The Private Medical Practice Academy

Understanding your obligations surrounding employee taxes is crucial for operating a successful business, whether you're an employer or an aspiring entrepreneur. 

In this episode, we explore the four primary types of employee taxes: 
• Federal and State income tax

• Withheld by employer
• Employer responsible for submitting

• FICA

• Funds Social Security and Medicare
• Employer responsibility is 7.65%

• FUTA

• Federal unemployment tax
• Paid by employer to fund state unemployment programs

• State Unemployment tax

• Based on employer payroll
• And number of unemployment claims

As an employer, you're no stranger to the deductions made from your employees' paychecks. Being on the opposite side of the table, though, offers a whole different viewpoint on employee taxes. 

Given the difficulty and significance of correctly filing employee taxes, it is understandable that doing so might take a lot of time and effort. There are several choices that can help make life easier and guarantee compliance. The process can be streamlined by using payroll software, outsourcing human resources and payroll to HR companies or CPAs, or hiring a qualified practice manager. Always remember that it is strongly advised to visit a tax specialist or have someone educated about tax issues.

Remember, mastering employee taxes is a crucial aspect of running a successful business, ensuring compliance, and fostering a healthy employer-employee relationship. Join us on this insightful episode as we equip you with the knowledge and understanding necessary to navigate the intricate realm of employee taxes. 

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

The Stark Law prohibits physicians from referring patients to entities in which they have a financial interest to prevent financial incentives from driving medical decision-making. The Anti-Kickback Statute prohibits the exchange of anything of value in exchange for referrals for services. 

Examples of Stark Law violations:

• A cardiologist refers patients to a diagnostic testing facility in which he has a financial interest. 
• A physician is found to be billing Medicare for services provided by an unlicensed midlevel. 

Other Exceptions to the Stark Law

•  "In-office ancillary services" allows physicians to refer patients for certain designated health services provided in the same building where the physician's medical practice is located if the service is furnished under the direct supervision of the referring physician or another provider in the same group practice and that the arrangement complies with fair market value (FMV). 
• Healthcare providers to give non-monetary compensation to physicians and their families up to the annual limit. 
• FMV compensation allows providers to enter into financial relationships with other providers if does not take into account the volume or value of referrals.
• Academic medical centers that meet certain criteria may provide compensation to physicians who are engaged in teaching or research activities.
• Rural providers  may be able to enter into certain financial relationships that would otherwise be prohibited under the Stark Law provided certain criteria are met. 

Safe harbor provisions that provide exceptions to the Anti-Kickback Statute :

• Investments in entities that provide healthcare services if held for one year, and is not be tied to the volume or value of referrals.
•  Office space or equipment rented between providers if the rental amount is consistent with FMV and is for a period of at least one year.
• Personal services and management contracts between healthcare providers if the compensation paid is at FMV and  not be tied to the volume or value of referrals.

The key takeaways—you can’t do things that are tied to volume or referrals and any financial arrangement has to be at FMV. 

I strongly urge you to discuss Stark and AntiKickback with your healthcare attorney so that you know

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Insurance is one of those things you never want to need or use. But, unfortunately, when life happens having insurance can save you. Some types are pretty obvious but there are some you probably haven’t thought yet. That doesn’t mean you don’t need them. In this episode, I'll tell you the types of insurance your practice needs to mitigate its risks.

• Medical malpractice insurance protects healthcare providers from claims of negligence and medical errors. You want to have a separate policy protecting your practice--not just the individual provider.

• General liability insurance covers your business from claims of property damage or bodily injury that may arise from accidents on your premises.

• Cyber liability insurance provides coverage for data breaches and other cyber threats that could compromise your patients' confidential information.

• Workers' compensation insurance is required by law in most states and provides coverage for your employees in case they are injured on the job.

• Business interruption insurance  can provide financial protection if your business is forced to temporarily close due to an unexpected event such as a natural disaster or a pandemic.

• Employment practices liability insurance can protect your business from claims of discrimination, harassment, and wrongful termination brought by employees.

• Business overhead expense disability insurance can cover operating expenses such as rent, utilities, and employee salaries, even if the owner or key employee becomes disabled and unable to work. 

Find an insurance professional who can bundle all of the business-related insurances. They can help you assess your needs (the amount of coverage, deductible, etc.) and bundling will give you the lowest cost.  

