Episode 17: Pitfalls of different surgery practice models with Dr. Matt Endara

The latest podcast episode is with Dr. Matt Endara- a plastic surgeon who has experienced multiple practice models. I thought this would be a great time to talk about different models given that many of you are looking for jobs. 

On this episode, we talked about how you get paid: 

Many hospital-based practices are rvu based. This is a productivity model with rvu (relative value unit) as the benchmark for determining your productivity. Each case, note, procedure have an assigned rvu value. The amount you get paid per rvu is dependent on the region you are in, and can be negotiated. 

Private practice models are run by individual surgeons. They can be small or large, depending on the specialty or the area. It is important to understand the overhead (expenses) and income generated to know if you are joining a viable practice. Many private practices are joining practice management groups which handle the HR, regulations, bills/insurance denials, negotiating contracts with insurance companies. This hybrid allows control of the practice without some of the headaches (Dr. Vertrees' practice is this model)

Aesthetics is often fee-for-service models without going through insurance. Many plastic surgeons will have a mixed model with aesthetics (fee-for-service) and insurance based practice (Dr. Endara's practice is this model). 

(although we didn't talk about it- Kaiser is an example of paying by the hours worked with possibility of partner. We also did not cover private practices where you "buy in" and have the potential to "make partner". Definitely get a lawyer and an accountant to review the options for a job like this).  

What are some of the pitfalls to look for?: 

- Family-run business or mom-and-pop businesses that don't know their numbers. They may have a viable practice, but noone really knows

- The payor mix in the area. If there are a lot of uninsured, you may have challenges maintaining a viable practice

- What will you get paid after the guaranteed income is up?

- Do you know what are the trade-offs for big city practices and smaller community hospitals?

- Are you keeping up with the times (new technology) and protecting against lack of diversity (pandemic-proofing your practice)

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 Do you have a topic you want covered? Send me an email at [email protected]

Dr. Endara can be found at https://perfectenn.com/about