From GIN11153 at aol.com Fri May 1 17:40:01 2009 From: GIN11153 at aol.com (GIN11153 at aol.com) Date: Fri, 1 May 2009 20:40:01 EDT Subject: [PrvPracNP] Urgent advice needed Message-ID: Hello all. Sorry to bother you on a Friday afternoon but need advice as I'm in a bind. It's kind of long but would so appreciate your comments. Next week I am planning to open my OB/GYN office with an OB/GYN as a medical director. Dr. D is going to see patients on Wed. afternoons and I am going to hire a nurse practitioner to see the patients full time as soon as I am taking in some money for salaries. Dr. D requested $1500 a month as the medical director and $150 an hour to see patients-not crazy about that but sending letters to 30 doctors only got me this one reply. The office lease, business license and liability insurance are in the name of my nursing corporation and I am the CEO and office administrator. The MediCal application was sent in as an addition office for the doctor since the billing will be done with his provider number. Today, my medical director called to tell me that a doctor he knows for a long time is closing his office and offered him 1000 charts ( I'm sure that less than 100 are active), but he doesn't want them because he is only working for me part time since he has 2 other offices that are about 20 minutes away. So, he said I could go pick them up along with any office supplies I can use. I called Dr. H to make arrangements to pick the charts up. He also asked me if he could rent space from me to see his current patients maybe one morning and one afternoon a week for $500 a month. Thinking it was a great idea to offset my $3000 a month rent, I said ok. He wants to come meet me and see my office on Monday at lunchtime. The next thing I know Dr. D calls me to blast me for making a decision without consulting him and that he does not want Dr H to share office space. Almost reduced me to tears saying that the charts were offered to him to see in my office, not offered to me. He said I should go pick them up tomorrow morning, and then stall the Monday meeting. I am now caught between the 2 and feel that something fishy is going on. I realized when I hung up that Dr D had a lot of nerve telling me who I can or cannot share office space with because it's MY lease, MY business license, etc. and that he is MY employee, not the other way around.Does anyone have a paper with the job function of a medical director in a private practice that they are willing to share with me? My hubby went off the deep end, saying that I cannot pick up the charts since Dr D feels that they were offered to him and that I cannot get in between the 2 docs. I am already caught in the middle. Hubby said that by picking up the charts, I am verifying that I am agreeing to let Dr. H share my office space. He also said that I should not tell Dr. D this afternoon that I cannot pick up the charts because now he's saying they are his and not offered to me. Hubby says to appease Dr. D so he doesn't up and quit despite the 60 day notification he verbally agreed to and signed the contract for. Needless to say, I am going to work on applying to MediCal for my corporation this weekend and see if I can find another medical director. I have been preparing to open this office for a year and am just waiting on the CLIA waiver form and Calif. Medical presumptive eligibility preprinted forms for immediate temporary MediCal to arrive so I can officially open. I have about $85,000 in credit card bills for this project that need to be paid off. Am I wrong to feel that this is my office and I can make my own decisions? Does a medical director take away all my authority? I did have Dr. D sign a contract last spring that he signed but I never got around to signing it because I figured I had to rewrite it when I had an opening date to insert. My contract with him also states that he would teach me and sign off on my midwifery program, and NP program when I get back into one. Please help. My day's been ruined with a huge migraine. just a nurse, Gail **************Join ChristianMingle.com? FREE! Meet Christian Singles in your area. Start now! (http://pr.atwola.com/promoclk/100126575x1221673648x1201419171/aol?redir=http://www.christianmingle.com/campaign.html%3Fcat%3Dadbuy%26 src%3Dplatforma%26adid%3Dfooter:050109%26newurl%3Dreg_path.html) -------------- next part -------------- An HTML attachment was scrubbed... URL: From bcp at npbusiness.org Sun May 3 05:13:33 2009 From: bcp at npbusiness.org (Barbara C. Phillips, NP) Date: Sun, 3 May 2009 