Comments on: Collaboration Fees? Space Fees? http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/ Resources for NPs in Business Fri, 29 Aug 2008 23:13:21 +0000 http://wordpress.org/?v=2.6 By: Maureen Richards http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-710 Maureen Richards Mon, 17 Mar 2008 01:07:50 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-710 I would also like to hear about collaborating physicians. Here in Florida we cannot even prescribe controlled substances, let alone get this law changed. Is there anyone in florida paying a collaborating physician? I would be interested to see how much is paid in Florida. I would also like to hear about collaborating physicians. Here in Florida we cannot even prescribe controlled substances, let alone get this law changed. Is there anyone in florida paying a collaborating physician? I would be interested to see how much is paid in Florida.

]]> By: Leslie McDowell http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-655 Leslie McDowell Tue, 19 Feb 2008 19:41:48 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-655 Would love to know more about how you decide what to pay your collaborating MD in the states that require one. When you say a percent of income, what percent? 5% sounds high to me. I am so glad I stumbled upon this website as I work hard to get my new clinic off the ground. Leslie Would love to know more about how you decide what to pay your collaborating MD in the states that require one. When you say a percent of income, what percent? 5% sounds high to me.
I am so glad I stumbled upon this website as I work hard to get my new clinic off the ground. Leslie

]]> By: Pat http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-635 Pat Tue, 12 Feb 2008 19:49:05 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-635 I have a speciality private practice (incontinence center) just outside NYC. NPs have to sell themselves and their value to a practice. If you are thought to be taking away patients rather than building a practice, they will never accept you. I advise you to find a niche. Something MDs dont have time for, like, smoking cessation, diet programs, etc. I made a deal with the MD that if he refers his patients to me for incontinence that he can bill for my services at his rate (100%) and that he can pay me based on the amount collected. I was also able to secure 2 contracts for annual physical exams with 2 local utilities companies that employs 300-400 employees which increases his revenue and exposure as well. I dont pay a penny out of pocket for using the space, phone, lights as well as the secretarial staff and medical assistants and he allows me to precept students too. Get more business savvy, and sell them your value. Make them a proposal and show them on paper what you are worth to their practice. I have a speciality private practice (incontinence center) just outside NYC. NPs have to sell themselves and their value to a practice. If you are thought to be taking away patients rather than building a practice, they will never accept you. I advise you to find a niche. Something MDs dont have time for, like, smoking cessation, diet programs, etc.

I made a deal with the MD that if he refers his patients to me for incontinence that he can bill for my services at his rate (100%) and that he can pay me based on the amount collected.

I was also able to secure 2 contracts for annual physical exams with 2 local utilities companies that employs 300-400 employees which increases his revenue and exposure as well.

I dont pay a penny out of pocket for using the space, phone, lights as well as the secretarial staff and medical assistants and he allows me to precept students too.

Get more business savvy, and sell them your value. Make them a proposal and show them on paper what you are worth to their practice.

]]> By: Carla http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-622 Carla Tue, 05 Feb 2008 18:20:21 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-622 In regards to Nancy, First of all, congratulations that you started your practice 30 yrs ago! How progressive and brave you were. I completely agree about starting small. I want to get a massage therapist who really needs a space to come in a couple days a week, and it will also bring business in for me, and allow us to advertise an entire new service, with discounts or specials, and help the massage therapist too. And an acupuncturist or psychologist would have a great space to come in once a week too! I am keeping my overhead super small, although in this area the rent space prices are double what they are in the Portland area ( I am in an affluent suburb 20 miles south)..but I got a pretty good deal.. I would like it to be 300 dollars less a month, but other than that utilities are paid with a one year lease. I just need help with the keeping track of bills..my biller is offsite, and I am going to need an in house biller to help me. It is just not working. I have no idea what she is doing or what she is not doing. And she sent out some inflammatory bills, and lost me some good patients. Carla , Oregon In regards to Nancy,

