Private Practice

[drpsychmd]

Hi - as a fresh attending I am looking to get started with private practice but have a few questions...

are psychiatry PPs like other group practices? ive just seen psychiatrists as flying solo or as a group with psychologists and other mid-levels. If psychiarists do groups what is the typical (financial) arrangement?

I'd like to do a bit of therapy in addition to meds, will this impact my bottom line significantly? how much does insurance reimburse for therapy?

am I correct in assuming that call is pretty much nil in private practice (compared to inpatient work where I had frequent call).

thanks.

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[drpsychmd]

bump

 

[Tradewind]

Group practice: I've heard anywhere from 20-45% of your income goes to the group in group practice settings. Pros - no overhead, colleagues can cross-cover patients (eg when on vacation), often get hospital admitting privileges, there's usu a secretary/business person to deal with insurance issues and setting up appointments.

PP: You get all the proceeds, but given the overhead and ramp up time, it may be a couple of years before you reap the benefits. I hear PP docs say they're on call '24/7', since they're solo, but I've heard other PP docs say they hardly ever get called. I think it depends on your patient population and how much you extend yourself.

As for therapy reimbursement, you make at least 1/3 less than if you did med checks all day, and then there are limitations on how many total sessions you can have per year before the insurance company won't pay for visits at all... So many PP docs ask for cash/check up front and ask patients to pursue their own insurance companies for reimbursement. In such cases, PP docs agree to help by filling in forms where MD signatures are needed.

I'd be curious how much insurance reimburses for pure psychotherapy, too. As opposed to the 50 min psychotx session + med management.

 

[drpsychmd]

Group practice: I've heard anywhere from 20-45% of your income goes to the group in group practice settings. Pros - no overhead, colleagues can cross-cover patients (eg when on vacation), often get hospital admitting privileges, there's usu a secretary/business person to deal with insurance issues and setting up appointments.

PP: You get all the proceeds, but given the overhead and ramp up time, it may be a couple of years before you reap the benefits. I hear PP docs say they're on call '24/7', since they're solo, but I've heard other PP docs say they hardly ever get called. I think it depends on your patient population and how much you extend yourself.

As for therapy reimbursement, you make at least 1/3 less than if you did med checks all day, and then there are limitations on how many total sessions you can have per year before the insurance company won't pay for visits at all... So many PP docs ask for cash/check up front and ask patients to pursue their own insurance companies for reimbursement. In such cases, PP docs agree to help by filling in forms where MD signatures are needed.

I'd be curious how much insurance reimburses for pure psychotherapy, too. As opposed to the 50 min psychotx session + med management.

Thanks, thats helpful info.

 

[Therapist4Chnge]

I've done a lot of leg work in this area for multi-disc practices, though obviously YMMV.....

Most multi-disc group practices would have a really hard time renting space if they charged more than the equivilant of 20% for anyone who is at least half-time. Overhead should be no more than 20%, probably 15-18% if you work half-time with a secretary, printer, office space, etc. In large cities it may be a bit more, but I'd consider it a red flag if someone is asking above 20%. Definitely inquire about billing services, setting appointments, office hours restrictions, etc....as that can vary a lot and may not be included in the fee. If you can negotiate a flat fee, it usually pays off if you have a decent flow of referrals or regulars.