recent grads - rollcall

[eyehope]

Although I enjoy my hour lunches and free time, I am going a bit crazy at work. I averaged 7-9 encounters per day in my first month (I feel an ideal number would be closer to 30-35). I know that it takes time to build a reputation and referrals, but is this ab/normal for a new graduate? I am not solo, but have joined a smaller group (2MDs).

I dictate and send letters back to PCPs/referring physicians within 24 hours. I see 'emergencies' the same day. I plan on meeting with referring docs for lunch in the area to get my name out.

Any wisdom from the elders?

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[Andrew_Doan]

I think you're on the low side of encounters, but things will be slow until you build up a practice.

Consider this article:
http://www.medrounds.org/ophthalmology-pearls/2008/11/opening-private-ophthalmology-practice.html

Opening a Private Ophthalmology Practice – Points to Consider During the First Three Months

By George L. Mayo, MD and Kathy Mayo, DO

 

[ophtho1122]

I too am 4 months into private practice. I am with a 5 M.D. (including myself) 3 O.D group in a large city. Only two of us operate. I sometimes have a 20 pt day with my associate's post-ops mixed in that number, but an average day would be 5-6 pts. I average 3 cat sx per week and 1-2 LASIK per month. It is tough getting new referrals. I have written O.D. letters, done lunches, etc. They are set in their referral pattterns and it is hard for a new grad to break that in a big city where options are abundant. I just keep on churning and doing good sx, hoping it will pick up.

 

[eyehope]

I appreciate the replies and links and welcome any additional comments.

Unfortunately, while training, we get little knowledge of life after residency. I guess I have to be a little more patient (no pun intended) but it's difficult when you see the AAO jobs advertising immediate volume of 40-50 patients/day. Personally, I'd be happy with 500 encounters/month and 200 cats for the year.

I hope to update my status every so often - maybe it will help the next graduating class.

 

[KHE]

I too am 4 months into private practice. I am with a 5 M.D. (including myself) 3 O.D group in a large city. Only two of us operate. I sometimes have a 20 pt day with my associate's post-ops mixed in that number, but an average day would be 5-6 pts. I average 3 cat sx per week and 1-2 LASIK per month. It is tough getting new referrals. I have written O.D. letters, done lunches, etc. They are set in their referral pattterns and it is hard for a new grad to break that in a big city where options are abundant. I just keep on churning and doing good sx, hoping it will pick up.

As an optometrist, let me make some suggestions:

1) If you already have 3 ODs in your group, the majority of optometrists are going to be reluctant to refer to you because of a high probablility that you (or at least your group) will keep the patient. You are going to have to show a sincere effort to make sure that that does not happen.

2) Like you guys, we really don't care much about introduction letters and being taken out for lunch.

3) How often do you ever refer a patient to an OD outside of your practice? Referals are not a one way street. The ophthalmologists that I refer to regularly refer patients of their own to me for contact lens, pediatric, or low vision care. Try to send a patient or two towards an optometric group that you would like referals from and that'll get you a lot farther than a sandwich from Panera.

 

[Andrew_Doan]

As an optometrist, let me make some suggestions:
3) How often do you ever refer a patient to an OD outside of your practice? Referals are not a one way street. The ophthalmologists that I refer to regularly refer patients of their own to me for contact lens, pediatric, or low vision care. Try to send a patient or two towards an optometric group that you would like referals from and that'll get you a lot farther than a sandwich from Panera.

This is a good point. I tell my patients to go to their local optometrist for their refractions and/or glasses. At U of Iowa, I did the same.

 

[KHE]

This is a good point. I tell my patients to go to their local optometrist for their refractions and/or glasses. At U of Iowa, I did the same.

But if you want referrals from someone, you can't just say "see your local optometrist." You have to say "I want you to see Dr. Smith and he will square up your glasses or contact lenses. He's a great doctor and he'll take good care of you."

That will get you a lot farther than "see your local optometrist."

 

[Andrew_Doan]

But if you want referrals from someone, you can't just say "see your local optometrist." You have to say "I want you to see Dr. Smith and he will square up your glasses or contact lenses. He's a great doctor and he'll take good care of you."

That will get you a lot farther than "see your local optometrist."

Yes, of course. But I'm not going to list specific doctors here. I was making the point that eye surgeons should make an effort to refer optical services back to their community optometrists.

 

[eyehope]

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[KHE]

Just an update - things are picking up a little, but not much.

I have a couple of pet peeves about my current situation and need some advice on how to handle it.

1. My 'partner' wants to retire to part-time over the next year. He doesn't like to see many patients a day (his preference). The office staff will field calls from his patients and offer an appointment with my partner in 4 months or with ("the new doc") me in a week. Invariably, the patient will choose to wait four months. Am I out of line to suggest that the office staff just schedule the patient with me rather than give them a choice? The transition has to occur at some time.

2. For patients (some are his former patients and some are the former patients of his prior partner) who choose to see me. I have been waiting on hospital privileges to operate. I've built up a modest list of cataract patients. Lost a couple to other providers because they couldn't wait. Now, that I can schedule surgery - a good 30-40% of these patients want my partner to do the surgery. Mind you, he is a good surgeon, but still does extracaps. I, of course, cannot simply say that phaco is better. Am I wrong to demand (well, demand is too strong of a word) that I have the first crack at these surgeries? My partner keeps telling me that he wants to cut back on his surgeries (and I believe him), so that I would eventually inherit the great majority of surgical cases. Should I just have some patience and hold out a little longer?

I hope someone has been in a similar predicament. I feel like a second class physician and do not feel that the office staff 'sells' me very well to patients.
I feel that if I do not say something, nothing will change (because no one is looking out for me besides myself!). But, I do not want to destroy my chances of partnership (just an associate now).

A couple of things here:

1) Do you have a partnership offer in writing? If not, you should get one. If your employer is serious about it, he should have no issue doing one.

2) How is your compensation determined? Is it production based or are you paid a flat rate? If it's production based, then you may be in a situation where your employer is actively DIScouraging the staff from scheduling you these patients, and may be actively DIScouraging the patients from seeing you. In essence, he may be using you to see the routine clinical cases and keeping the cream for himself.

3) What are you doing to bring new patients into the practice? Are you actively promoting yourself in the community or are you relying on the practice to provide you with your patient base?