First of all, congratulations that you started your practice 30 yrs ago! How progressive and brave you were. I completely agree about starting small. I want to get a massage therapist who really needs a space to come in a couple days a week, and it will also bring business in for me, and allow us to advertise an entire new service, with discounts or specials, and help the massage therapist too. And an acupuncturist or psychologist would have a great space to come in once a week too! I am keeping my overhead super small, although in this area the rent space prices are double what they are in the Portland area ( I am in an affluent suburb 20 miles south)..but I got a pretty good deal.. I would like it to be 300 dollars less a month, but other than that utilities are paid with a one year lease. I just need help with the keeping track of bills..my biller is offsite, and I am going to need an in house biller to help me. It is just not working. I have no idea what she is doing or what she is not doing. And she sent out some inflammatory bills, and lost me some good patients. Carla , Oregon

]]> By: Tammy http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-607 Tammy Tue, 29 Jan 2008 23:10:02 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-607 The office I previously worked at had Amazing Charts, so I am familiar with it. I also wanted to say I am researching private practice as well. Some rental space, at best that I have seen has been $10-$12/sq. ft. and I have also heard of arrangements where rent is based on 25% of earnings (to which I hope their is a cap). Some who only do minimal consulting rent space by the hour. I don't know what collaborative MDs should be compensated, mine has not asked for anything, but I have not actually "started" yet either. I will not be accepting insurance (they won't pay for a holistic practice as far as I know). Start up costs are unreal....but I have learned a few ways to decrease some pf them, at least initially. Does anyone have any ideas of how to assess marketability and time commitment to run the business? I am not looking to work full-time, although I know there will be additional hours for running the business that are not patient contact hours. Thoughts? The office I previously worked at had Amazing Charts, so I am familiar with it. I also wanted to say I am researching private practice as well. Some rental space, at best that I have seen has been $10-$12/sq. ft. and I have also heard of arrangements where rent is based on 25% of earnings (to which I hope their is a cap). Some who only do minimal consulting rent space by the hour. I don’t know what collaborative MDs should be compensated, mine has not asked for anything, but I have not actually “started” yet either. I will not be accepting insurance (they won’t pay for a holistic practice as far as I know). Start up costs are unreal….but I have learned a few ways to decrease some pf them, at least initially. Does anyone have any ideas of how to assess marketability and time commitment to run the business? I am not looking to work full-time, although I know there will be additional hours for running the business that are not patient contact hours. Thoughts?

]]> By: Nancy Dirubbo http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-606 Nancy Dirubbo Tue, 29 Jan 2008 22:14:55 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-606 I just discovered this web site and I wish something like this was around 30 years ago when I started my practice. I have seen lots of NP's try to open practices and frankly most have failed. So, you have to do your homework and I think you have to start small. The first office I had I rented and sublet an office within to psychologists and massage therapists. Let someone else help you pay your rent. They were totally independent of me - own phone, made their own appointments, collected their own fees. This could cut your rent by a third and could bring in traffic to your office that you might not otherwise see. In the beginning I had a collaboarative MD. I never paid him. I never worked for him. I did sent him referrals. Find out what the MD's in your area need and fill that need. Do they need help with call? Do they need referrals? It sounds like you are offering too much. Don't pay them if you dont have to. Find out waht they really need and fill that need if you can. And then - get the laws changed in your state that require this relationship. We hated the concept of collaborative MD's and so, in NH we got the law changed. I haven't had a colloaborative MD for over 15 years. I just discovered this web site and I wish something like this was around 30 years ago when I started my practice. I have seen lots of NP’s try to open practices and frankly most have failed. So, you have to do your homework and I think you have to start small. The first office I had I rented and sublet an office within to psychologists and massage therapists. Let someone else help you pay your rent. They were totally independent of me - own phone, made their own appointments, collected their own fees. This could cut your rent by a third and could bring in traffic to your office that you might not otherwise see. In the beginning I had a collaboarative MD. I never paid him. I never worked for him. I did sent him referrals. Find out what the MD’s in your area need and fill that need. Do they need help with call? Do they need referrals? It sounds like you are offering too much. Don’t pay them if you dont have to. Find out waht they really need and fill that need if you can. And then - get the laws changed in your state that require this relationship. We hated the concept of collaborative MD’s and so, in NH we got the law changed. I haven’t had a colloaborative MD for over 15 years.

]]> By: grace grymes chapman http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-598 grace grymes chapman Fri, 25 Jan 2008 06:53:16 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-598 Carla, can you give me some more details on Amazing Charts. I am looking into a system and it looks like a good deal. Grace Carla, can you give me some more details on Amazing Charts. I am looking into a system and it looks like a good deal.

