Friday, June 06, 2008

Doc vs World: Episode 2

Imagine this:

  • You're an orthopedic surgeon and part of a group. You have 3 partners, 2 of whom have been in the practice for 15 or more years. You are a partner, but not a managing one. What that means is that you come to work, do your thing, and get "partner's pay." One day, the managing partners call a meeting. In the meeting, they ask that all employees go 2 weeks without a paycheck because the practice is out of money. The partners, they say, will go without pay "until further notice." What do you do?
You don't believe this scenario? Believe it. This exact thing is happening in an orthopedic group with which I am familiar. So, again what do you do?

Well first, as a partner you must make it your business to know about the financial health of your business. You are a partner and it is your right. In this case, however, your options will depend on your answers to several questions.
  1. Do you have savings?
  2. Do you have another source of income?
  3. Do have good credit and can you get a loan?
  4. Are you willing to relocate?
  5. Have you planned for this contingency?
If you have savings or a source of income that can last 1 year, you can go off on your own. Otherwise, I don't believe that this is a viable option, unless you have an established practice, a loyal patient and referral base, and an unenforced no-compete clause. In that instance, you may be able to become cash positive in 2-4 months. Here's how to start.
  1. Get phone.
  2. Get a box.
  3. Get an address, even if it is a PO Box.
  4. Get all your provider ID information and credentialing information gathered and organized.
  5. Put all of the above information into the box.
  6. Set-up a new PC or LLC.
  7. Get a biller, even if you need to out-source it.
  8. Change your provider IDs to your new location and your NPI to your new address.
  9. Find office space or sublease on a per diem basis if need be.
  10. Collect all copays.
  11. Do not submit ANY claims until all provider IDs and your NPIs have been confirmed as switched, unless of course you want your old employer to get all the money.
  12. Answer your phone 24/7.
  13. Tell your kids they ain't going to camp.
Good luck. But there is a lesson here. Whether you are a partner or not, as a doctor you are a small business man. You must know the details of your business and you must have an exit plan. This disaster plan must be in place even during the good times. When the bad times come, they'll come plenty fast and your plan could save you. This plan should include savings, alternative income sources, your own insurance policies, knowledge of the competitive landscape and possible employment opportunities and even a license to practice in another state.

I hope this never happens to you, but if you're reading this intently, I suspect it did. Contact me if you'd like.

Again, good luck.