Monday, January 12, 2004

High tech

I finally received my refrigerator-freezer today. The delivery guy was most unhelpful, when he realized the large box and wooden pallet it was strapped to would not be able to fit through the rear doorway of my office. He just put it down, asked for my signature on the work order, and left. I didn't put up much of a fight, since I figured I could get a mini-refrigerator inside by myself.

This is when I encountered Surprise #1 of My Solo Career (the first of many to come, I am guessing). Before I had ordered this refrigerator, I had carefully measured the space where it would go in the little kitchen area, next to the other mini-refrigerator already there, and made sure it would fit. Unfortunately, I forgot to measure the doorway INTO the little kitchen area. It was too narrow for the refrigerator to fit. So I just hauled it into my cluttered up exam room for now. While annoying, it only forces me to be a little more cramped for space than before. Nothing disastrous.

I have anticipated that I will need to be flexible as I set up my solo practice, in ways that I have not imagined. Hopefully, this is the worst surprise that happens to me.

I am in my supply-acquiring phase right now. I am driving out to Camarillo, an hour away, to take a look at a Welch-Allyn Schiller AT-2 ECG machine. Manufacturer's suggested price: $4411.30. This place quoted me a price of $1549 for a new machine. That's why I'm driving out to see it with my own eyes. If it is indeed new, I'll buy it.

I've read that doing your own ECG's is not a big moneymaker, with reimbursements about $25-30. At that rate, I'd have to do ECG's on 62 patients before I start to make any money off it. But that's still a lot better than having to see 147 patients (if I bought it at full price). The main reason I want an ECG machine is because I think patients would expect a doctor to have one. Plus, it might come in handy if someone is having chest pain and I see ST depression.

I guess every piece of equipment I get has to have a reasonable ROI, or Return of Investment. I found this gadget called the CardioCheck PA Analyzer, which can do a complete lipid profile from a fingerstick drop of blood. Plus it's CLIA-waived, so I can do it in my office without having to pass an inspection. From crunching the numbers, if it costs $800, and Medicare reimbursement minus supply costs will pay $11 per test, then I would need to test 72 patients before I broke even. If I don't buy the thermal printer, and just write down the numbers myself, then I would only need to test 41 patients to break even. Hmm, this might be a way to generate some income, and provide convenience to patients at the same time. Plus, I hate to draw blood.

I wonder what other gadgets are out there that I could use? I realize that using these machines does not necessarily equate with better care. But I also realize that there are a lot of people out there who do. Part of being successful in private practice is in meeting the patients' expectations, within reason, of course.

So for those patient who are into high-tech, I'll be covered. And for those who want high-touch, I've got them covered, too.

Countdown: 21 days until new target start date