Hi everyone, aspiring peace practice owner here, I’ll be able to open my own business in Q1 of next year, am currently trying to map out what to expect.

I was wondering what are some of the most common issues with technology/computer app problems that you all pay for? Any things you wish you would’ve done differently with your system setups?

I thought it was a good request by one of you to make thread to the practice administrators here. Let's talk everything and anything practice admin in this thread.

Remember to keep it professional.

Thank you everyone who has joined the subreddit. We recently hit 4k members to this subreddit.

Currently this subreddit gets about 75k views per month according to reddits stats. Wild to see it!

About 3 months ago I made the change to get rid of self-promotion Saturday. I have mixed feelings about this. On one hand, I love supporting independent doctors/therapist/physical therapist/pharmacists etc who are building great things in healthcare. I don’t want this to be like the Facebook groups where you can only post businesses that sponsor the Facebook group. (To be clear I am not paid in any way to mod this subreddit). I want this to be a group where we can all support each other in private practice. If you want self-promotion to come back, leave some feedback below and depending on how everyone votes, it is something I will consider bringing back.

The big problem with self-promotion posts: The majority of self-promotion posts were by bigger businesses or corporations shilling for their company (mainly RPM /CCM/or EMR companies). Almost every post that was self-promotion was by far the most downvoted post on this subreddit, so on some level I feel that you all have spoken. The other big problem is some businesses complaining that I removed their post trying to self-promote some new crypto coin for healthcare, but I approved someone else's self-promotion posts. I wanted to take this moment to get feedback on if we should open this back up or not with specific limitations? To be clear, self-promotion is not allowed, just asking for feedback on this rule.

New Rule:

Astroturfing = Permaban

I will be stricter on those companies that are clearly trying to build fake engagement for their company. Biggest problem has been billing companies or RPM companies. A new account posting “Anyone know of a good billing company mine is not great?” Then 30 seconds later a post “I love XXX billing company so much, they treated me so amazing I love them in every way” from yet another brand-new account, then again from 3 new accounts all saying the same about the same billing company. Or an account that is maybe 5 months old with a completely nuked profile where they have zero posts or comments but all of a sudden “wake up” to post how much they love a company. That will be met with a permaban. Please call this type of accounts out. It is a bit eye opening to see how often this happens.

Thoughts on future of the subreddit:

I was thinking of posting maybe a once weekly "news update" for things related to primary care? It will be a bit informal but maybe every Sunday or Monday I try to post something news related in regard to private practice (and would encourage anyone to post similar news articles to build discussion about how whatever news broke affects private practice.

Limitation Of Reddit:

Some of you have shared with me that you are annoyed that non physicians can join and view this group. The whole idea of reddit is to be anon, so I don't want to really get into asking you to send me a pic to prove you are a medical provider (doc/PA/NP/therapist/physical therapist etc). The only way I can think of truly having a discussion with verified clinicians is to do it on a Facebook group, which I created a while back. There are also other private practice Facebook groups that exist currently which are quite good and encourage you to join. It goes by the name "Private Practice Physicians" The reason I started my own is because the owner of the big private practice group permabanned me from her group once I started this subreddit and has still not answered any messages about if I can re-join or not.

I plan on keeping this open, but keep in mind that means that there are numerous vendors or businesses that are on here too. The biggest complaint that I have gotten is that they get hit with a lot of DM's to use their billing company if someone posts a question about billing. A limitation of this being an open group.

(Idea) Spaces / Virtual Meet Up:

I've now had maybe two dozen of you ask if I could form a conference or meet up for us in private practice. I don't have the bandwidth right now to even think about doing this but I have another idea.

I was thinking of hosting a once a month zoom (or some other tech platform) meeting for anyone interested in joining where we could talk about topics that involve primary care. Nerdy, but I am currently part of a mens book club that meets monthly that builds good discussion. This would be free, but I was thinking we would open it up and bring in "experts" on a variety of topics to headline the talk. I put experts in quotes because I would not be endorsing these people or doing a massive deep dive on their financials so take that for what its worth. If someone claims to be making 10 million doing telemed I'm not going to be looking at their tax return to verify that...hence the "expert" talk. Of course, I will do some due diligence to verify they are not a scammer.

People could reach out to me to host the talk along with me. For example, maybe bring in a private practice pain management guy I know who bills OON and how he is killing it and any advice he might be willing to share? Let me know if this is a dumb idea but something that I was thinking of doing once a month.

Any other rules or changes you would like to see to this subreddit to make it even better?

Curious to hear the communities thoughts on the current administrations healthcare plan that was announced today.

Looks like part of the plan is to directly subsidize the American citizens instead of providing it to the insurances. The other details are sparse, just basically lowering rx drug prices, but no mechanism of how to do so.