05:13:33 -0700 Subject: [PrvPracNP] Urgent advice needed In-Reply-To: References: Message-ID: <96605ace0905030513r6aeeadb8s13c037333ec9767c@mail.gmail.com> Good Morning Gail, Sounds like a sticky mess. You've gotten some sound advice from the others here. Definitely would evaluate your physician relationships and the contracts with an attorney. Better yet...and NP attorney. I don't know here, but I've heard of Melanie Balestra who is both (www.balestralaw.com). I'm not sure why Dr. D is giving you such mixed messages (doesn't want the charts, wants the charts), nor why he is unhappy you want to rent space out to another physician (which by the way, if structured correctly is a great way to reduce your overhead and everyone can win). I have to say, doesn't sound like he's the best match for YOUR vision and your business. It is my understanding that an NP in California cannot own a practice. According to my conversations with Matt Freitas, FNP-C (Modesto, CA), the practice has to be owned (51% @ least) by a physician. With this, Dr. D may see YOU as the employee and not the other way around. Perhaps Dr. H might be a better match for you (as medical director)? Consider delaying the opening of your business until you get this essential part squared away and there is a clear understanding of the roles that each player will be making. I know that you have planned this for a long time, however, getting this straightened out now will save you time, frustration and perhaps your practice in the long run. Best wishes, Barbara Barbara C. Phillips, NP ---------------------------------------------------- Assisting Nurse Practitioners to fulfill their dream of business ownership through education, resources & support. ---------------------------------------------------- www.NPBusiness.ORG www.NursePractitionerBusinessOwner.com *NEW: Facebook Group for Nurse Practitioners in Business: http://is.gd/rY6C On Fri, May 1, 2009 at 5:40 PM, wrote: > Hello all. Sorry to bother you on a Friday afternoon but need advice as > I'm in a bind. It's kind of long but would so appreciate your comments. > > Next week I am planning to open my OB/GYN office with an OB/GYN as a > medical director. Dr. D is going to see patients on Wed. afternoons and I am > going to hire a nurse practitioner to see the patients full time as soon as > I am taking in some money for salaries. Dr. D requested $1500 a month as the > medical director and $150 an hour to see patients-not crazy about that but > sending letters to 30 doctors only got me this one reply. The office lease, > business license and liability insurance are in the name of my nursing > corporation and I am the CEO and office administrator. The MediCal > application was sent in as an addition office for the doctor since the > billing will be done with his provider number. > > Today, my medical director called to tell me that a doctor he knows for a > long time is closing his office and offered him 1000 charts ( I'm sure that > less than 100 are active), but he doesn't want them because he is only > working for me part time since he has 2 other offices that are about 20 > minutes away. So, he said I could go pick them up along with any office > supplies I can use. I called Dr. H to make arrangements to pick the charts > up. He also asked me if he could rent space from me to see his current > patients maybe one morning and one afternoon a week for $500 a month. > Thinking it was a great idea to offset my $3000 a month rent, I said ok. He > wants to come meet me and see my office on Monday at lunchtime. > > The next thing I know Dr. D calls me to blast me for making a decision > without consulting him and that he does not want Dr H to share office space. > Almost reduced me to tears saying that the charts were offered to him to see > in my office, not offered to me. He said I should go pick them up tomorrow > morning, and then stall the Monday meeting. I am now caught between the 2 > and feel that something fishy is going on. > > I realized when I hung up that Dr D had a lot of nerve telling me who I can > or cannot share office space with because it's MY lease, MY business > license, etc. and that he is MY employee, not the other way around.Does > anyone have a paper with the job function of a medical director in a private > practice that they are willing to share with me? > > My hubby went off the deep end, saying that I cannot pick up the charts > since Dr D feels that they were offered to him and that I cannot get in > between the 2 docs. I am already caught in the middle. Hubby