06/26/2012
RESPONSES / COMMENTS (MEDICAL / LEGAL)
RE: Restrictive Covenant (Ron Raducanu, DPM)
From: Pat Caputo, DPM
In reference to Dr. Raducanu's statement: “That being said, I'm also a believer that the solo practice is going extinct precisely for the reasons you've stated.” Didn’t Mark Twain say, "The reports of my death are greatly exaggerated"?
Belief in the extinction of solo practice is a little extreme. True, it is very hard to open cold with your debt and lack of available financing. But don't give up if owning your own practice is what you want. The delivery of medical care and medical re-imbursement is changing, absolutely-positively yes; however, a well designed business model of a solo practice will thrive if properly done in most any re-imbursement environment. Not that it will be easy. It is not for everyone. I concur that the majority of podiatrists should practice in a large group.
However, even in managed care or a national “single payer” system, there will STILL be at least two tiers of delivery of care and opportunities for smart and talented well trained docs in solo or small group practices.
The demand for services will ALWAYS be there. Finding a niche, and determining the delivery of that supply of doctors and their care of patients will be the key to very successful small practices of the future. Look for it, it is not an entitlement. Just because you are smart, have worked hard in your training, and earned your degree, doesn't mean success will be handed to you.
Pat Caputo, DPM, Holmdel, NJ, capstops@aol.com
06/23/2012
RESPONSES / COMMENTS (MEDICAL / LEGAL)
RE: Restrictive Covenant (Ron Raducanu, DPM)
From: Juliet Burk, DPM
I write as a provider who has tried to hire an associate for MULTIPLE years. There are good situations available for graduating podiatrists. They just may not be in areas where you want to live. I have tried offering a flat salary with bonus incentives or “eat what you kill and just pay me rent” scenarios—with health insurance. A hard worker could make a killing as we sometimes get 10 walk-ins a day just coming off the street. Not only can I not hire anyone in my remote, but beautiful city with two lakes, I can’t even get people to come look.
It seems that all the graduates we have had contact with want a guaranteed high salary for commensurately little work, lots of time off right away, and big city living. So, I’ll pass on the sob story. I’ve started businesses and closed them. Took my 6 figures of debt and the banks' “nos” and started businesses with credit card loans when I had to. It has taken me every bit of 16 years, but I’m paying off my school debt this year. And I cheerfully work 50 hours or more per week.
Juliet Burk, DPM, Ponca City, OK, juliet-burk@cherokee.org
06/22/2012
RESPONSES / COMMENTS (MEDICAL / LEGAL)
RE: Restrictive Covenant (Ron Raducanu, DPM)
From: Jeff Mennuti, DPM
1. Being fresh out of residency and having a little track record for income, it is nearly impossible to get a loan. Bundle that with a breathtaking student loan burden (mine was in excess of $275K, podiatry school only, no undergrad).
2. Getting on board with insurances will take an excess of time, and since there is no/low cash paying patients, it would take nearly six months by the time income was seen.
3. What one is then left with is...
Editor's note: Dr. Mennuti's extended-length letter can be read here.
06/19/2012
RESPONSES / COMMENTS (MEDICAL / LEGAL)
RE: Restrictive Covenant (Name Withheld)
From: Ron Raducanu, DPM
This makes me so sad to hear. I wish that you had had a better experience. I can tell you that you are not alone, BUT there are good people out there who will look out for you. After a couple of false starts myself, I am thrilled to say I am in a wonderful situation, practice wise, where everyone looks out for everyone else, the egos are put aside for the betterment of the patient and the practice. It's a wonderful breath of fresh air for me and a situation I feel lucky to have landed myself in after almost 10 years of struggle.
Please find a place for yourself that you will be happy in. Life is too short to be miserable. You're right. You've worked too hard to be treated that way. If you need any guidance or just someone to talk to, please feel free to e-mail me anytime.
Ron Raducanu, DPM, Philadelphia, PA, kidsfeet@gmail.com
06/16/2012
RESPONSES / COMMENTS (MEDICAL / LEGAL)
RE: Restrictive Covenant (John Morris, DPM)
From: Ron Raducanu, DPM
Let me throw another scenario at you. A new associate comes in and sees ALL the post-op patients (who don't pay) and most, if not all, the nail care patients (who pay far less than those with office visit appointments), giving his boss the freedom to open up his schedule to ALL the new patients.
The boss is making sure that the Medicare patients who qualify for shoes see him for the once a year that Medicare pays for an office visit, and makes sure to get the credit (and money) for the shoes that are dispensed to this patient through Medicare and a supplemental. The associate is now taking ALL the calls and ALL the in-house work, giving his boss a ton of time off.
The boss buys a new car since he is making more money seeing...
Editor's note: Dr. Raducanu's extended-length letter can be read here.
06/12/2012
RESPONSES / COMMENTS (MEDICAL / LEGAL) - PART 1B
RE: Restrictive Covenant (Name Withheld)
From: Ron Raducanu, DPM
I am not an attorney, but do have some intimate experience with this. First and foremost, please get a good medical practice attorney. If you have a medical school in your area and don't have an attorney, speak to the administration there, and they may be able to help find you a good one. Expect to pay for it. It's worth it all the way.
Here are a couple of tips that I've learned in my travels BUT again, consult an attorney for the details.
- If you can prove that you were "recruited" for...
Editor's note: Dr. Raducanu's extended-length letter can be read here.
