Monday, July 29, 2019
Exploring: One of the Pluses of Locum Tenens Urology
Wednesday, July 24, 2019
An excerpt from my newest book
Thursday, July 18, 2019
Let's catch up
It has been a while since I wrote about independent practice. What can I say? I've been busy. Very busy. That is a good thing.
It has been 13 years and a few months and I enjoy solo practice as much as I did on day one, even more so.
The early years were tough.
Lean.
Now is good.
Phone rings non-stop. I had added 13,000 plus patients to my practice and I am really appreciated.
I have built the practice I have always wanted but never thought I could have.
I have a solid sub-specialty practice in male infertility, have a vasectomy center, do vasectomy reversals in-office and I have client depositor sperm bank.
How many other urologists have that in Suffolk County? Zero. Nassau County? Zero. New York State? Zero.
Am I proud of this? Hell yeah!
I have a strong referral base of independent docs, like me, who have resisted acquisition for all these years. They ain't going anywhere.
The majority of my patients come from professional referral, word of mouth referral & web.
I do advocacy work for https://nysurologicalsociety.org/ on their exec committee and I am the President of the http://www.scms-sam.org/index3.html
It is all good.
Lov'in it.
The IU.
Tuesday, June 18, 2019
Monday, April 08, 2019
Friday, April 05, 2019
Medicine Unplugged
Tuesday, December 18, 2018
The Downside of Locum
Control over schedule? Not as much as you'd think
Time away from family
Loneliness & boredom
Saturday, December 15, 2018
Dip a toe in the water!
You can jump in the water and hope it is a suitable temperature
OR
You can put your toe in the water
THEN
Your ankle...calf...knee..thigh...
You get the point.
Maybe hospital based practice is a fit,maybe not
Maybe rural locales work for you, maybe not
Maybe the diamond is already in your own backyard
Perhaps before totally giving up what you love, try a temporary assignment.
Thursday, December 13, 2018
The locum gig
Everyone who does locum, it seems to me, has a story. A good story. One that speaks to me and my independent streak.
The full time locum who refuses conform
The mom who wants to spend more time at home by being away
The harried independent combatting burnout
The retirement plan
The mid-career "what's next?"
Is truly amazing, this option. This locum tenens option.
Thursday, November 29, 2018
Wednesday, November 28, 2018
Monday, November 26, 2018
A discussion with a health care attorney about practice acquisition
Thanks so much to Gary Herschman of Epstein Becker Green for his terrific wisdom on private equity acquisition of medical practices.
Saturday, November 24, 2018
An interview with Dr John Phillips
Dr John Phillips: For more information on Dr Phillips.
In this interview we discuss:
- prostate cancer screening
- advocacy
- medical education
- life
Saturday, October 14, 2017
1: Control. One must have control of day to day, week to week and have decision making ability. We all have constraints, but within their confines we need to be able to make meaningful decisions to be happy
2: Meaning: whether one lays brick, cleans floors, or does surgery, one must have the feeling that what they do has meaning and importance in the broader sense of life, to feel as though you will have left a positive mark, and that one's time here on Earth was not wasted. One must feel as if their work is critical to the success of their organization's mission, whatever that role maybe.
3: Respect: one must feel as though peers feel positively about your career and skills and that such skills are valued above and beyond a paycheck. One must feel that their patients respect them as well. Skills ought to cultivated and nourished.
4: Academics: medicine demands a decades long learning process. When a physician no longer finds learning fun, professional and personal happiness will suffer.
5: Compensation: once basic needs are met, happiness is not increased by absolute W2 income levels. While important, W2 is not everything. Compensation ought to be linked to effort but without the other 4 elements to satisfaction, professional satisfaction and happiness will always remain elusive.
Tuesday, May 23, 2017
Remaining Solo: 5 Strategies
1: Go micro: go super small. One doc. One staff or no staff. EHR, patient portal, no phones. No insurance. Good option for family doc.
2: Go concierge: charge extra fees. No insurance. Good option for family doc
3: Go super special: cosmetic, anti aging, infertility. Easier said that done. Good for plastic surgeon and derm.
4: Go non par: take no insurance. Bill at crazy out of network rates. Good for neurosurgery, Ortho, general surgery
5: Go stupid busy: how the rest of us do it. Take everything. See everything. Work everyday, everywhere. Not sustainable.
For option 5: rethink contracts. Get in with IPA.
Any other options? PM me.
Thursday, May 18, 2017
5 Threats to Independent Care
- MACRA/MIPS This is a very complex endeavor. No one who I have spoken to really knows precisely how to proceed. It is also a zero sum gain: the bonus payments from successful practices come from the deductions from the unsuccessful ones.
- Cyber security If you use any electronic resources, which includes electronic claims submittal, you are at risk for malicious cyber attack. Protection in the form of best practice IT solutions and insurance cost $$$
- Cost sharing/deductibles Even for patients with insurance, the dollar amounts of deductibles have risen dramatically over the past 10 years, far outpacing wage increases. This translates to fewer patient visits and more expensive collection efforts
- Consolidation Health care has become consolidated over the past 15 or so years. In some markets there is only one payer. On the provider side there has been a major shift to employed models into larger and larger entities. This means drying up referral networks combined with declining reimbursements to offices and increased premiums for employee health insurance.
- Income inequality The majority of increases in wealth, income, and standard of living have gone to the top 1%. Most doctor practices cater to the lower 99%, who struggle to pay bills and as such, put off health care as long as possible.





































