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youngdad

GP side projects/supplemental income

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30% would be about the average of the clinics I have visited.  I hear tales of woe; only 10 years ago the clinic I was at was at 41% overhead.  Yikes. 

Now we are a lean machine, our support staff are happy as far as I can tell, we are not overcrowded but space is getting limited.  Our facilities are nice.  We are always looking to cut costs but not corners.

Things can change in a hurry.  If a doc retires and you cant find someone to take his/her place suddenly their overhead share needs to get paid by everyone left. 

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Any side projects that a student can start learning during clerkship?

 

I have a few weeks off and am trying to arrange horizontals in joint injections, anesthetic injections etc. But I'm trying to think of anything else where a student could get involved. I have a contact for Botox but I feel like they would only let me shadow...

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The first post in this thread is not my personal experience over the last 2 years of practice. My main place of work is a large city in Alberta but I've done everything except obstetrics. In order of best paid to least:

-Emergency/Urgent care on a weekend, evening or statutory holiday

-Efficient LTC, ~10 patients/hr (although the added billing crap you have to do afterhours ruins the experience)

-Busy walk in clinic

-ARP hospitalist, ARP LTC, ARP anything (it's a set hourly rate). Anecdotally, hospitalists often "bill" for more hours then they normally work.

-Efficient clinic booking 4 patients an hour

-Emergency/Urgent care on a weekday

-Extenders, surgical assists

 

Obstetrics is a bit tricky because they often have different shifts. Some do 24 hours shifts, others 12 hours, some are nights which screw your following day, some are on weekend, etc.. so I don't know how it washes out in the end. On a per shift basis, it certainly is good but you have to look at the complete picture.

With cosmetics there's a huge variation in income. For it to really be profitable, you almost have to do it 100% and have a constant referral base.

Even then, the difference between best paid and least paid on above scale is barely 100%, so do what you like and mix it up.

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There are a variety of sessional positions you can sign up for with your health authority, most allow mixed billing.  I do OAT clinic and mental health work this way.  If it is a slow day, you make $133 and change/hr for surfing the internet (or catch up on paperwork etc...), if it is busy, you bill and make more than that (all without overhead!).  Granted, these are easier to come by in places outside of major cities.

Also, one of my colleagues does group obesity and diet counselling, and makes a lot of money doing it.  He has now hired a nurse to carry out the curriculum he developed.  

 

Finally, looking at the fee codes here in BC, it doesn't seem like lumps/bumps/joint injections pay particularly well.  Unless you are ultra efficient, it is probably hard to increase your income (vs seeing regular office patients) doing these type of procedures.

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On 9/23/2018 at 12:48 AM, bloh said:

The first post in this thread is not my personal experience over the last 2 years of practice. My main place of work is a large city in Alberta but I've done everything except obstetrics. In order of best paid to least:

-Emergency/Urgent care on a weekend, evening or statutory holiday

-Efficient LTC, ~10 patients/hr (although the added billing crap you have to do afterhours ruins the experience)

-Busy walk in clinic

-ARP hospitalist, ARP LTC, ARP anything (it's a set hourly rate). Anecdotally, hospitalists often "bill" for more hours then they normally work.

-Efficient clinic booking 4 patients an hour

-Emergency/Urgent care on a weekday

-Extenders, surgical assists

 

Obstetrics is a bit tricky because they often have different shifts. Some do 24 hours shifts, others 12 hours, some are nights which screw your following day, some are on weekend, etc.. so I don't know how it washes out in the end. On a per shift basis, it certainly is good but you have to look at the complete picture.

With cosmetics there's a huge variation in income. For it to really be profitable, you almost have to do it 100% and have a constant referral base.

Even then, the difference between best paid and least paid on above scale is barely 100%, so do what you like and mix it up.

When you mention urgent care during weekends, and evenings and statutory holidays; does that refer to walk in clinic or doing urgent care clinic at your Family Health Team? or ER work?

 

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Probably as important as everything that has been posted is what type of contract you sign with your clinic re: overhead  and what types of duties are included in the overhead.  The contract I signed at my own clinic, only in office visits and anything done during an office day from the office (ie. phone calls) is required to be paid into the overhead.  I do out of office visits to semi-assisted living care homes and residential care and get to keep 100% of the income (I do organize the scheduling of these places by myself and do all my own billing on a separate billing platform, though get to use the EMR free of charge).  My partner gets to keep 100% of hospital work.  Some clinics you get to keep 100% of private payments after a certain amount etc...  So things that are average income can be very good income if you don't have to pay overhead..

If you look around at how desperate some clinics are to attract docs, these types of things can be negotiated into the contract.

On a final note, here in BC, your income goes up significantly once you attach yourself to a clinic and have your own practice (vs. walk in , locuming et...) because at that point you have access to all the chronic care and complex care fees.

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