it will happen. Link to comment Share on other sites More sharing options...
janice6 Posted October 8, 2017 Share Posted October 8, 2017 Hang in there. As was once said: "No pressure, no Diamonds". If success were easy no one would see the need for it. “Many of life’s failures are men who did not realize how close they were to success when they gave up.”- THOMAS EDISON "Success requires a persistent misreading of the odds." -Tom Peters “Don't try to be different. Just be good. To be good is different enough.” Arthur Freed “Life doesn't require that we be the best, only that we try our best.” H. Jackson Brown, Jr. “The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. But no price is too high to pay for the privilege of owning yourself.” Friedrich Nietzsche “Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time.” Thomas A. Edison “The worst thing one can do is not to try, to be aware of what one wants and not give in to it, to spend years in silent hurt wondering if something could have materialized - never knowing.” Jim Rohn 2 Link to comment Share on other sites More sharing options...
holyjohnson Posted October 8, 2017 Share Posted October 8, 2017 2 hours ago, NPTim said: So I found a new space to set up shop. It has a lot of benefits. But one of the drawbacks is the lease. Now leases are usually one sided, I get this and so does my lawyer. But this is ridiculous. I have to take out insurance and name them as primary beneficiary of the policy. i am responsible for rent if the place should suffer total loss. So it burns down in the first month, I still have to pay them rent for the remaining 11 months. They have dozens of clauses that say they are responsible for nothing. They can terminate for any reason or no reason while I can not. I am responsible for their legal fees if say I get robbed and call them in as witness. my lawyer is advising me to not sign it. That is what I am paying her for, so I better listen. Shame too. I really liked the space. Well, it’s in God’s hands now. If it was meant to be it will happen. yeah,no that`s sounds like a terrible lease. i`m betting you`rent is his Mortgage payment as well,sounds like a terrible landlord to try to deal with. you`ll get there. 1 1 Link to comment Share on other sites More sharing options...
NPTim Posted October 9, 2017 Author Share Posted October 9, 2017 18 hours ago, holyjohnson said: yeah,no that`s sounds like a terrible lease. i`m betting you`rent is his Mortgage payment as well,sounds like a terrible landlord to try to deal with. you`ll get there. I fully understand that leases tip in favor of the landlord for their protection, but most of this is just crazy. it seems that all my options are with “alternative medicine” practitioners. i just got off the phone with another chiro/naturopath. Reasonable rent and has a sink in the room. A rarity apparently. oh if only I did psych. I wouldn’t need a sink and I’d be in business. 2 Link to comment Share on other sites More sharing options...
holyjohnson Posted October 10, 2017 Share Posted October 10, 2017 sink?!? what next a coffee maker? new Aquarium for the leeches? you wipe you`r hands on you`r pants like the rest of us! seriously i`ve gone through a few leases and have seen crazy stuff. most times they put that stuff in because they are not a good landlord,not because it has anything to do with the leasees that came before. 1 Link to comment Share on other sites More sharing options...
NPTim Posted October 10, 2017 Author Share Posted October 10, 2017 Great news! I made major changes to the lease and submitted it for approval and they APPROVED them all! I’m very relieved. Link to comment Share on other sites More sharing options...
NPTim Posted October 11, 2017 Author Share Posted October 11, 2017 So, the movers had to reschedule. This may work out very well. My lawyer is working on the new lease and if she can get it to me by Thursday I can save $175 and move directly into the new office. In my mind this is a sign from God that I am on the right path. Link to comment Share on other sites More sharing options...
NPTim Posted October 24, 2017 Author Share Posted October 24, 2017 So, I moved into my new office. I really like it. im sitting in my office, minding my own business. This dizzy dame pokes her nose in and asks what I’m about. I tell her, and she tells me I need a license and where is my license. I tell her I don’t need one. She proceeds to tell me that she has opened hundreds of clinics, smaller than my room and they ALL needed licenses and where is mine. Then tells me to put posters up. I get the feeling off of this broad that she is dying to turn me in and put me out of practice, for who knows what miserable reason. so I call the licensing agency and spoke with a surveyor. She tells me I’m good to go, and not to worry. Why do some people have to be miserable fucks?! Link to comment Share on other sites More sharing options...
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