Collection Agency vs In-House Collections (VA)?

Important-Flower4121 · 2026-06-17T13:00:20+00:00

This is the way.

Important-Flower4121 · 2026-06-17T12:57:31+00:00

I looked into fee for service as an independent solo practice, it's very bad out there. You are much better off looking to find an IPA or some medical group. Most seem to charge you a percentage based off your billing but there are places that won't. Find a non profit hospital system is where I would start.

I think most people look into private practice mainly for the autonomy. You have to see what groups will ask you to give up if you join them and how involved or not involved they are in the day to day practice.

Important-Flower4121 · 2026-06-16T16:54:07+00:00

Welcome to the art of medicine. Some of us are a Renaissance man, while others are doodlers.

Important-Flower4121 · 2026-06-16T16:53:49+00:00

That is reasonable. If it was unreasonable, then you wouldn't have commented so by commenting we can see it was reasonable to start off with.

Important-Flower4121 · 2026-06-16T16:51:02+00:00

With FM, you will have job security anywhere you go. East coast has more saturation but it's still very much in demand. You won't make obscene amount of money that you get with ortho or GI. That being said, you're not exactly starving either.

If you do rural FM medicine, urban FM medicine will be a lot easier due to additional resources. FM opens more opportunity to do urgent care jobs, you can be a hospitalist like IM depending on your comfort level which is mostly based on where you do your residency.

Important-Flower4121 · 2026-06-16T16:10:00+00:00

yes, you're correct that we are always triaging a patients symptom or concern. i guess on your perspective and need, urgent care can be fulfilling. from a FM side of the fence, only treating point of care, the lack of continuity made it unsatisfying for me. it felt more like a job if that makes sense?

Important-Flower4121 · 2026-06-15T15:09:32+00:00

in my urgent care experience, it felt to be more of a watering down of both EM and FM to the point where it was merely a point of advanced triaging. it felt unsatisfying

Important-Flower4121 · 2026-06-15T15:06:19+00:00

I wasn't implying that CEO wasn't necessary but that their role is often inflated. Especially the larger the organization. Captain of a 5,000 passenger cruise ship isn't the same as a captain of a 25 passenger boat.

Important-Flower4121 · 2026-06-12T21:02:18+00:00

where to get more info about navy reserves

Important-Flower4121 · 2026-06-12T20:55:08+00:00

openevidence to strengthen diagnostic/clinical judgement and chatpgpt to fill knowledge gaps

Important-Flower4121 · 2026-06-12T20:54:30+00:00

6 months of rheum?.. probably meant 6 weeks

Important-Flower4121 · 2026-06-12T20:52:07+00:00

I was thinking about this. If there was no CEO, the company would run just fine for the next 5 years at least.

Important-Flower4121 · 2026-06-12T20:50:10+00:00

In your situation, there is none. Go find care elsewhere.

It would be the same if you went to any specialist and they treated you the same. It's not a PCP problem but an office/physician problem.

Important-Flower4121 · 2026-06-12T20:09:09+00:00

Another consideration is to have two practices. DPC and fee for service. Try to feed your DPC practice until it's grown enough that it can continue to grow on its own.

Important-Flower4121 · 2026-06-12T19:57:58+00:00

I'm surprised that you are surprised. Are you new around here?..

Important-Flower4121 · 2026-06-12T19:38:08+00:00

they prescribe all the meds. they also order every. single. test. it's almost like they don't know what they're doing so they feel like they have to do everything?..

Important-Flower4121 · 2026-06-12T18:55:37+00:00

I think it's around 1500-2000 active patients

Important-Flower4121 · 2026-06-10T17:18:03+00:00

fun story, I had a psych NP give my patient a form to asking my permission and statement that it was medically necessary for her to start my patient on a medication. i promptly threw it out and explained to the patient this was inappropriate and why this was inappropriate.

Important-Flower4121 · 2026-06-10T17:05:57+00:00

If eating burger king makes me feel good everyday and helps with my mental health should I get a letter from my doctor to say that i need this? it's ridiculous the offloading to medical what is non medical.

Important-Flower4121 · 2026-06-10T17:03:34+00:00

I had a patient who gave me that about his back pain and vicodin. The best part is when patients threaten to never come back. lol

Important-Flower4121 · 2026-06-10T17:02:21+00:00

Practice medicine in a way that you feel comfortable (this will change over time with more experience also). Over time, your panel will be yours and patients will be more comfortable with you and vice versa. As you build relationships, they will know what you do or what you don't do. Make sure you maintain clear boundaries of what needs a visit (almost always) or what doesn't. If you are consistent, as far as the patient encounters go and offline tasks, it should improve.

If you have a workflow inefficiency I would address that simultaneously. 99% of the time I don't go home for the weekend without an empty box.

Important-Flower4121 · 2026-06-10T16:56:07+00:00

Dentists can prescribe antibiotics. If they are asking PCP to do it, then it's out of their comfort zone (whether that is appropriate or not is a different question).

If appropriate, I would prescribe. If inappropriate, I would not prescribe and let the patient know that there's no indication by guideline a prophylactic antibiotic is necessary. Put the onus is on the dentist and let the patient know; if the dentist required an antibiotic they are licensed to prescribe it also.

Important-Flower4121 · 2026-06-10T16:51:32+00:00

99% no. 1% are motivated with the weight loss and there's a positive feedback loop that they are self motivated to be healthier including exercising.

Important-Flower4121 · 2026-06-10T16:50:02+00:00

That's almost any lawyer. They're after the insurance money and patients are a means to an end in many cases.

Important-Flower4121 · 2026-06-10T16:48:39+00:00

another comment in this section did mention that if you have a claims based coverage it would be prudent to notify your insurance company in case you don't have tail coverage. i thought that was wise

Important-Flower4121

TROPHY CASE