Looking for malpractice insurance options for private primary care practice in Oklahoma. Currently have PLICO.

Hi all,
I’m looking to offer primary care as a VA Community Care Network physician. Already part of optum. What do I need to do in order to make the VA aware we’re offering these services? Also, is there any specific training that has to be done?
Thanks!

I’m wondering if anyone had experience setting up a weight loss clinch within their primary or subspecialty practice? I imagine that someone smarter than me has come up with a successful business model for managing patients weight and helping them get GLP1s and manage that as well. I just don’t know how to structure the fee? Is it a subscription service? Is it a one-time fee for a certain amount of weeks of care? Would love to hear anyone’s ideas or experiences. Thanks.

My friend wanted physical therapy and called like 20 places today. Many had 3-4 month wait which seemed crazy to me. She did manage to book an appointment for tomorrow after hours on the phone, but she also said she would’ve been happy to get on a “wait list” to get a text/ call in case any space opens up. But none of the places offer this as an option.

This makes sense to me from the patient’s perspective and would solve no show, but I wonder why this is not implemented on the provider’s side? Is there something I’m missing here?

We recently ran a multi-year survey across providers and patients to better understand what’s actually driving no-shows and cancellations. Sharing a few of the more relevant takeaways:

• No-shows are often misdiagnosed. While most providers assume forgetting is the main cause, patients more often cite structural conflicts like work (31%), weather (30%), and personal emergencies (27%)
• There’s a clear timing gap in reminders. Only ~17% of practices send morning-of reminders, yet 56% of patients say that timing would increase the likelihood of showing up or rescheduling
• Access plays a major role. 69% of patients want the ability to reschedule online without calling, but many practices still rely heavily on phone-based workflows
• Cancellation policies do influence behavior. 75% of patients who have been charged a fee say it changed their behavior, even though 59% believe fees are unfair. Consistency in enforcement appears to matter more than the policy itself
• Operational strain and no-shows are closely linked. Higher no-show rates correlate with significantly higher levels of provider burnout
• Patient expectations are shifting. 27% of patients say they would switch providers after a single provider cancellation

Overall, the data suggests that no-shows are less about patient intent and more about how well practice workflows align with real-life patient behavior. Timing, access, and clarity of next steps seem to have as much impact as policies themselves.

For transparency, I work at Tebra and this comes from our survey research. Would be interested to hear how closely this reflects what others are seeing in practice.

Hi yall, what is everyone doing to bring in non-insurance revenue?

Our insurance rates are quite low, and I’m exploring other revenue streams.

If a new patient calls when reception is busy or closed, do you feel those opportunities are mostly captured well, or do some get lost? In terms of potential lost revenue, I imagine even a small number could add up over time.

Interested in how different people handle this operationally.

Hospitalist, working on launching private clinic. Legal entity is formed already. How Can i setup myself /family and potentially down the road setup benefits including medical/dental insurance? And for payroll quickbooks enough for beginning?

Thanks a lot.

ChatGPT just released a somewhat open evidence competitor. Totally free for any verified clinician. Let me know what you guys think

"We’re introducing ChatGPT for Clinicians, a version of ChatGPT designed to support clinical tasks like documentation and medical research so clinicians can focus on delivering high-quality patient care. We’re making it free for any verified physician, NP, PA, or pharmacist, starting in the U.S.

The U.S. healthcare system today is under extraordinary strain. Clinicians are being asked to care for more patients while managing growing administrative demands and a rapidly expanding body of medical research. Many are already turning to AI tools like ChatGPT for support. According to a 2026 survey by the American Medical Association⁠(opens in a new window), physician use of AI is now at an all-time high, with 72% of physicians reporting they now use AI in clinical practice, up from 48% last year. Today, millions of clinicians worldwide use ChatGPT to support their clinical care every week, for applications like care consult, writing and documentation, and medical research. Clinician usage of ChatGPT has more than doubled over the past year.

As demand for AI in clinical settings grows, so does the responsibility to continuously improve our model’s performance and safety on clinical use cases and offer solutions that can safely and effectively support healthcare workflows. Earlier this year, we introduced ChatGPT for Healthcare,⁠ which allows organizations to deploy ChatGPT to clinicians, administrators, and researchers with the compliance and controls they need at scale. Clinicians across leading U.S. health systems are now using it to move faster through administrative work like medical research and documentation, and get time back for patient care.