While hopefully you will never need to make a claim against any of  your insurance policies, the cost of having the insurance is trivial compared to what it will cost to deal with any of these events without insurance.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Owning a private medical practice is a journey. Initially, you're focused on how to get the practice up and running. The next phase is how to best run the practice. Over time, you transition to how to grow and leverage the practice. And, at some point, you will want to leave the practice that you started. 

Having a roadmap definitely makes the journey easier. That's where having a business plan helps. One of the key considerations, from the start, needs to be "what does my exit look like."  Now I totally understand that this may be difficult to envision but many of your decisions will depend on where you want to head. 

You wouldn't get in the car without knowing where you are going. 

In today's episode, I speak with Eric Miller of Econologic Financial Advisors about the five most common options for exiting a private practice. 

• Die with your boots on 
• Just close your doors and turn off the lights
• Bring on partner physicians and selling them shares of the practice
• Sell the practice to private equity or other corporate entity
• Sell the practice to a hospital system

It's exceedingly unlikely that you want to die while still owning/running your practice. If you simply turn off the lights then you don't get any sale price for having built this successful business. And, for most of us, it's unlikely that one or more of your children will join you. 

Realistically, that leaves the last 3 options. Given that, how do you maximize your practice's EBITDA so that you get the biggest return on your investment? Because your practice is an investment. 

There is no "right" answer for what your exit strategy should be. You need to educate yourself and understand the pros and cons of each option.  Set yourself up from the start to have multiple options by having a well-defined operating agreement that spells out buy-in/buy-out, drag along rights, decision making, partnership and more. Understand what's need to sell your practice to others including partner physicians, physicians (not already in your practice) or corporate entity.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

More patients equals more money. Right? Not necessarily.

If you want to grow your practice, you're probably thinking how do I get more patients. But is that really the right question to ask?

In today's episode, I had the pleasure of having Zed Williamson from TrackableMed back with me to address what you should be asking. For starters, increasing your practice's volume and revenue does not happen by chance. Here are some of the questions we address:

1. What type of patient do I want to bring into my practice?
   • Better insurance/payer
   • Need a specific procedure
   • Have a certain diagnosis
2. Where do I find the patients that I want?
3. Why do they want to see me? And how do I communicate that?
   • Hint-it's not about you. It's about them
4. Are there obstacles in your practice that limit your growth?
   • Scheduling
   • Space
   • Staffing

Zed also shared how to determine the cost of acquisition of a new patient. You can reach out to Zed for his calculator at [email protected]

Last,  we discussed the invaluable task of writing out the step-by-step process that a new patient would go through so that you can identify any roadblocks that limit  your practice's growth. 

Zed Williamson founded TrackableMed in 2011, a patient demand acceleration platform rooted in neuroscience. Zed grew frustrated by the lack of accountability in the advertising industry and started TrackableMed to focus on results. TrackableMed  helps private practices create patient demand for their therapies.

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

You've probably heard me say that medicine is a business.  It takes work to run a successful business.   There are good days and bad days.  And, no matter how hard you try, like all business owners, you'll make mistakes. That's the truth.

But with mistakes comes experience. The key  to running a successful private medical practice, or any business for that matter, is to learn from missteps. Ideally you learn how to grow from other people's mistakes rather than have to make them yourself.

Today I chat with Dr. Christine Meyer of Christine Meyer and Associates about her journey from being an employed physician to starting her own practice and ultimately growing it to the 19 providers she has today.  While I want you to hear that it is really possible to have a phenomenally successful practice, the real goal of this episode is to talk about the mistakes she and I have both made along the way.

Dr. Meyer and I discuss everything from hiring providers, to figuring out space requirements to managing staff, how and what to delegate and more. You'll hear about the common pitfalls that many practice owners experience and how to avoid them.

One of the most important takeaways from my conversation with Dr. Meyer is, no matter what stage you are at in starting, running or growing your private practice, you need to be actively involved in the management and learn from every experience.

More about Dr. Meyer:
Dr. Meyer was born and raised in New Jersey to first-generation Egyptian parents. She received her Bachelor’s  from Rutgers University and MD from Hahnemann University School of Medicine (now Drexel University). Dr. Meyer  completed an Internal Medicine Residency at Thomas Jefferson University Hospital and is board certified in Internal Medicine.

She met her husband, Dr. Christopher Meyer, on the first day of medical school.  In 2004, the Meyers realized their life-long dream to have a medical practice together. Christine Meyer, MD & Associates, and Healthy Steps Pediatrics are considered the premier primary-care practices in Chester County.

