Physician's Practice - November 2008 - (Page 73)

CASH-ONLY VS. RETAINER-BASED Speaking of numbers and patients and payment styles, there’s one last issue that needs inspection. Consider that when Wehr ﬁrst went cash-only, about 150 of his patients went with him. Of that portion, about 60 were fee-forservice, while the rest paid an annual retainer. However, Wehr has found that the cash-paying subset is much more likely to display drug-seeking behavior, which, of course, completely ﬂies in the face of his desire to treat the whole patient. Wehr would do well to shift his cashbased practice to a pure retainer model, as this will drive off the ne’erdo-wells while keeping the patients who truly want a well-qualiﬁed, attentive doctor heading up their care. Granted, this is a scary prospect on top of the initial scary prospect of going cash-only. First, dump the payers; now, dump the patients — yikes. “When you rebrand, it’s not without pain,” agrees Albenberg. Many of those fee-for-service patients are decent people who value the alternative model of care you’re espousing, and yet you’ll lose a certain fraction of them if you go retainer-only because they simply don’t have the initial funds to participate, or because they just don’t see the value. What a bummer, in those cases, to send out your “I’m changing” letter. But if Wehr truly wants to transform his practice to a model that aligns with his values and serves his patients well, then change he must. Unfortunately, change comes with some pain, and it delays gratiﬁcation. With 60 percent of his patients paying on a fee-for-service basis, Wehr can expect his patient load to drop off drastically if he goes retainer-only. It takes time to rebuild. But the alternative to not embracing and enacting the whole package means that Wehr can expect to eventually ﬁnd himself back where he started — practicing within a traditional, volume-based model, seeing 20 to 30 patients a day, taking a few days to return a phone call, keeping people waiting — with the added “bonus” of a defeated sense of déjà vu. Anything’s better than that. • Shirley Grace, MA, is an associate editor on staff at Physicians Practice. She can be reached at shirley.grace@cmpmedica.com. *The Great Practice Makeover is getting a mini-makeover of its own. From now on, the individual practice we’re proﬁling won’t be identiﬁed, and we’ll be focusing our advice on a single issue to give the feature even more practical applicability. So, got some dirt to dish? Worried about an especially sensitive situation? E-mail lchrobertson@physicians practice.com for a chance to have your own practice “made over” — anonymously. WWW.PHYSICIANSPRACTICE.COM NOVEMBER 2008 | PHYSICIANS PRACTICE | 73 http://forum.physicianspractice.com/ http://forum.physicianspractice.com/ http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physician's Practice - November 2008

Physician's Practice - November 2008 Contents Death of Solo Practice Just a Myth Letters HSAy What? Noteworthy Finding Lost Revenue: The Search for Billing and Coding Gold Getting More: Our Annual Physician Compensation Survey ’Tis the Season to be Neutral Ask the Experts Evaluating Paperless Labs HR in a Box? The Guide Coding Third-Party Audits on the Rise Branding the Cash-Only Practice Intra-Office Tug-of-Wars Stickin‘ Up For Yourself Classifieds Advertiser Index

Physician's Practice - November 2008

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