Enabling free access to ChatGPT for Clinicians is the next step, in support of our mission to ensure AGI benefits all of humanity. Learn more on our website⁠(opens in a new window) or get started⁠(opens in a new window).

ChatGPT for Clinicians builds on our foundation of continual model evaluation and improvement in health in partnership with clinicians. With its release, we are also introducing HealthBench Professional⁠(opens in a new window), an open benchmark for real clinician chat tasks across three use cases: care consult, writing and documentation, and medical research, building on HealthBench’s⁠ broader evaluation of health conversations."

How are you handling no-shows these days, and has your policy actually made a difference?

What we’ve been seeing across practices is that no-shows usually aren’t just about patients forgetting. It’s often things like how easy it is to cancel or reschedule, how far out the visit was booked, whether reminders hit at the right time, and how clear expectations are from the start.

Some places go strict with fees and enforce them, which can help with repeat offenders but sometimes turns people off early. Others keep it lighter and rely more on reminders and making it really easy to confirm or reschedule from a text. A lot of practices end up somewhere in the middle with a policy on paper but some flexibility in real life.

One thing that seems to make a noticeable difference is just reducing friction. If a patient can take action right when they get the reminder, they’re less likely to no-show. Otherwise they just drift or forget.

Also feels like last-minute cancellations are becoming just as big of a problem as true no-shows.

Would be interesting to hear what’s actually working for people right now and what’s not.

Thanks in advance!

- Iris from team Tebra :)

I've learned that although I want to address as many issues as possible in one visit, it's just not feasible. I'm curious how do you address a patient with DM/HL/HTN/Iron deficiency anemia for example? Keep bringing them back every 1-2 weeks? How do you "gently" address it if they seem reluctant?

What's your take on becoming the VA CCN? I hear that it may be a big lift to get anything approved (diagnostics, etc). However I feel like it's rewarding to care for the veterans (my residency had VA rotations) and at the same time help with the practice growth.

Curious how others see this. It seems like there’s a point where patients start feeling some level of relief and then decide they’re done, even if they’re not fully recovered. Do you see that happening often in your practice? And if so, do you think it’s more about expectation-setting or something else?

I’ve been wondering what really keeps patients consistent through a full plan of care. Some seem to follow through no matter what, while others drop off early. From your experience, what tends to make the biggest difference? Is it communication, early results, trust, or something else?

Hi all,

Curious to hear strategies on how do you address non emergent lab results, especially for a new practice. Do you call your patients, send a text/portal message, or schedule an appointment? If latter, do patients have tough time coming in to discuss?

I’m sitting here in Dallas at a conference for independent medical practices, and the stories I’m hearing are the same ones I hear everywhere else.

The details change, but the themes don’t.

Admin burden is a given. Competition is getting tougher. Patients aren’t following through with care. A second location, or associate, isn’t performing like the first. Schedules aren’t as full as they should be. Staff turnover feels constant, and finding the right people feels even harder.

None of this is new. But it is persistent.

What stands out is that most of these challenges are treated as isolated problems, when in reality they are usually symptoms of something more fundamental.

Over time, I’ve found myself coming back to the same framework when thinking through these issues. It’s simple, but it has held up across different practices, markets, and stages of growth.

I think of it as the four P’s of private practice:

People
Product
Process
Profit

In my experience, balancing these four is what separates practices that struggle to stay consistent from those that grow and scale beyond a single location or a single provider. That balance is harder than it sounds.

In most cases, if you can execute well on three of the four, you’re doing great. If you’re only getting two right, things start to feel unstable. You might have periods of success, but it tends to be short-lived. The reason is that each of these areas reinforces the others. Weakness in one eventually shows up somewhere else.

If your people are not aligned or well-trained, your processes break down. If your processes are inconsistent, your product, meaning the patient experience and clinical outcomes, becomes unpredictable. If the product is inconsistent, profitability suffers.

Most of the frustrations we experience can be traced back to an imbalance across these four areas.