said that by > picking up the charts, I am verifying that I am agreeing to let Dr. H share > my office space. He also said that I should not tell Dr. D this afternoon > that I cannot pick up the charts because now he's saying they are his and > not offered to me. Hubby says to appease Dr. D so he doesn't up and quit > despite the 60 day notification he verbally agreed to and signed the > contract for. Needless to say, I am going to work on applying to MediCal > for my corporation this weekend and see if I can find another medical > director. > > I have been preparing to open this office for a year and am just waiting > on the CLIA waiver form and Calif. Medical presumptive eligibility > preprinted forms for immediate temporary MediCal to arrive so I can > officially open. I have about $85,000 in credit card bills for this project > that need to be paid off. Am I wrong to feel that this is my office and I > can make my own decisions? Does a medical director take away all my > authority? I did have Dr. D sign a contract last spring that he signed but I > never got around to signing it because I figured I had to rewrite it when I > had an opening date to insert. My contract with him also states that he > would teach me and sign off on my midwifery program, and NP program when I > get back into one. > > Please help. My day's been ruined with a huge migraine. > > just a nurse, > > Gail > > ------------------------------ > Join ChristianMingle.com? FREE! Meet Christian Singles in your area. Start > now! > > _______________________________________________ > PrvPracNP mailing list > PrvPracNP at nurse.net > http://lists.nurse.net/mailman/listinfo/prvpracnp > % You can change you list options and unsubscribe from this page > -------------- next part -------------- An HTML attachment was scrubbed... URL: From laurahoemanarnp at aol.com Sun May 3 21:59:56 2009 From: laurahoemanarnp at aol.com (laurahoemanarnp at aol.com) Date: Mon, 04 May 2009 00:59:56 -0400 Subject: [PrvPracNP] Urgent advice needed In-Reply-To: <96605ace0905030513r6aeeadb8s13c037333ec9767c@mail.gmail.com> References: <96605ace0905030513r6aeeadb8s13c037333ec9767c@mail.gmail.com> Message-ID: <8CB9A8C4C963E22-55C-5C3A@webmail-db05.sysops.aol.com> Hi all. Well, Gail, you could move to Washington state where the problems you're having would be unthinkable. I agree with Barbara...Dr. D is not a good match for you, he sounds like a control freak and you don't need that!!!? It's good you DIDN'T sign the contract!? Thank all that is holy that you realized Dr. D's true colors before you got in? any deeper. Maybe Dr. H is the answer for you. Good luck!? --Laura, ARNP in Wash. state -----Original Message----- From: Barbara C. Phillips, NP To: Private Practice NPs ; NP Info Sent: Sun, 3 May 2009 5:13 am Subject: Re: [PrvPracNP] Urgent advice needed Good Morning Gail, Sounds like a sticky mess. You've gotten some sound advice from the others here. Definitely would evaluate your physician relationships and the contracts with an attorney.? Better yet...and NP attorney. I don't know here, but I've heard of Melanie Balestra who is both (www.balestralaw.com). I'm not sure why Dr. D is giving you such mixed messages (doesn't want the charts, wants the charts), nor why he is unhappy you want to rent space out to another physician (which by the way, if structured correctly is a great way to reduce your overhead and everyone can win). I have to say, doesn't sound like he's the best match for YOUR vision and your business. It is my understanding that an NP in California cannot own a practice. According to my conversations with Matt Freitas, FNP-C (Modesto, CA), the pract ice has to be owned (51% @ least) by a physician. With this, Dr. D may see YOU as the employee and not the other way around. Perhaps Dr. H might be a better match for you (as medical director)? Consider delaying the opening of your business until you get this essential part squared away and there is a clear understanding of the roles that each player will be making. I know that you have planned this for a long time, however, getting this straightened out now will save you time, frustration and perhaps your practice in the long run. Best wishes, Barbara Barbara C. Phillips, NP ---------------------------------------------------- Assisting Nurse Practitioners to fulfill their dream of business ownership through education, resources & support. ---------------------------------------------------- www.NPBusiness.ORG www.NursePractitionerBusinessOwner.com *NEW: ?Facebook Group for Nurse