Guarantee a group like this has an in house billing person, otherwise they’d be bleeding tons of money on billing (at 5% of what they’re generating even salary+ benefits for a dedicated billing staff you could hit with 3-5 FT psychiatrists). Most of the rest of what you’re putting in there is fixed overhead that doesn’t incrementally change much going from 12 to 13 psychiatrists. You do not really need to add “extra staff” for every additional psychiatrist…I current have an admin assistant that handles admin/scheduling/basic phone triage and basic prior auth stuff for 4 psychiatrists. Therapists/psychologists need even less admin support.
I mean yeah overhead is a thing but a group like this doesn’t or shouldn’t have 100K of added overhead per person.
Sure they may have in house billing people which is still an expense. Adding clinical staff eventually reaches a point where you add more billing staff.
If you over-rented/purchased to add for growth, that is great planning. It also means you’ve been running extra overhead on space, electric bills, etc for months to years. That is still $ lost.
We are running 1 admin/psych right now. No additional for therapists. Staff do vitals, screening tests with patients, schedule, PA’s (frequent with child work), pull charts, answer phones, send records, type reports (some contracts we have require this), relay messages, assist with pharmacy problems, etc. They stay busy.
I always expect to pay more than I think in overhead to ensure it is covered. The first 1-2 years of building a new psych will result in much less revenue. There won’t be $200k to work with. If the psych decides to leave early, we have recruiting costs, contract negotiation costs with a new psych, staff to notify and coordinate transfers, etc. That is more lost $.
With child work, we have an attorney on retainer to prevent court days which would pull us out of the office. I’ve paid another attorney to win a labor dispute which was thousands lost in attorney fees.
Credit card fees knock out 2-4%. Then there are credit card chargeback disputes. While not common, I got one today from a disgruntled patient. If I lose the dispute resolution process, it’ll essentially wipe out all profit from this psychiatrist for the week. Despite having thorough documentation, some of these disputes are impossible to win.
My point is that there are tons of expenses that people don’t think of when running an efficient practice for psychiatrists. It isn’t just add a new psychiatrist and pad your pocket with $200k.
I get that I’m coming from the owner perspective here. By all means negotiate for the best deal for you. I’m just saying that you need to keep in mind that there may not be a lot of room to work with depending on how the clinic is run. If I didn’t provide near as much support, I could pay more, but the psychiatrists would have more admin time to keep patients.