Home Forums Discussions General Discussion Jump ship?

Hello all

I am 11 years out of GI fellowship. I first worked with a MSG, then left them due to too much call. Then joined a solo guy for 3 years. When it was time for "partnership", I thought the $200k he wanted was too much of a buy-in into the accounts receivable. I didn't have a non-compete clause with him, so I was able to stay in the area and went solo. That will be 3 years in April. In short: I'm failing, and I don't know why, or what to do to fix it.

I started the practice from scratch using a bank line of credit. I thought I would be home free in 6 months to a year. But the practice remains too slow. I'm still unable to even afford a full-time practice manager, let alone a PA or a second GI. I use Amazing Charts for the clinical part, but I don't have a PM software. For billing, I use a lady who does it out of her home for 6% of collections. She's the practice manager for a local primary care practice, and she helps me with some aspects of managing my office and my 3 employees. But I really do not have a clear picture of my practice finances at all- floating aimlessly, to put it mildly. Most months I have a hard time paying my personal and practice bills. I haven't been able to find a stable or reliable bookkeeper and CPA. I'm even more than a year late filing taxes. Certainly not where I thought I would be after 11 years of practice.

I have done the usual things for marketing: visiting PCPs, faxing my notes promptly, being responsive and accessible, giving away pens and mugs to the referral coordinators of primary care practices, etc. But the practice is at a plateau. Part of the reason might be that there are 7 other GIs in a 250,000 people catchment area, but I'm not sure.

To make things more complicated, I have had my share of adverse personal life events, which have left me "all over the place" mentally. I think that's part of the reason I have not been more organized with my record-keeping and finances. Also, I have not passed my Boards recert and will have to sit for it again.

Wanted to get y'all's thoughts on what I'm doing wrong, and what could be done to fix it. And whether it's time to look for an employed position somewhere else and drop this. Of course I can't even apply for jobs before passing the Boards. So I'm stuck where I am for a while.

Thanks
Khaled

Khaled,

Don't give up, but sounds to me like you have isolated the problems and you will get them solved.

You have identified the single most important issue and if you deal with that the others will fall into place.

Many moons ago, I found myself in a similar spot and got through it but you have to get the personal stuff worked out first and foremost. Hang in there.

Get your dealings with Unc Sam straightened out quickly, if you owe back taxes he is not forgiving to docs; may need to get an intermediary (tax lawyer) to deal with him.
Sounds like you have 1 employee too many unless they are all part-timers.
I've been there and am still paying the price but at least the bleeding has been stopped and can see improvement.
You are still young and can do it.
You may have started the private practice anticipating better revenues and spent accordingly ie overspent. Cut expenses.
Good luck,get the boards done, keep positive you have the ability to change things and improve your situation.

Khaled...come to Findlay, Ohio...you will be busy when you get out of your car....Blanchard Valley Hospital, Findlay Ohio as they are looking for GI people...we only have 2 and they are booking well into May...only about 3 docs in this town actually scope.....todd

My thoughts are if you're in such a pickle and haven't gotten your practice humming after 11 years of experience, then you probably need to bite the bullet and work for a salary.

Being a CEO isn't for everybody and there is something to be said for just going to work and getting paid.

Keep in mind that you're in a profession and specialty that would allow you to sign a $200K+ contract within a month at any number of locations across this country and have a stable paycheck for as long as you wanted. 99% of Americans would kill to be in your situation.

Thanks, all.

Jimmie
When you say I identified the most important issue, are you talking about the local competition?

Koby
Agree completely about taxes.

Todd
I actually emailed the recruiter my CV yesterday. Will see what happens. Thanks for the tip.

BamaDoc
Thanks. I'm looking into moving.

Khaled

Khaled,
Putting together a PM; will send it to you later.

Khaled,

Thanks for opening up about this, but this is only my opinion, and I may be way off base. But I meant the adverse life events that have left you mentally all over the place--I think if you get those things in order (and you may already have) and then everything else will fall into place.

Khaled,

When I've been in trouble in the past (in a number of occasions usually due to my own stupid mistakes) I never made progress until I could admit to myself and others the exact nature of the problems. You've done that--it's a HUGE step forward.

With best wishes to you during this difficult time,

John

If the recruiter for Findlay, Ohio doesn't give you a good feeling let me know. I would love to see you up in business...It wouldn't be that hard