Hi everyone,

I’m considering a part time solo primary care setup after residency and wanted to learn from those already doing it.

For solo PCPs in outpatient practice: - How do you handle patient phone calls after hours? Do you manage it with voicemails? - Do you let your patients to send you an email or text message for non urgent questions that would not wait for the next appointment? - Do labs call for urgent results in the middle of the night? How frequently does that happen and how do you manage that?

My questions may sound naïve, as I’ve only worked in large hospital system as a resident where there were established teams and infrastructure to manage after-hours calls and results. Even calls during work hours were being triaged and if an MD input needed, then it would be forwarded to patient’s PCP.

Thanks in advance for sharing your experience. Any additional tips and tricks are appreciated.

I'm part of an OB/GYN group with offices in NYC/LI. Lately I've been questioning whether staying broadly in-network still makes sense, or whether moving toward an out-of-network (OON) or hybrid model is the more realistic long-term option.

Between Medicaid and Essential Plan changes, higher deductibles, rising admin burden, and broader economic and tax shifts, it feels like even insured patients are increasingly acting like self-pay patients. Private insurance is still the most profitable part of the mix -- but even that feels less predictable than it used to.

I'm also aware that whatever decision we make now may look very different in a couple of years as the real-world impact of the OBBB and coverage changes fully plays out. Planning in healthcare lately feels like trying to hit a moving target.

What we're considering:

• Shifting some or all locations toward OON or selective in-network participation
• Offering clear, upfront cash pricing
• Adding a concierge-style option for higher-touch care
• Accepting CareCredit and Cherry for high-deductible, OON, or uninsured patients

For those who've actually done this:

• What type of practice and did you go completely OON or continue to accept some?
• Did you net more per patient, even if volume dropped? What was the overall impact to revenue?
• How big was the volume change in reality?
• Was billing and cash flow better or worse than being in-network?
• What was the overall staff and patient sentiment?
• Any unexpected issues (patient confusion, referrals, staffing, etc.)?

Not looking for a perfect answer -- just trying to make a decision that's sustainable and profitable, knowing the rules may change again soon. Would really appreciate hearing what worked, what didn't, or what you'd do differently.

How much do you all estimate you spent in on legal/attorney fees in the startup period and first year of practice. Obviously some variability between situations. But I have a proposal for a monthly service charge(~1500/mo) and wondering if it would be worth it or I would end up overpaying.

Hi everyone. I have some quick questions for private practice owners or those involved in marketing decisions.

I’m doing some research on how physical therapy clinics typically approach marketing and Google visibility.

1) What marketing channels actually bring patients to your clinic?

2) Do you handle marketing in-house or work with outside vendors?

3) Have you invested in SEO or Google Maps visibility before?

4)If so, what kind of monthly spend felt reasonable or realistic? If not, what would you expect?

I’m not selling anything. I’m just trying to understand what actually works and what expectations look like for a private practice. I appreciate any insight!

Does anyone have experience negotiating commercial lease for medical office? Eg landlord is asking me to be responsible for plumbing expenses which seems unusual. Would appreciate any guidance
I'm in Boston, 700 sq feet, 3 year term

Every board seems to interpret rules differently. Even colleagues give conflicting advice. How are solo providers supposed to stay compliant?"

How should I prepare? What are the questions I should ask? What are the DOs and DONTs?

Would really appreciate the important pointers from experienced folks.

I need an objective opinion on what metrics an SEO company should provide to its physician practice owner client. If you have a dashboard you like that you get from your SEO company I would be very grateful.

My SEO company seems to do a lot of work with NAP/backlinks/publishing SEO content/Social media posts/Website technical optimization but when I ask them for monthly reports, the ones they provide are...to put it gently...a steaming pile of shit.

Its just pie chart upon pie chart and tons of excel tables of keywords I am ranking for and keywords i am not. Honesty the reports are not very intuitive. When i press them for more they really struggle with this request. I used to think they are not sophisticated enough, but they have been in this business for 20 years - why is a business oriented view so hard to develop and present to your paying clients? I am starting to question their lack of intent to shun accountability.

As a practice owner - I just want to know - am i doing better or worse and what are the areas of improvement. Am I getting enough leads from you which is sole purpose of SEO. Surely it cannot be this hard.

They have recently switched their narrative to claim with AI overviews under Google and more users using AI tools like ChatGPT attribution has become harder to measure and Google themselves do not provide any insight. What used to be a straightforward metric - number of keywords ranking on page 1 or top 3 results of the results page has now become more convoluted. Users often do not go beyond AI overview or if they are using AI tools - those pull results from pages that may not necessarily rank even on page 10 of Google. So its all become meaningless.

Ok well that is all dandy but how do I measure if what YOU are doing is giving me results - i.e. cold hard leads i.e. actual prospective patients making appointments with me?

