u/InvestingDoc

Happy Fourth of July to all of my fellow private practice physicians.

I've been thinking a lot today about where I came from.

My grandparents immigrated from Germany. My grandfather's brother fought in the Battle of the Bulge and later served during the Nuremberg Trials. My grandfather started as an apprentice, became a master plumber and electrician, and eventually built his own business.

When I was younger, I used to ask him, "Why didn't you ever teach us German?"

His answer was always short and sweet: "We're Americans now."

It took me years to understand what he meant.

It wasn't that he disliked the German language or wanted to erase his heritage. It was a different era. He had lived through the aftermath of Hitler's rise and understood how important it was to embrace the country that had given his family a new opportunity.

The town my family came from has more cows than people. Yet somehow, a few generations later, I have the privilege of owning a growing medical practice, employing an incredible team, caring for damn near 40 thousand patients, and helping other physicians build practices of their own.

That kind of upward mobility isn't guaranteed anywhere. It certainly wasn't guaranteed for my family.

America isn't perfect. No country is. But I'm grateful to live in a place where hard work, calculated risk, and entrepreneurship can completely change the trajectory of a family in just a generation or two.

As physicians, we're fortunate to have the opportunity to build something that serves our communities, creates jobs, and leaves a legacy beyond ourselves.

So today, I'm thankful, for my family, for the sacrifices that came before me, for the freedom to build, and for this community of independent physicians who refuse to stop believing in private practice. I'm thankful for you guys and gals. I also learn a lot from you guys.

Wishing all of my brothers and sisters in medicine a safe, meaningful, and Happy Fourth of July for this special year.

🇺🇸

I'm curious what you all doing in terms of booking numbers.

We book 22 per day, usually have 2 no shows for more established panels so the doc usually sees 20 per day.

How many do you book per day and how many do your people see per day?

Competitor books at least 25 per day for us and allows up to 3 overbookings during a regular 8 hour day.

My dentist started to charge a credit card fee recently. This got me thinking about this topic again.

Is anyone here passing these costs along to the patient?

Last month I paid about $6,800 in credit card fees alone to the processing company. That is not an insignificant amount of money that I'm debating on starting to pass along to anyone who pays via credit card.

Some states its not legal, so if you are thinking of doing this check your local laws.

Many medical companies sell physician personal info to broker websites for anyone to buy. Ever singed up for Sermo...yeah they sold all your personal info to whoever is willing to buy a list with your personal info. Want a list of doctors who own their own practice? There is a list you can buy with names, numbers, and email addresses.

I get at least 5 texts a day from random companies who want to sell me something or buy out my practice. Today alone, I've gotten over 30 text messages and I'm over it.

Have any of you been successful in finding where your info is being sold and then removing your info from these brokers?

Hey everyone,

First off thanks for everyone who is a part of this subreddit. I really appreciate all of you and all the feedback that you all give me. I am doing my best to foster an environment where we can talk about everything private practice related.

We just hit nearly 6,000 members. That's incredible, and it's a testament to how many of you are serious about building and growing sustainable private practices. Thank you.

As the community grows, so does the noise. I've made some rule updates to keep this space high quality and actually useful for people in the trenches.

❌ Problems that I have noticed since last rule update:

➡️ I will admit that IMO, astroturfing and shilling is this subs biggest problem. This is an anon website, and as such part of the limitation is that ANYONE can join. This leads to many companies who almost daily trying to shill or astroturf their company on this subreddit. Please flag those users or members if you see these types of posts or accounts. I will be banning any account that is shilling or astroturfing on here. I have to ban about 10 accounts a week for this problem.

➡️ Along with that is a new problem. Some billing companies, RPM companies / or other businesses targeting medical professionals are creating their own subreddit and attempting to post low effort posts to their subreddit and cross posting to this subreddit to build engagement to their subreddit for their business. I view this as a hidden form of astroturfing personally. It is a smart way to try to circumvent the no shilling or astroturfing rule directly in this subreddit and I salute you for being crafty to try to get around the rule. However, that comes to an end today.

