Creative ways for private practice groups to earn additional ancillary revenue?

[Bonez]

Some companies offer to give profit sharing in place of a lease payment (a percentage for instance). If you believe the numbers could be in your favor...

[Bonez]

Right now we have MRI for MSK/spine only. Hours aren't always consistent, but largely based on demand. Maybe could contract with local PCP groups to get...

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Have any of you [your group] found creative ways to earn ancillary revenue beyond traditional approaches? I would assume the main income to a physician...

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I'm in a large orthopedic group. We have a consistent compensation model for all the surgeons (partners and not-yet-partners). When someone new joins...

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Yeah I guess that's probably true. I think several of them came from families with a lot of $$ and wouldn't be surprised if they had no debt after finishing...

[Bonez]

As far as the multifamily and single family rentals go... You mentioned that you have a company that manages them for you. Are they spread out throughout...

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I keep in touch some of the other residents I graduated with. A couple of them bought $1M home almost immediately upon graduating and then the $150k wakeboarding...

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I know your post is relatively old, but if you're still watching the thread.... Are you investing in residential real estate / rentals? Or what kind of...

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11/2017 (-$300k) - shortly after finishing fellowship
1/2022 +600k - have largely been just maxing out 401k (w/ profit share), backdoor roth IRA...

[Bonez]

As an orthopedic person I'd say that skiing or snowboarding could both be hard on your joints depending on how you ride. So I'd probably just leave it...

[Bonez]

Thats a great rate. I wonder how much the % down affects the rate one gets? At the time of closing 2/2021 the mortgage I'm getting after downpayment will...

[Bonez]

Reviving an old thread for a different purpose... I have had USAA for decades - checking / savings / CC / auto ins / valuable personal property ins /...

[Bonez]

For purchase (not re-fi), the best rate I got was 2.625% fixed for 30 years. This was with 5% down only on a house that is $568k. Closing costs estimated...

[Bonez]

Anyone getting better than 2.625% on a 30-year fixed mortgage (conventional) recently? I had a broker that quoted me that. I also looked at a physician...

[Bonez]

If they've dropped their rate by quarter percent since then maybe I should apply at Laurel Road too. Thats where I just refi'd my student loans to as...

[Bonez]

Anyone checking rates on physician loans for 5% down recently? I just got a quote for a conventional mortgage 5% down 30 year fixed (with PMI) for 2.625%....

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Update: I was able to get a 2.8% fixed rate on student loan refi and I also applied for the mortgage which didn't further drop my any further. My score...

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I was also looking at these two about 5 years ago. Then I test drove a Subaru Outback and really liked that. I ended up buying a used Subaru and have...

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No mine are private. I just noticed that rates kept dipping so I'm doing another re-fi to take advantage....

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Yes it is still >810, but it had gone down about 15 points with my credit pull to apply for student loan refi. If it goes down more to apply for a...

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I know that because people will frequently shop multiple lenders for mortgages or student loans that multiple inquiries for one of these purposes within...

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I've gone through the preliminary "check my rate" part of several of the student loan refinance websites. So far Laurel Road is the only one...

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I never thought about the relationship discount... I currently have a loan at a local bank for an ASC investment. They apparently do mortgages as well,...

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When trying to find the best mortgage (considering both conventional and physician mortgages), do most of you use a broker? I had been looking at houses...

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Just out of curiosity.... Why would a seller care how much you are putting down if you can get a mortgage to cover the difference between the down-payment...

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I was just looking at various lender websites that do physician mortgages, and at least on their websites I'm still seeing at least a couple with 100%...

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I get what you're saying, but I don't think there is any obligation for lenders to chose the SOFR as the index they peg the variable rate to. Maybe they...

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Interesting. I didn't know that. How long have you had that loan? Does the verbiage in your contract state that this SOFR index will take over when LIBOR...

[Bonez]

For those of you who have variable rate student loans... How many looked at forecasted 3-month LIBOR rates prior to choosing a variable rate? Did anyone...

[Bonez]

Consider looking for a plot of land that backs up to some sort of state-owned or federal-owned land. Many of those types of land allow public use (including...

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This is for student loans. No fees/points involved...