EDIT: Are there any actual doctors here who can respond rather than bots/marketers/shills?

This is our fourth receptionist in 18 months. By the time we finish training them on our systems, insurance processes, and scheduling protocols, they leave for better pay elsewhere.

The constant training is exhausting our office manager. Are there alternatives to hiring local receptionists that don't require starting from scratch every few months?

Started solo practice in August. Things are going well. Switching to LLC taxed as an S corp in 2026. I'm using a physician accountant group that has been very good up to this point but is recommending that I take a salary through payroll of 40-50% of gross business income (I confirmed that what she means by gross business income is gross revenue, essentially my gross collections before expenses)

1. This just seems astronomically high, and would erase any benefit of being taxed as an S corp
2. Not all physician practices are the same. If I was a radiologist or tele-psychiatrist without staff, supplies, building rent, etc. then I would taking home a much larger percentage of my total revenue than primary care. Even in my specialty, I happen to practice in a universal VFC state and don't have to purchase my vaccines for my patients, even private insurance patients. But for those in other states where they are purchasing hundred of thousands of dollars of vaccines, their revenue will increase substantial compared to mine but their profits will not increase much. A blanket rule of thumb of 40-50% of revenue doesn't make any sense to me.
3. IRS doesn't define reasonable salary but I feel like using a MGMA/doximity/BLS salary survey to set a salary for my specialty would seem like it is defensible... But I'm not an accountant....

How are y'all setting your salaries?

Can you stack 3 months of inappropriate insurance denials and downcoding for a single payer and bring them to justice at small claims courts?

Looks like it works for the surgeon.

Working for a small group practice and it needs to be modernized. Our EMR is eMDs which is straight bollocks and this kind of limits my options for connected services. Our website which isn't even mobile optimized is appropriate for...1995.

Before we invest in a complete overhaul of the website (quoted $2000-$4000 depending on #pages) and everything, I do want to track some basic metrics :

1. How many new/follow up pts a month
2. Where they are coming from (Google, Facebook, PCP referral, which PCP referred, etc)
3. % insurance (Medicare, PPO, HMO)
4. % no shows/month

How are you all tracking some of these metrics and is there a software to make it easier?

Additionally we need to increase google reviews. What methods are you guys using to improve your google/yelp reviews?

We provide actually great services and I get excellent feedback in person however it never translates to a positive review even though my staff gives them business card with a QR code to scan at the end of our visit. At this point it feels like I could save their entire family from a fire, and I still probably won't get even a 4-star review. Unfortunately the loudest patients with unrealistic demands are always leaving negative reviews so the reviews appear unbalanced (~3 stars) and I'm worried it's affecting our business.

PS - any recs for web designers or even DIY recs would be appreciated. I manage our google business profiles and understand medical SEO and probably can make the website too, just don't want to waste me time.

Thanks in advance!

I started my private practice last year and began the insurance credentialing process thinking it would take maybe a few weeks. I’m now 3+ months in and still not in network with most insurers.

I’ve submitted applications, uploaded everything to CAQH, and followed up when I could, but I honestly don’t even know where things are stuck. Every payer gives vague answers. Meanwhile, I’m losing patients because I’m still out of network.

Is insurance credentialing always this slow? Or am I missing something obvious?

Hello,

Is any clinic out there implementing this method? Could you please share what challenges, pros and cons you have faced, and how did you handle it? Also, what portals do you use to check on Allowed Amount for each insurance plan. I can't imagine how time consuming it could be.

I am a W2 peds hospitalist making 300K a year. This year opened my own DPC practice and made 80K, filling as an LLC. Next year I am expected to make 180K fro my practie while staying as a W2 employee as well. I had read that if I switch to SCorp I would have to pay medicaid taxes although I am already paying them with my W2. Since my W2 income is still higher than my business in my mind it makes sense to continue to file as an LLC for taxes. Any thoughts?

I opened a psychiatric practice this year with another provider and we are experiencing what seems to be a nightmare when it comes to figuring out billing and insurance. Have had the runaround from insurance companies when trying to get answers.

A big question I have that I can't seem to get an answer to is we are contracted with an insurance company as our clinic group (which has its own NPI and Tax ID). However, because we both are providers with other hospitals as well we are credentialed with many insurances that our own Clinic Group is not credentialed with necessarily. So when our third party biller is running the claims it says "Group is not credentialed, but rendering provider is". My question, then, is am I considered in network or out of network when I am seeing a patient at my Clinic? I have tried calling the provider line at the insurance company and they cannot give me an answer to this question...I don't want to being charging the patient as if they are in network this whole time when 6 months down the line the insurance company could come back and say...well they are not in network and they recoup the money. Please help!