Sunnyn

PA - owned practice and salary advantage

20 posts in this topic

Dear All:

 

Could you kindly put forth the struggles, the overheard costs, and what kind of salary can one expect with a PA owned practice.

 

Typically how much of a fee would one be expected to provide to the SP?

 

Thanks.

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This is a super-broad question, which is probably why you haven't gotten any replies. 

 

There are prior posts on this board, with first person accounts of such endeavors, you could search for them.

 

As with many aspects of healthcare work, Sunnyn, the most success and fulfillment stem from a love of the work first, with income being a secondary reward.

 

But you knew that already, didn't you?

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simply stated

 

it is not worth it....

 

doc's are no longer in private practice.....

 

and small practices are a dying bred

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Hey All:

 

With the current introduction of Healthcare reform, and projected increase in salary for primary care/mid-level providers do you all think that PA-owned practices may still not be a feasible thing to do in the near future?

 

Are there any loop holes to perhaps pay less taxes on earned income in PA-owned practices that could change the dynamics?

 

Many thanks

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I'm on a sabbatical in Malta for a month to recover from my five years of PA Ownership. I think I will put up either a written post-mortem or video "chat" on my blog when I get to it in a few days. The purpose it for the education of those who are considering this path. Would I have done it if I had to do it over? Absolutely. Could I do it better this time around? Absolutely!  The things that made me "retire" (moving on to an employee position when I get back) were not the things that I had planned on or expected.  It is very tough for any small medical practice to survive in this present environment.  We did survive and I could have continued, but not with a quality of life because it demanded my attention 24-7.  Answering your question was that my practice was a PLLC and I paid myself a salary and was taxed (on an individual level) like any salary. However, the business never had enough additional profits to be a tax issue. The taxes were the least or our problem. Constant insurance denials for almost everything we did was part of the problem.

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I'm on a sabbatical in Malta for a month to recover from my five years of PA Ownership. I think I will put up either a written post-mortem or video "chat" on my blog when I get to it in a few days. The purpose it for the education of those who are considering this path. Would I have done it if I had to do it over? Absolutely. Could I do it better this time around? Absolutely!  The things that made me "retire" (moving on to an employee position when I get back) were not the things that I had planned on or expected.  It is very tough for any small medical practice to survive in this present environment.  We did survive and I could have continued, but not with a quality of life because it demanded my attention 24-7.  Answering your question was that my practice was a PLLC and I paid myself a salary and was taxed (on an individual level) like any salary. However, the business never had enough additional profits to be a tax issue. The taxes were the least or our problem. Constant insurance denials for almost everything we did was part of the problem.

Pls do....with any or all the information about it.  Thanks.

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I'm thoroughly grateful for your candid and honest recounting of your private practice experience.  I see why you would make a video - the acreage of events and learning experiences you've had would only fit into a novel's worth of words.  

I can't help but to state the obvious irony of a headache clinic's upbringing inducing perhaps many headaches itself.  But it is so important to our future for making a difference in corporate and economic culture - towards educating people about what a PA is and the legal and excellent capabilities of a PA.  

+1 The name is important - P. A. is still a confusing term for many people (Oh dear, someone believed you to be a medical assistant?) 

+1  Insurance companies are not liable, and indeed, they benefit from their own mistakes; and that should be changed at a legislative level. 

+1  One can't rely on much litigiousness (lawyers are expensive (not always successful) and don't always holistically benefit one's own cause) to get what you need.  Move on to something else. 

 

Owning a private practice comes with many good qualities and liberties that can provide extra benefit to the patients.  Cash pay seems like a good marketing point as well.  But it seems very risky to own a private practice at this point.  Anyways Thanks again for sharing your fascinating story.

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Hello all.

 

My partner and I are both PAs here in Florida. We are in our 8th year of owning, operating and expanding urgent care clinics. We currently have 4 clinics throughout Central Florida and are proud to announce that we have developed a model that works and can be duplicated. For this reason, we are now franchising our business which will make the process easier for a PA who wants to branch out into the wonderful world of ownership.

 

The past 8 years have not been easy but we are a testament that It can be done.

 

For more information on our franchise opportunity please visit www.ParamountUrgentCare.com

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jmj11, hate to hear that you closed up from practice. Nonetheless, your hard work and dedication to expanding the PA field is very much appreciated. We all know it is an uphill battle for PAs in ownership positions and insurance companies are designed to work against us. 

 

I am going to watch the videos you posted when I find some free time (current didactic student right now). But if you are ever up Raleigh, NC area please send me a message. I would love to buy you a beer and talk about your experiences as a PA owner. 

