End of month, End of quarter

It's the end of the month and quarter.

Before I get to numbers, it has been an aggravating tech couple of days. My website had been down for 3-4 days. My webmaster had the hosting switched from one server to his, and it took 3-4 days to switch and "propogate". Of course this happened as soon as I sent out an email newsletter to my patients that included links to my site that they could not get to!!! Great timing!!!!!!!!!!!

Next tech hassle is my EMR. I use soapware. I have been happy with it for 4 years, but over the past 6 months, since their frequent upgrades to become C-CHIT certified, there have been many bugs and glitches, and their tech support has been lacking. I am contemplating making a switch to another vendor if the switch itself does not become another nightmare!

My third tech hassle is that along with my website, my email is also down, now for 4 days. I am being promised it will be back up by tomorrow, but that is the same promise I have heard for the past few days.

Pearl of the day: Technology can be wonderful, but when it does not work it becomes a nightmare.

What will happen next? Hopefully not that April fools worm that might hit tomorrow!

The numbers..................

Pts seen for the 1st quarter of 2009: 590
Average $/patient for the 1st quarter of 2009 $95.53


Pts seen for the 1st quarter of 2008: 570
(if I remove leftover 2007 insurance patients from the total)

Average $/patient for the 1st quarter of 2008: $89.19
(when old(2007) insurance $ removed)

So by switching to a zero copay wellness option, with more money upfront, it seems that I have had a slightly higher patient volume and better $/patient. This may decrease if I do not continue to sign up new wellness patients each month. Of these patients, just over 1/3 are on the monthly autobank draft option that keeps monthly revenue flow coming in. About 25% of the 2009 wellness patients are new to my practice, whereas 95% of 2008 were established patients. About 15% of the new wellness plan patients were self pay in 2008. I have had a few patients switch back to selfpay, almost always the result of either a job loss, or less need for medical care. The new patients and the switch-in patients outnumber the 2008 wellness patient's who went elsewhere for their care in 2009.

The breakdown in patient visits for the first quarter 2009:

Selfpay 39%, Wellness 37%, Medicare 24%

The breakdown in patient visits for the first quarter 2008:

Selfpay 56%, Wellness 22%, Medicare 22%

So the selfpay decreased by 17%, wellness increased by 15%, medicare down 2%
Now part of the wellness relative increase is due to some 2008 patients whose old plans are still in effcet for part of 2009. January 2008 started with zero plan members and it took a few months to increase the wellness patient volume.

My ultimate goal is for Wellness to be about 60%, Selfpay 25%, Medicare 15%. At this breakdown, overhead and collections will be even lower than at present.

Expenses for 2009 are lower than 2008 by about 10% and from 2007 by about 35%.
The revenues have not made up the difference yet, as my take home is still lower.
But the joy of going to the office and just being a doctor, and working for my patient's and not any third party is a pleasure.

My hope is that the revenues increase with slightly more volume. In my set up, if I get 800 active patients, with 600 in wellness plans, averaging about $425 per year per wellness patient, that would bring in $255,000. Selfpay patients would be about 50 visits per month averaging another $48,000 per year. Medicare would be another 25 visits per month averaging another $21,000 per year.

Total hopeful revenues would be about $325,000 per year, with expenses coming in at about $15,000 per month or $210,000. That would be profit of $124,000 per year, with a patient practice of about 800, and seeing about 12-18 patients per day, 4 days a week. If I want to work harder and work 5 or days a week, then increase the profit accordingly.

I welcome any thoughts.

DoctorSH