➡️Growth for posting and expert advice. A few of you have reached out to me to do an AMA for this subreddit. I have approved only one person so far to do the AMA in the coming future as of the time of me making this post. I get paid nothing from this person to do the AMA and have no conflict of interest to disclose with this person. I get paid nothing for modding this subreddit. The one AMA that I approved is someone who claims to be an expert at filing and hopefully winning IDR cases. I am not an expert in IDR and since we have quite a few surgeons on here, I figured it would maybe be helpful for them.

I will be listening to feedback from you all to see if you want more of these or less of these. I have put some criteria for this person. They need to publicly try to answer every question they can within reason so that every response is not (click my link to learn more). The responses need to be helpful, and they need to disclose their name and conflict of interest somewhere in their post.

I'm happy to listen to feedback on if the community wants more or less of these AMAs.

If someone wants to do an AMA, for now you can message the mod (me) and I will consider whatever the topic you want to talk about. The purpose of the AMA is to teach on the subject, not to just shill your company or recruit people to join your website / business / etc.

Other quick automatic updates:

➡️ I set up an automod. It was a bit overzealous flagging comments and I have been paring it back from flagging so many comments. I will continue to tweak the automod based on frequency of rule breaking behavior.

➡️ There is a karma threshold to now post here. Almost 100% of the time when I have to take mod action on accounts, it is for accounts with < 50 karma. I have set the threshold at 30 karma to participate in this subreddit and will adjust as needed.

Here's what else is changing:

🚫 No more cross-posts All cross-posts from other subreddits are now automatically removed because of the shilling problem.

🚫 No subreddit funneling I've been seeing low-effort posts designed to drive traffic to other subreddits. This community isn't a launchpad for someone else's audience for their business. Posts like this will be removed automatically by an automod. Repeated offenders will be banned.

🔍 Astroturfing & shilling will be auto flagged If your post reads like a soft pitch "stumbled upon this," "not affiliated but," "game changer for me" well, it's going in the mod queue. You may have seen some automod pending approval from comments. I will keep refining triggering words or expressions that I see commonly used in astroturfing or shilling. Genuine experiences are welcome. Disguised ads are not.

What we want more of:

• Real questions from people building practices
• Honest wins and lessons learned
• Pushback, debate, and experience-based advice
• Support (venting about a tough business event)
• Anything that goes along with starting, scaling, or running a private practice in any specialty of healthcare

Thanks for everything everyone, and as always I'm open to feedback on what you want me to change, see more of, or less of. Have a great day!

I just negotiated for a 9% raise this year from Aetna a few months ago. Now every single level 4 visit we bill since I negotiated that raise, they are requesting records on every visit before paying.

It feels like a bit retaliation from our recent pay raise. We have not been downcoded yet by Aetna for any notes + claims we send to them, but my billers are having to send any claim to Aetna that is level 4 or 5 before we get paid now.

We have not received notice from Aetna that we are under any formal review. our rep just tells us this is new standard protocol.

Anyone else going through this with Aetna?

Happy Wednesday everyone. Figured I would post a little light humor for all of us who struggled with finding good talent to hire. You are not alone.

I have been blessed with a great team but anytime you hire new employees, there's always the risk that you get a bad apple.

Yesterday our newest hire who is about 5 days into her job...had her pot dealer stop by for lunch, get high in the car together, then try to come back into work smelling strongly like marijuana. She passed a drug screen, a background check....but you never know and sometimes people eventually show you their true colors.

Lucky My staff called it out right when she returned from lunch and she never had any patient interaction after returning from lunch smelling of a strong odor.

Keep grinding it y'all! This is a part of the reason why I have no issue overpaying got good talent. Good help is hard to find haha

Not happy with the absolute horrible rates I'm getting from wells Fargo. Looking to switch for the cash just sitting there as a rainy day buffer.

Which business banks are you using for your business checking or savings accounts that have a decent interest rate?

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."