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I previously had a 7-year term loan at 4.3% fixed that I refinanced in March of this year to 5-year term loan at 2.89% fixed. That is obviously a pretty...

[Bonez]

I'm in private practice ortho in a large group. Our compensation is tied directly to our production and there is an economies of scale such that the more...

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I was thinking about that as well. A bunch of my partners use the same accountant and they have been pleased with the service. I contacted them and they...

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Can you elaborate on how one goes about #3? Thanks...

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I should be able to do this pretty easily - so rather than making estimated tax payments of $X with my distribution check (different company than my W-2...

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I recently bought shares in an ASC (LLC) and I should be getting my first quarterly distribution after the end of Q3. My regular pay is otherwise W-2...

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Haha naw. I'm more into fishing, hunting, remote wilderness camping, etc. ;-)...

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late 30s ortho spine private practice

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I have a pair of these:

https://www.universalmedicalinc.com/...n-glasses.html

They're more than the 80-120 range you saw, but...

[Bonez]

I did this too... knowing that I could be out o there in 1 year if i wanted to (or earlier if I paid a penalty). The actual apartment unit was nice, but...

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Is that common to negotiate a lower salary in order to expedite partnership? What are the benefits of partnership in your group that made you choose to...

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I got hold of the financials. There is definitely a drop in revenue and net income for March/April of this year due to COVID. There was a drop from 2018...

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I will ask for some professional help determining if this is all re: COVID vs other additional issues. I know all the people on the ASC board and they...

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One guy cashed out right after Christmas last year (2019) and the other guy was slated to retire in October 2020 but when COVID hit he just said "screw...

[Bonez]

Thanks for the replies. I will try to get my hands on a 2-3 years of financial statements if they give them to me (I would think they would do this if...

[Bonez]

After two recent retirements in my group (both who invested in a local surgery center), two of us "younger guys" who have similar practices...

[Bonez]

I just noticed that I had some responses from the post I made ~3 years ago I did register a domain name I wanted and toyed around with WordPress, but...

[Bonez]

How are the surgical subspecialists holding up during Coronavirus? Our state just opened up for "elective surgeries" last week, but the hospitals...

[Bonez]

SunTrust bank has reasonable rates for used cars. I had one when I was a resident and bought a newer used car that I couldn't afford to pay cash for....

[Bonez]

My rent goes up a little bit each year. At the end of last month I was at a point where I'd have to re-sign a lease or give notification that I would...

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What region do you work in?...

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Our group has too many employees to qualify for PPP unfortunately. We have a meeting tonight, so I'll ask about the Medicare thing. The employees are...

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Seeing about 1/3 patients, >90% reduction in surgical cases. No salary, so im not getting paid at all. Eat what you kill, but killing less than overhead...

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I read that some docs on here were applying for unemployment. Is anyone applying for partial unemployment? Im still working (<50%), but not getting...

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I have really been liking YouTubeTV. We also have NetFlix and Prime and the cheap version of Hulu

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Ortho surgical volume down 80% in our group. Clinic volume down 60-70% which would be worse if it werent for adding virtual visits. I have a 6-7 week...

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If you have an assistant who can schedule visits on Zoom and teach patients how to install it and joint a meeting that works pretty well. We've been using...

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My wife and I still don't have combined finances haha. She makes significantly less than me (not in medical field). She has some bills that she pays on...

[Bonez]

No group tax to support general functions of the umbrella organization. Each division under the umbrella operates almost as its own separate entity as...

[Bonez]

We had a kid come into our clinic with a broken ankle the other day. His mother was just laid off from one of the major health systems in my area as an...

[Bonez]

I'm in a private practice orthopedics group. We recently formed a larger umbrella organization under which other private practice groups have joined (cardiology,...

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I'm in ortho private practice. Our clinic volumes are down 70% and surgical volumes down 80%. At this point we basically aren't getting paid anything...

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I've asked for an economic hardship forbearance on my private student loan (MOHELA). Apparently the servicers have been sensitive to the COVID situation...

[Bonez]

Nothing wrong with wearing a P100 (or P95). They're likely more readily available than an N95 if those are running in short supply. The N95 respirators...

