March 27th, 2013

SOLO, Serious!?

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In February I kicked around the options open to me. I had decided not to go back to my previous employer and needed a new direction. I thought about ER but did not think that would give me the patient contact that I needed. ER is great from a time committment standpoint, but you never get to hear if what you recommended worked out as you expected. I did not want to sit at a desk all the time. I finally thought about solo practice. At first I thought I must be slipping into a psychotic episode. But then I realized, if I can do outpatient only, with limited hours and no or minimal staff, I would not need to see 40+ patients a day to make a living. I had already decided that it would take a bit of doing but financially we would be okay. I started looking for small ERs to work at occasionally to keep up my ER skills and bring in a little cash flow. I was already a team physician for a local hospice group, which I really enjoy. Working with folks that provide care at the end of life is a blessing. I did not want to give that up. I decided, however, that I did not want to play the game of chasing the insurance tail. I made the decision to not contract with any insurance, I opted out of medicare (you cannot just not take medicare, you have to opt out. More on that at a later time). I did not take medicaid, or hawkI (the state childrens plan). This was the hardest for me, as I knew that I would not be seeing as many children.

The hardest part thus far has been to contact the insurance companies and let them know I am no longer with my previous employer. As well as contacting all the referral doctors/hospitals to tell them my new address, and for them to actually do it. I had sent in all the information to one insurance provider. It was 3 months later when a patient told me their insurance said I did not exist. Now, even though I do not participate in insurance I do provide patients the codes for our visit and, if possible, a form specific to their insurance to fill out and submit on their own. For those of us old enough that was the way it had been done not that long ago.

I contacted the provider relations person for that group, who was quite helpful. The information that I had sent 3 months prior was still sitting on someones desk. It was quickly corrected and I am now “in the system”.

I started looking for just the right place for a practice. I talked with a local chiropractor, a friend of mine with clinics that were not used every day. I looked at an old clinic in a small town and another clinic in the county seat. All would have worked, but would have been cramped or a bit out of the way. It was about this time I asked a local realtor about space at her business. It happened to be the old Pedrick Funeral home, which I found ironic. It turned out to be just the fit. An older facility with much character. When folks ask me about practicing in a funeral home I always say “I like to take things full circle”.

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