All of them. When I got out of residency, I essentially became a yes man. If a NH needed a new Med Director and asked me, I said yes. When the local Hopsice company wanted me to be Med Director, I said yes. I was soon propositioned by neighboring, competing NH’s and built up my reputation and this led to Med Directorships at over 5 NH’s. I hired a bunch of well trained MId-Levels to staff those facilities during the day, I billed for all those visits under the mid levels I employed. No overhead other than what I paid them. I rounded at each facility monthly and billed for all those visits. Collected Med Director stipends ($2-$3k/month/facilty). On top of working at a FQHC community center 3 days/week, serving under/un-insured pt populations for a very meager salary. I have my own MAT clinic with 3-4 providers seeing about 600 pts monthly @ $140/visit. And finally built up a cosmetic practice doing Botox/Juvaderm to very well to do clientele out of my home spa/office -lots of repeat business and word of mouth marketing - now have a pt population of about 300 cosmetic pts that rotate in every 3-9 months. Recently resigned from the FQHC clinic - became way to much to juggle. It paid me the least and took the most of my time. But now everything runs like a fine-tuned machine. Took a lot of blood, sweat and tears to get to this point, over 10 years, but it is possible. Utilizing good mid-levels, I have created a passive income machine that essentially prints money…and provides damn good patient care- prevents unnecessary hospitalizations and ER visits from the NH’s, keeping opioid dependent patients clean. Provide good end of life care to hospice pts, thereby improving end of life and actually prolonging life while providing a resource for their families as well. And helping beautiful women with low self esteem and too much money, more beautiful. Total Win-Win situation. Hope this helps. CHEERS!!!!