[Bonez]

I have a lot of "favorited" houses on apps like Redfin. In the last few days my phone has been sounding off frequently with notifications of...

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I imagine that private practice surgical subpecialty groups will be having a hard time with the moratorium on elective cases. Unless there are large cash...

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Update: I'm glad I didn't end up buying the house

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What is happening with your staff at the "extra offices"?...

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I'm also reducing my clinic schedule to necessary post-ops. I haven't taken "new patients" off the schedule because I don't know if they are...

[Bonez]

I am a partner in an orthopedic group...

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For those of you in surgical or procedural specialties and in private practice... What are your practices doing if you are currently faced with all elective...

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Since you are an employee and they're asking a lot of you, I'd tell them you want 1.5x the money to cover those 5 days extra and put a time limit on it...

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I chose the cheapest school. I'm not sure how much it matters going into Cardiology, and maybe things have changed since I graduated about 10 years ago,...

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ortho

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https://www.latimes.com/world-nation...-test-positive

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The American Academy of Orthopaedic Surgeons cancelled their annual meeting in Orlando that was supposed to start two weeks from today

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I have factored these expenses in. We owned a house in another state before moving here. Although it was a lot less expensive than what we're looking...

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I get what you're saying, but the interest rates certainly can have a big impact. Assume a $600k mortgage with fixed rate over 30 years. The difference...

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I'm not ready by the standpoint of what I've read on this forum (i.e. no student loans, 20% down), but by the time I get there I'm worried that might...

[Bonez]

Average 30-year fixed rate mortgages are at an all-time low since the 1970's currently. If one has been considering buying a home "within a couple...

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Thanks for the input so far. To clarify, I have not signed any agreements for a buyers agent (the lady showing the house or otherwise). It is my understanding...

[Bonez]

My wife and I have been casually looking at open houses on weekends in the area we eventually want to buy a home. Last weekend we toured a home that was,...

[Bonez]

I will have to clarify with our plan administrator, but basically he sent us an e-mail that said "let me know how much you want to contribute - up...

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I am currently meeting my savings goals - about 30% of my gross income. My income was about $320k last year, but I expect that to increase to over $400k...

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My practice is starting a new cash balance plan that I have the opportunity to begin participating in next month. Currently we have a 401(k) that I max...

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Has anyone done a Backdoor Roth recently on Vanguard? I have done the backdoor Roth IRA for a couple years now, but the interface looks a little different...

[Bonez]

What happens if there is an in flight emergrncy and I'm an orthopod?...

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Great idea. I never thought about opening multiple accounts with Ally. For some reason I just feel better about keeping things in different buckets: Emergency...

[Bonez]

Any upside or downside to having more than 1 high yield savings account? I have an Ally accout currently for my emergency fund with 3+ months all expenses....

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I have partners that took out loans and structured the loan payments such that it was in-line with the quarterly distributions. Usually the ASC returning...

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2009 Subaru Outback limited. 140k miles. Looks mint and drives like a champ. I plan to keep it as long as I can because I love this car

[Bonez]

I remember when I was in med school I used to have more free time and would go to the gym and do cardio AND weight-training at least 5-6 days per week....

[Bonez]

I guess what I mean is that the entire right column is blank with a "$0" at he end for earnings/loss. So there is no adjustment to my income. Not that...

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I received a Schedule K-1 for an LLC formed in 2018 for some clinics my group is building (that I am a small partner in). It is a work in progress and...

[Bonez]

If they think its a "neck" problem and shes already gone through extensive therapy then the MRI may very well be the next step. You may find that a physiatrist...

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I have to tell some patients that they are literally too fat for me to operate on (unsafe for anesthesia, don't have appropriate sized detractors, etc...)....

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Thanks for all the great advice everyone! I'll keep working hard and making a good impression. I'm sure later this year I'll be a lot busier when my other...

[Bonez]

I do spine surgery. To give you an idea of the size of my group without giving it away, it is in the top 10 biggest in the country (>100 surgeons) and...

[Bonez]

G wrote: I would be surprised if it were cost effective for you to arrange (let alone take an afternoon off) a drop by in a clinic. Click to expand... Thats a good point. ...