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DOT Physicals Only Practice?

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Guest UVAPAC

I was contemplating ways I could make some extra money asides from working per diem at Urgent Care which I have been doing for the last year (Working full time in Occupational Medicine).

 

I think we can pretty much all say that doing DOT Physicals is a royal pain in the _ _ _.  However I have noticed the demand for these physicals is going through the roof.  No primary care physicians are performing these anymore, a lot of urgent cares are stopping as well.  

 

Is it possible to rent out an office space 1 day a week (or 2) for the sole purpose of performing DOT Physicals?  I would obviously need my own malpractice insurance.  Any ideas on cost?  I assume I would need a physician (even though they wouldn't have to do anything).  I feel like lining up 10-15 physicals a day (at $125-150 each) would be quick easy cash.

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Lease space in a executive suite, get an exam table and all other relevant equipment and have at it, depending on state laws. You could even expand/travel to other locations throughout your state using the same business model. Just be sure to have a written agreement with the SP and all that entails.

 

 

 

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Okay, but the question - and the thing you need to plan around - is what do you do with the people you don't approve? Are you going to allow for "determination pending" and re-visits within 45 days? If you don't have support staff and a facility to be part of, mind your logistics and prepare for the unlikely weird stuff, is my advice. 

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Guest UVAPAC
34 minutes ago, Febrifuge said:

Okay, but the question - and the thing you need to plan around - is what do you do with the people you don't approve? Are you going to allow for "determination pending" and re-visits within 45 days? If you don't have support staff and a facility to be part of, mind your logistics and prepare for the unlikely weird stuff, is my advice. 

Yes obviously there would be the cases which someone is pended or disqualified.  

It would be made clear that they would have to follow up on a Saturday/Sunday, as those would be the office hours.  If they were not agreeable to this, I would not proceed with the initial physical.

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You will need the ability to receive outside records and have the time or help to do leg work and research such as cardiac clearance, ophthalmic waivers, endocrine records etc.

Who is going to log your physicals on the national data base? Where will you keep records? 

Also, how do you plan on addressing the gray area of BMI >33 and necks over 17 - automatic 3 month card and require a sleep study? 

If you are only open on weekends - you will have ZERO access to clinics and records. 

I have done DOT for all of my 25 years and it has become more precarious. I believe in its safety benefits but personally tire of being threatened and constantly mired in the outside record stuff.  Hx of MI = ETT every 2 years. AAA over certain size = yearly abdominal US. Sleep apnea requires compliance data from the SD card or wifi hookup on the machines.

BP has to have follow up and staging. I have to look each and every driver up on the state med website for controls. 

Not really trying to burst your bubble but an all day DOT clinic is not as simple as it sounds. They all aren't going to be 21 yr olds on no meds with no history. 

I am moving to a federal job at the VA and will no longer do DOTs in a few months and am sooooo excited to not do them anymore. They have become more trouble than they are worth where I am. 

Just thoughts that came to mind from someone who has done these for a long time.......

Best of luck.

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Guest UVAPAC
7 hours ago, Reality Check 2 said:

You will need the ability to receive outside records and have the time or help to do leg work and research such as cardiac clearance, ophthalmic waivers, endocrine records etc.

Who is going to log your physicals on the national data base? Where will you keep records? 

Also, how do you plan on addressing the gray area of BMI >33 and necks over 17 - automatic 3 month card and require a sleep study? 

If you are only open on weekends - you will have ZERO access to clinics and records. 

I have done DOT for all of my 25 years and it has become more precarious. I believe in its safety benefits but personally tire of being threatened and constantly mired in the outside record stuff.  Hx of MI = ETT every 2 years. AAA over certain size = yearly abdominal US. Sleep apnea requires compliance data from the SD card or wifi hookup on the machines.

BP has to have follow up and staging. I have to look each and every driver up on the state med website for controls. 

Not really trying to burst your bubble but an all day DOT clinic is not as simple as it sounds. They all aren't going to be 21 yr olds on no meds with no history. 

I am moving to a federal job at the VA and will no longer do DOTs in a few months and am sooooo excited to not do them anymore. They have become more trouble than they are worth where I am. 

Just thoughts that came to mind from someone who has done these for a long time.......

Best of luck.

I have been doing DOT PE's for 3+ years now (obviously nowhere near as long as you).

 

In our office we have forms for when we require additional information.  Basically we just add in a sentence or two about what we need, but the rest of the form is self explanatory.  

 

I would probably higher a receptionist for the days we were open (to handle billing, go through faxes/paperwork, return phone calls and schedule appointments etc.  Monday-Friday I would check voicemails from home.

 

Believe me I don't anticipate every PE being a healthy 21 year old.  I have dealt with everything from narcotics/benzos, MI's/Arrhytmias, murmurs, hx of seizures, cancers, AVMs, all kinds of psychiatric disorders, and all of the regular run on the mill stuff.  It can be quite frustrating, and I have certainly had my fair share of angry patients.  

 

 

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Think this could work pretty well

 

you would become an expert on the DOT PE and therefore highly efficient - that is the key to practice ownership

 

 

 

I would think a high functioning LPN/Office manger as your employee and a back up part time office person 

Between these two people you end up with a great office support staff that can "run the office" for 30-40 hours per week

 

If you do 2-3 clinical days a week and keep overhead to a minimum, put the LPN on profit share and expect a lot - you could have a winning business (minus the 5-10% you loose to the doc) and poof you profit is gone!!

 

 

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