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I just opened my practice a couple of weeks ago. I have been in this rural area for 15 years and am selling my good reputation. I have developed a model of lean small primary care clinics that can flourish in small markets (rural, under served) where physicians won't go. It is early but I have a 60% insurance, 40% cash model (weight management, hormone therapy, DOT physicals). If I average 15-16 patients a day I can cover overhead and pay myself 120k. After that come mostly profit. I know next to nothing about practices in built up areas but know a lot about under served areas.  I have been open 6  days and average 2 patients a day. I just started advertising. It costs me about 25k to get the door open and fully supply a full 3 exam room space. Smart shopping and planning helped a lot.

My SP is a very cool hands off kinda guy who does  what we need to do to stay legal and otherwise doesn't bother me. Because I am a start up he is charging me $500/month for 3 months and then $1000/month.

Time will tell but so far being the king of my own tiny little kingdom I like a lot.

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Hello all.

 

My partner and I are both PAs here in Florida. We are in our 8th year of owning, operating and expanding urgent care clinics. We currently have 4 clinics throughout Central Florida and are proud to announce that we have developed a model that works and can be duplicated. For this reason, we are now franchising our business which will make the process easier for a PA who wants to branch out into the wonderful world of ownership.

 

The past 8 years have not been easy but we are a testament that It can be done.

 

For more information on our franchise opportunity please visit www.ParamountUrgentCare.com

well done!!!

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simply stated

 

it is not worth it....

 

doc's are no longer in private practice.....

 

and small practices are a dying bred

 

I couldn't disagree more with the above statement.  I opened my own practice 5 years ago and fought with all of my might to get it going and keep it going for the first two years.  When we finally turned the corner at the 2 year mark we have thrived and have not looked back.  At the 3 year mark I hired my best friend from PA school and we grew even more.  About a year later we opened a second location and hired a third PA, now that location is starting to thrive as well.  In Feb I purchased a new 6,000 square foot facility, new ultrasound machine, new x-ray machine, started a new CLIA lab ($350,000 worth of lab equipment and analyzers) and am getting read to hire our 4th and 5th PA.  Small practices are dying because not many docs have the business acumen to make it work or are lured away by the cash that hospitals wave in front of them.  The CEO of one of the big hospital systems came by to meet with me as well and offered to buy me out too.  I never let him finish his thought before I shut him down and I wasn't interested before he could ever get the dollar amount.  I'm not saying it's easy, you have to have a knack for business as well as medicine and be willing to take on a crushing amount of responsibility secondary to both, but it can be done and you can be successful.  Just know that IT WILL BE HARD, but it can be very rewarding!!

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Congratulations. I agree with what you said (I owned my own family practice in NYC and the medical center). Maybe left out one thing "Luck" Everything has to come together to make it work. Ventana jumped through many hoops and fought the good fight but in the end had to let it go.

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I just opened my practice a couple of weeks ago. I have been in this rural area for 15 years and am selling my good reputation. I have developed a model of lean small primary care clinics that can flourish in small markets (rural, under served) where physicians won't go. It is early but I have a 60% insurance, 40% cash model (weight management, hormone therapy, DOT physicals). If I average 15-16 patients a day I can cover overhead and pay myself 120k. After that come mostly profit. I know next to nothing about practices in built up areas but know a lot about under served areas.  I have been open 6  days and average 2 patients a day. I just started advertising. It costs me about 25k to get the door open and fully supply a full 3 exam room space. Smart shopping and planning helped a lot.

My SP is a very cool hands off kinda guy who does  what we need to do to stay legal and otherwise doesn't bother me. Because I am a start up he is charging me $500/month for 3 months and then $1000/month.

Time will tell but so far being the king of my own tiny little kingdom I like a lot.

Any updates? Would love to follow and see how things are going. I work in a rural health clinic (solo coverage) and have had comments by the SP and owner about buying the clinic and/or the one in the next town (40 miles away). I am very interested in this, but would like to see others ups/downs. Also, jmj11, I have watched all your videos and they were helpful. I might watch them again in the new future. 

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Greetings to all:

 

I have read your comments and success stories, and I think all of should you be very proud of your accomplishments, and even your failures (I see failures as teaching moments). I'm a PA student at UT, Ohio right now and plan on opening my own clinic after gaining some experience once I graduate. My father is also a PA (going on 17 years), and brought up the idea of opening a clinic together. With that said, would you recommend having a family business, or would you frown upon the idea? Also, how can I find rural areas where a PA owned clinic would thrive? I'm also an Army Veteran, and I think the VA backs small business start ups, but i'm not 100% confident (I'll do more research on that matter). Either way, I'd like to thank you in advance for reading and replying to my questions. 

 

Leo T

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