Her most recent passion has been the launch and growth of her podcast, Tell Me More: Better Conversations in Healthcare, 

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

In this episode, I'll outline the key steps you need to develop your practice's strategic plan for the new year.

The first step: doing a review of the past year. For this you will need a few things:

• 2022 Profit and Loss statement
• 2021 Profit and Loss statement (so you can look at the year-over-year changes)
• Year end billing reports

To develop this year's strategic plan we need to do a post-mortem on the prior year. We need to figure out what went right and what we can improve. Examples of what we're looking for:

• Did you meet your 2022 goals?
• Did your revenue grow? 
• How's your volume?
• What's happening with your expenses? What expenses  can be pruned?

One of the first goals should be your profit projection. How much money do you want to make this year?

This year's strategic plan involves setting both yearly and quarterly goals. These goals depend on the stage you are at. 

The quarterly goals should  build to achieve the yearly goals.

Examples of possible yearly goals:

• Getting credentialed and contracted by Fill in the Date
• Add a new physician and/or midlevel to my practice
• Add a new revenue stream
• Have X% year over year growth in Revenue &/or Volume

Examples of possible quarterly goals:

• Increase volume by X%
• Develop standard operating procedures for front desk (or whatever needs work)
• Decrease average days in AR
• Decrease number of days until claims are submitted
• Decrease days to complete charts
• Increase front desk collections

Mine last year's data to look for the good, bad and ugly of how things are going to help you determine the items to focus on this year.

If you have any questions about your practice's strategic plan for 2023 contact me at [email protected].

Earn 1 AMA CME when you learn and reflect: CMEfy link for it: https://earnc.me/tkXPli

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Finding space for your medical practice can seem very intimidating.  So when someone asked me for a consultant in the Dallas-Ft. Worth area to help them figure out where to look for space for their new office I realized that I need to address this topic head on.  You don't need to pay a consultant for this. You need a commercial realtor. 

That's why I invited Colin Carr, the founder of Carr Healthcare, to join me today to discuss the nuts and bolts of finding a lease space for your practice.  

In this episode we cover some of the topics you are frequently asking about. Here's just a sample of what we discussed.

• Where should I choose a space to lease for my practice?
• How does using a commercial realtor work?
• Can I negotiate with multiple landlords at the same time?
• Should I choose a gray shell or a turn-key space?
• Do I have to pay for tenant improvements or does the landlord?
• How much does a buildout cost?
• Do I need an architect and/or contractor before I choose a space?
• and so much more

If you ever need to look for space for your medical practice you are not going to want to miss this episode!

Colin's firm only represents physicians who are looking to rent or buy medical office space. Here's the link to Carr Healthcare Realty-- https://carr.us. (I have no affiliate relationship with Carr Healthcare Realty)

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!

Drug and Device reps often drop into medical offices--usually uninvited. And they seem to always to be there at the most inopportune times. Most annoying is when they camp out in the back waiting for you. It's no wonder that many physicians have disdain for Drug and Device reps.

If this is your attitude, you're missing out on a great (free) opportunity to grow your practice.

In this episode, I chat with Omar Khateeb who helps med tech companies grow sales and drive product adoption using social media.  Omar is an interesting guy. His dad is a vascular surgeon and Omar went to med school before becoming a device rep. Omar ultimately transitioned to marketing and teaching reps how to interact with physicians.

Drug and device reps can help you grow your practice in multiple ways. They can:

• help you assess your draw area
• give you insight into your competition and  community in general
• help market you
• do research for you--about reimbursement, new procedures, demographics
• help you recruit new physicians
• help you determine where to open a satellite clinic
• help you with social media posts
• help you with social media content including testimonials, videos of procedures

Key point: Make the rep part of your team rather than view them as a nuisance. 

Here's some suggestions for how to make the rep part of your team:

• Set parameters for when you are available to meet with them
• Be explicit in what your needs and wants are
• Understand they may not have dollars to spend but they have time
• Empower them to help you
• Be nice. Get to know them.
• Give them something back. Sure they want you to use their product more. But aside from that--a Linkedin pat on the back, a written or verbal compliment to their manager, inviting them for a cup of coffee. All of these things are either free or low cost to you and high value to them.

I know that all of this may seem counter-intuitive and burdensome. That's exactly why you need to listen to this episode. I don't want you to miss out on this opportunity to grow your practice!

Support the show

Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com

Join my FB group, The Private Medical Practice Academy.

Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.

Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.

Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!