Grace

]]> By: Cindy Jensen http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-597 Cindy Jensen Fri, 25 Jan 2008 02:51:13 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-597 As for rent, shop carefully. I have four locations and spend months looking at the local commercial market before I bite. I like using craigslist and officespace.com to look for space. Because I don't run a full service medical office my needs are less that what you might be looking for but I am a firm believer in keeping your overhead low. I pay on average $9 to $15 per square foot/year. This includes my satellite office in high-rent Redmond, Washington. Looking for space has almost become a hobby to me...I really need to get a life! Cindy As for rent, shop carefully. I have four locations and spend months looking at the local commercial market before I bite. I like using craigslist and officespace.com to look for space. Because I don’t run a full service medical office my needs are less that what you might be looking for but I am a firm believer in keeping your overhead low. I pay on average $9 to $15 per square foot/year. This includes my satellite office in high-rent Redmond, Washington. Looking for space has almost become a hobby to me…I really need to get a life!
Cindy

]]> By: Cindy Jensen http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-596 Cindy Jensen Fri, 25 Jan 2008 02:40:19 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-596 Hi. I think trading a days work/clinic coverage/call coverage instead of paying the physician for collaboration may be the way to go. If physicians really want to pick up extra hours/$$$ they can find that type of work. In my opinion, what independent physicians are really short of is...time. This is your true bargaining chip. If they are solo providers they are often on call many/most nights of the week unless they are part of a larger call group. Most physicians work long hours to support their lifestyle. Offer first to take call for him. This would be something you could do from home that wouldn't cost you time in your own clinic. If you do work one day a week in his clinic, your value to him will probably be higher if he gets to be off that day. In reality, you are not going to collect $60 per visit. Don't see it as money you don't make. See it as a trade that allows you to do what you want to do on your terms. Just my 2 cents, Cindy Hi. I think trading a days work/clinic coverage/call coverage instead of paying the physician for collaboration may be the way to go. If physicians really want to pick up extra hours/$$$ they can find that type of work. In my opinion, what independent physicians are really short of is…time. This is your true bargaining chip. If they are solo providers they are often on call many/most nights of the week unless they are part of a larger call group. Most physicians work long hours to support their lifestyle. Offer first to take call for him. This would be something you could do from home that wouldn’t cost you time in your own clinic. If you do work one day a week in his clinic, your value to him will probably be higher if he gets to be off that day. In reality, you are not going to collect $60 per visit. Don’t see it as money you don’t make. See it as a trade that allows you to do what you want to do on your terms.
Just my 2 cents,
Cindy

]]> By: Carla Anderson http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-592 Carla Anderson Tue, 22 Jan 2008 07:52:23 +0000 http://npbusiness.org/2008/01/11/collaboration-fees-space-fees/#comment-592 Hi Clavel, I am sorry, I did not see where you asked for me to contact you. Thank you regarding the website. I still am going to get some better pictures, including one in front of my car (as I do housecalls, and my lettering and log is on my car window, in my labcoat, and one in my exam room with a baby or another patient. One great thing about my website, is it is attached to many many key words. Some one can type in health clinic, or medical clinic, or urgent, or medical clinic wilsonville and my entire website link will come up, or the dex knows or yellow page ad... so it links me to all sorts of places.. Do you have an email you want me to contact you at? Or you can go on my website, and go under "contact me" , and it sends it directly to my regular email.. I would love to answer any questions from what I have learned by not going around, but going "through" the learning process.. Take Care, Carla Hi Clavel,

I am sorry, I did not see where you asked for me to contact you. Thank you regarding the website. I still am going to get some better pictures, including one in front of my car (as I do housecalls, and my lettering and log is on my car window, in my labcoat, and one in my exam room with a baby or another patient. One great thing about my website, is it is attached to many many key words. Some one can type in health clinic, or medical clinic, or urgent, or medical clinic wilsonville and my entire website link will come up, or the dex knows or yellow page ad… so it links me to all sorts of places..

Do you have an email you want me to contact you at? Or you can go on my website, and go under “contact me” , and it sends it directly to my regular email..

I would love to answer any questions from what I have learned by not going around, but going “through” the learning process.. Take Care, Carla

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