We Currently Have 5 Doctors Sharing 2 Exam Rooms
Our office and my practice has been growing at a breakneck pace after the initial slowdown for the pandemic. We now have 5 doctors in total sharing the office which has 2 exam rooms in it. Two of those doctors are not employed by me, but sublease the current space of 800 usable square feet. It seems insane, but lets take a look at how I made all of this work to lower overhead and increase profits. There is a reason my current overhead is still hovering between 20 to 30%.
We move into our new building in 2 weeks! Soon our limiting factor for space will be a thing of the past….for now.
COVID And TeleHealth
The government in March 2020 came out saying that they would cover COVID-19 diagnosis codes and start allowing telemedicine visits. Currently, telemedicine visits pay the exact same as a face to face visit. While this for sure will not last forever, this has opened the flood gates for changes in practices to non procedural subspecialties.
I would estimate that about 60-70% of our visits are done currently via telehealth. Without this, our practice would have taken a huge financial hit. This has saved our practice and opened the floodgates for telehealth in the future.
This is a big part of how we have so many doctors in such a small space. Two doctors see patients face to face in our exam rooms, the other 3 are doing telemedicine. Prior to COVID-19, the though of having 5 doctors share such a small space would have been laughable.
Scheduling Nightmares
Until we move into the larger office, we have to work around each other. Instead of waiting until the office is totally ready to move into, I decided to start ramping up visits for my 2 physician employees. This has mainly done via telemed.
Our current schedules are broken down into half day clinics.
Only 2 doctors can physically see patients in the office at any given time. The other 3 are forced to do telemed visits. For now, this has been a bit of a scheduling nightmare to make sure that our telemedicine patients do not accidently show up to our clinic.
Although it has not happened frequently, it has happened before. We simply had them go back down to their car and did the visit while they were sitting in their car.
Why Reimbursement Will Drop Big Time For Virtual Visits
We previously used doxy.me for our telehealth visits. Even paying the monthly fee for premium access, we found it to be unreliable. About 50% of the time, the virtual calls would drop and we would have to restart them.
In our opinion this was a very unprofessional look to the patient having their calls constantly dropped so we switched to a different provider. We switched our phones to a provider that offers free video calls with their services. Another benefit, it is the same cost of what we pay now.
On top of those benefits, we also get secure texting. Most of our patients do not answer the phone when we call them. Texting patients though has lead to a huge benefit all around. My staff does not have to sit on the phone with patients and can use their time to do other things. They quickly send out a secure text and get a reply.
My overhead to practice medicine has shot way down via telemedicine. One MA can now easily handle the virtual visits for all 5 of us on a day to day basis. Since they are not in the office, less I have to pay for commercial real estate.
I’m saving money on all avenues, which is fantastic. We started to pass those savings along to patients. Some easy telehealth cash pay visits we have decreased our payments by half due to increased competition. Eventually the market will adjust and I expect payments to drop about 50% with telehealth visits.
Getting My Employees Off The Phone
The biggest time waste for my employees is when patients call us instead of messaging us. Moving to a patient portal, secure email, and now secure text has been huge.
It frees up my employees to multitask instead of being stuck on the phone for 10 minutes trying to schedule someone.
The rapid shift in tech has been a huge blessing to our clinic and has decreased cost significantly. At first I wondered how our clinic would survive. Now I’m wondering how big this can get and how low we can get our overhead.
Adapt or die as a company and we sure are adapting quick.
This is super interesting, thanks for sharing. I am a physician doing consulting for telemedicine companies and the trend is to go towards lowering the cost of telemedicine down to nearly zero. The benefit of course will be that these companies will obtain data instead.
I actually think this is good for the self-employed docs because they can charge a higher fee since they will be offering higher quality of care.
I see the fees dropping for visits to almost nothing. I’ve seen as low as $9 for a visit. Insane that the race is to the bottom when they are going to make very little money. We already see it in our clinic where people don’t want to pay for a telemed visit with their high deductible because they saw a Facebook ad where they can get the same visit for $20.
I get that companies are trying to collect data, but I find it hard to imagine that these companies can easily sell HIPAA data without creating controversy.
I think that telemedicine companies will probably be hurting short and probably long term as every practice in the united states is now a competitor. I think the big few will have most of the market and the rest will basically die off as the primary practices take up the slack.
Good for you and glad to hear your practice is doing so well! You sure were able to adapt quickly to a rapidly changing environment.