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primary care docs, i want your input/opinion/answers..how much do you gross per day?

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  • #31
    I have come to the conclusion that most people on this forum are fat city (specialist with specialty earnings). Yes, you read this right, fat city.

    I work per diem in primary care as employee with set salary, about $1200 per day. In a previous role as a hospital employee, my compensation model was wRVU based and I made about $1400 per day seeing about 20-22 per day.

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    • #32
      I don't know how primary care physicians survive based upon their collections. I probably see 10-15 outpatients per day on clinic days because I have to round on dialysis patients those days as well. I see far more dialysis patients then clinic patients, but the clinic patients take far more time then rounding on the dialysis patients. The clinic patients also require staff to check in, make referrals, and are responsible for our office rent, etc. If we were reliant on clinic patients for our salary, I think that we would be at less then 100K per physician. I am usually pretty tired after seeing 15 patients in clinic as well, I don't think that I could do much more then that. I think that most pcp's should try to set up systems like hospitalist have where they are not just dependent on their billing for their salary, the hospital subsidizes them to be there. PCP's generate a lot of money into a hospital system through their referrals, I think that a lot of places with competing hospital systems are paying them more on a supply demand salary vs what they are collecting.

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      • #33
        The requirements for coding 99214 and 99215 changed in 2021,so seeing 20 99214 patients in 4 hours would be pretty doable with an efficient office, the right doctor and the right patient mix. People should make sure they are up to date on coding guidelines. Whether you'd actually want to work in such a practice is a separate question.

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        • #34
          Originally posted by CordMcNally View Post

          As a PCP, do you feel like you’re giving not only good care but the care your patients need? That seems like a lot of important things will wind up falling through the cracks.
          You’d be surprised what can happen in 5-10min. All of their questions get answered, that’s what I spend doing the entire visit. All the other extra junk like quality metrics gets done after the patient leaves like ordering mammograms,Colonoscopies, etc.…

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          • #35
            Originally posted by HikingDO View Post

            20 99214/99215s in 4 hours in family med? You sure you’re giving good care to those patients?
            Absolutely

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            • #36
              Originally posted by B1GM0N3Y86 View Post
              3 yr post residency.
              FM outpt, no OB. Mid sized city
              In my first year with current organization.
              $115/hr during the guarantee period.

              Afterwards, guesstimating in the $140-170/hr based off collections. Haven't calculated what quality metrics would add.
              Thanks.
              after your guarantee I think u can make more as long as you have patients and bill 99214/5s.
              if you can see 6 pts per hr, then that should be $250/hr

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              • #37
                Originally posted by gap55u View Post
                I can envision (but would not enjoy) 5 patients per hour 99214. Suspicious if you do no 99213’s as an FP. I would be very interested to know how many 99215’s you see, and please PM me or post about some typical 99215’s. Clearly you aren’t doing that by time. I see a lot of complicated patients and it’s possible I under code (our compliance person is famously conservative). If in fact you see 20 99214’s in 4 hours, you’ve gotta be above 95% mgma.

                I'm in a desirable city hence pay is lower. I think I’m circa 150/hr.

                Also: I spent a year above 90%tile mgma and it was great for burnout and bad for my family. I’m much happier working less.
                I do very little 99213s…uti wo chronic conditions, mild viral uri(except covid), otitis media etc . Everything else is 14s, 15.
                look at the 2021 coding guidelines, aafp has a good overview. That way you can justify your billing to your compliance people. Mine freaked out when I billed so many 99215s but I just explained the guidelines to her and she was fine. As long as you document the requirements appropriately there’s no problem. Use the emr to your advantage, order sets, text macros help a ton.

                I would be above 95%mgma however my dollar per rvu is low and my org refuses to increase so I have top 10percent production but get median pay. Go figure. So in my case I just max my billing.

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                • #38
                  Originally posted by bobedwards View Post
                  I have come to the conclusion that most people on this forum are fat city (specialist with specialty earnings). Yes, you read this right, fat city.

                  I work per diem in primary care as employee with set salary, about $1200 per day. In a previous role as a hospital employee, my compensation model was wRVU based and I made about $1400 per day seeing about 20-22 per day.
                  Your probably right…I think it’s hard for them to comment from the ivory tower

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                  • #39
                    Originally posted by nephron View Post
                    I don't know how primary care physicians survive based upon their collections. I probably see 10-15 outpatients per day on clinic days because I have to round on dialysis patients those days as well. I see far more dialysis patients then clinic patients, but the clinic patients take far more time then rounding on the dialysis patients. The clinic patients also require staff to check in, make referrals, and are responsible for our office rent, etc. If we were reliant on clinic patients for our salary, I think that we would be at less then 100K per physician. I am usually pretty tired after seeing 15 patients in clinic as well, I don't think that I could do much more then that. I think that most pcp's should try to set up systems like hospitalist have where they are not just dependent on their billing for their salary, the hospital subsidizes them to be there. PCP's generate a lot of money into a hospital system through their referrals, I think that a lot of places with competing hospital systems are paying them more on a supply demand salary vs what they are collecting.
                    I work for a large hospital org, their cheap as cheap gets. Plus our ancillaries are terrible so I’m sending all my imaging to our competitors!!

                    Comment


                    • #40
                      Originally posted by Savedfpdoc View Post

                      Absolutely
                      I’ve been doing family med for 26 years and I really don’t see how you could, but ok, if you say so….

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                      • #41
                        Originally posted by HikingDO View Post

                        I’ve been doing family med for 26 years and I really don’t see how you could, but ok, if you say so….
                        I’d be happy to consult. Here’s my website … (jk I don’t think wci allows free advertising)

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                        • #42
                          Originally posted by Savedfpdoc View Post

                          I’d be happy to consult. Here’s my website … (jk I don’t think wci allows free advertising)
                          Nah, I’m good, I prefer giving my patients more than five minutes of my time, but thanks anyways.

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                          • #43
                            I'm psychiatry and pretty much only bill 99214 for follow ups but they're all 30 minute appts!

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                            • #44
                              Originally posted by Savedfpdoc View Post

                              Thanks.
                              after your guarantee I think u can make more as long as you have patients and bill 99214/5s.
                              if you can see 6 pts per hr, then that should be $250/hr
                              I'm about 80% 99214s, 10% 99213s, 10% 99215s. I'm sure tho that some of my 4s are 5s. Coding them correctly and being bit more efficient on my end could get my rate up bit more. However I am unsure about the $250/hr tho, I just dont think I would be comfortable averaging 6 pph. But that is just me, not saying it couldn't be done by certain physician and office system.

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                              • #45
                                Originally posted by Savedfpdoc View Post

                                Your probably right…I think it’s hard for them to comment from the ivory tower
                                A bit salty this week are we?

                                kudos to you on billing and pushing that edge while sticking it to your institution at the same time. OTOH, hard to justify a sweeter contract with them if they see your referral pattern (and they do if it's a money driven large institution).

                                Does your institution EHR play nicely with your outside imaging?

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