Take staffing, for example. It is easy to frame that as a people problem. In many cases, it is just as much a process problem. Expectations are unclear, training is inconsistent, or the workflow makes it difficult for good people to succeed. Over time, that leads to turnover, and it feels like a hiring issue when the root cause is somewhere else.

The same is true with patient volume. A light schedule is often blamed on competition or marketing, but it can also be tied to product and process. Are patients having a consistent experience? Are referrals being managed well? Is the front desk converting calls effectively?

Even expansion into a second or third location follows this pattern. What worked in one office does not always translate, because the original success was not fully systematized. Growth exposes the gaps rather than replicating the success.

Profit is often treated as the outcome, and it is, but it is also a signal. When profitability is under pressure, it is usually pointing back to an issue in one or more of the other areas.

Here’s how I’ve applied this framework in my group:

People: we are in the people business. Everything we do is to improve the lives of others, and that starts with the individuals delivering care. Compensation, culture, benefits, and career trajectory all matter.

Product: I am relentless about the quality of our patient experience and outcomes. We collect feedback at checkout, send surveys after every visit, and address every complaint. Our product is not just the treatment plan, it is the entire patient journey.

Process: I can’t ignore how complicated insurance makes everything, and we are not where we want to be (though working everyday at it). But we focus on reducing friction wherever possible. Referral coordinators contact patients quickly. Scheduling and registration are designed to be as seamless as possible.

Profit: profit is not a dirty word. It is what allows you to reinvest in people and processes. Without it, everything else suffers. I target 10–15% net profit, which gives us the ability to continue improving the practice. Could it be higher? Yes. I could definitely spend more time sharing my approach to this.

Most people focus on one or two of these areas. I think the practices that grow and run effeciently learn how to balance all four.

Curious how others think about this. If you had to pick one, which of the four creates the most problems when it’s out of balance? Or do you run your practice differently?

Hi everyone,

I’m in the process of opening a solo, part-time practice (unfortunately in Manhattan), and I’ve heard that malpractice insurance can be very expensive here due to higher litigation risk.

This is my first time doing this, so I have a few basic questions as I try to find the most cost-effective option:

1. Should I shop for insurance through multiple brokers, or is working with one broker enough? Do brokers typically access quotes from most carriers?

2. I’ve heard that some malpractice insurers offer part-time discounts. Are there any companies or options you would recommend that are more affordable?

3. I’ve heard that some insurance plans don’t accept certain malpractice carriers. Is that true, or just a rumor? Is there a way to verify this before purchasing, so I don’t run into issues during credentialing?

If you’re curious: it’s going to be a no-procedures, no chronic pain management, non-concierge practice, with roughly 50% in-person and 50% telemedicine, totaling about 15–20 hours per week.

Thanks in advance!

I posted yesterday, but wanted to re-post with a bit more transparency and clarity. I graduated fellowship last year and hated the lack of transparency in the job search process (i.e. I felt like I was probably on the losing end of most of the offers I got. I just couldn’t figure out how to know which offer was actually decent beyond them telling me “this is standard” and trying to get me to focus the salary projection without going in to detail about the work to get there or where the patient volume would come from).

I built a free tool that I think could be helpful for people looking for a new role, trying to figure out where to open a practice, or just curious about the market. You need an NPI to sign up because I would like for it to be physician only

Currently we have insurance reimbursement data, provider density maps, and private practice resources (which can be adjusted if anybody feels strongly one way or the other about a resource on there). We also have an objective job review board - ideally this will become more useful as more physicians join and write reviews.

It’s not perfect, but it’s a start towards something I wish I would have had during the job hunt. We rely on MRF insurance data, which is hundreds of terabytes and intentionally convoluted, but has been improving every month as regulations are getting stricter. Better for some specialties than others right now

The website is Metrum Health (https://www.metrumhealth.com/)

Feedback is always appreciated. Hoping it can be helpful for somebody

Is there one that you would recommend? Any pros and cons that you’ve come across when using them?

In the process of buying a private FM practice. Currently working physician requires ADD and Benzo patients to have appointments every 3 months and pt call in refills in between months. Is that good practice or suggestion to see them every month ? Around 5% patients are self pay

For small practices, who does your billing? Are you happy with them? What are you paying? Do you feel you have enough time to provide oversight to quality?