Practitioners in Business: ?http://is.gd/rY6C On Fri, May 1, 2009 at 5:40 PM, wrote: Hello all. Sorry to bother you on a Friday afternoon but need advice as I'm in a bind. It's kind of long but would so appreciate your comments. ? ?Next week I am planning to open my OB/GYN office with an OB/GYN as a medical director.?Dr. D?is going to see patients on Wed. afternoons and I am going to hire a nurse practitioner to see the patients full time as soon as I am taking in some money for salaries. Dr. D requested $1500 a month as the medical director and $150 an hour to see=2 0patients-not crazy about that but sending letters to 30 doctors only got me this one reply. The office lease, business license and liability insurance are?in the name of my nursing corporation and I am the CEO and office administrator. The MediCal application was sent in as an addition office for the doctor since the billing will be done with his provider number. ? Today, my medical director called to tell me that a doctor he knows for a long time is closing his office and offered him 1000 charts ( I'm sure that less than 100 are active),?but he doesn't want them because he is only working for me part time since he has 2 other offices that are about 20 minutes away. So, he said I could go pick them up along with any office supplies I can use. I called Dr. H to make arrangements to pick the charts up. He also asked me if he could rent space from me to see his current patients? maybe one morning and one afternoon a week for $500 a month. Thinking it was a great idea to offset my $3000 a month rent, I said ok. He wants to come meet me and see my office on Monday at lunchtime. ? The next thing I know Dr. D calls me to blast me for making a decision without consulting him and that he does not want Dr H to share office space. Almost reduced me to tears saying that the charts were offered to him to see in my office, not offered to me. He said ?I should go pick them up tomorrow morning, and then stall the Monday meeting. I am20now caught between the 2 and feel that something fishy is going on. ? I realized when I hung up that Dr D had a lot of nerve telling me who I can or cannot share office space with because it's MY lease, MY business license, etc. and? that he is MY employee, not the other way around.Does anyone have a paper with the job function of a medical director in a private practice that they are willing to share with me? ? My hubby went off the deep end, saying that I cannot pick up the charts since Dr D feels that they were offered to him and that I cannot get in between the 2 docs. I am already caught in the middle. Hubby said that by picking up the charts, I am verifying that?I am agreeing to let Dr. H share my office space. He also said that I should not tell Dr. D this afternoon that I cannot pick up the charts because now he's saying they are his and not offered to me. Hubby says to appease Dr. D so he doesn't up and quit despite the 60 day notification he verbally agreed to and signed the contract for. Needless to say, I am going to work on applying to? MediCal for my corporation this weekend and see if I can find another medical director. ? I have been preparing to open this office for a year and am just waiting on?the CLIA waiver form? and Calif. Medical presumptive eligibility preprinted forms for immediate temporary MediCal to arrive so I can officially open. I have? about $85,000 in credit card bills fo r this project that need to be paid off. Am I wrong to feel that this is my office and I can make my own decisions? Does a medical director take away all my authority? I did have Dr. D sign a contract last spring that he signed but I never got around to signing it because I figured I had to rewrite it when I had an opening date to insert. My contract with him also states that he would teach me and sign off on my midwifery program, and NP program when I get back into one. ? Please help. My day's been ruined with a huge? migraine. ? just a nurse, ? Gail Join ChristianMingle.com? FREE! Meet Christian Singles in your area. Start now! _______________________________________________ PrvPracNP mailing list PrvPracNP at nurse.net http://lists.nurse.net/mailman/listinfo/prvpracnp % You can change you list options and unsubscribe from this page _______________________________________________ rvPracNP mailing list rvPracNP at nurse.net ttp://lists.nurse.net/mailman/listinfo/prvpracnp You can change you list options and unsubscribe from this page -------------- next part -------------- An HTML attachment was scrubbed... URL: