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SJBird55 -> Re: what are your thoughts (August 28, 2005 3:57:00 AM)
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It might be a good idea. I think you'd have to consider the patient populations a little bit better though. From another listserve I'm on, I get the impression that pediatrics had very poor attendance (meaning lots of cancels and no shows). Also, if you toss pediatrics in the mix, that would probably mean you'd need to increase the size of the facility (which increases the lease cost) and would need to have specialized equipment just for pediatrics.
There would need to be something in place though that united the therapists, I would think. If one therapist had a bad reputation, would the reputation of that therapist be carried over to everyone else? I know with hair salons, a bad reputation of one hair dresser doesn't necessarily mean all of the hair dressers are terrible. I see the set up you are describing of being like a hair salon (business structurally).
The marketing strategy would need to be thought out. Marketing isn't a simple kind of thing. It is time consuming and ongoing.
Why not just have a business structure that is like physicians or lawyers? My sister-in-law is working with a company that specifically works with the various govt entities here in MI and provides the health insurance plans. She's in a cool place - she has her normal salary (which is about at a recent grad PT level) and then has bonuses based on new clientele AND bonuses based on new clientele for the people she manages AND she has the option to purchase stock to capture even more financially. She takes her clientele seriously and is very consumer-oriented.... her performance directly ties into her ability to capture more financially. You can see it in her attitude too, when she talks. I doubt if the business structure of her company would work in the rehab world, but wow... definitely some wonderful financial perks.
In my mind, I highly doubt if I'd set myself up in a subcontracted place. I'd worry about ethics and the legal aspects because we aren't really joined as one. Also, you didn't mention billers - who would be responsible for that and how would the decision be made in regard to who chose the billers? Who would have the authority to decide who was accepted to be subcontracted out? Who sets the fee schedules? I could work, I guess, depending on who owned the facility and to what degree that person creates the environment including policies and procedures.
Also, with subcontracting, I believe here in MI the one doing the subcontracting work is tossed into a higher tax bracket. I don't know if it would make more sense financially if the salary made wasn't substantially more than if just W-2'd. And, then of course, the subcontractors would also need to definitely have their own professional liability insurance (which doesn't have to happen in employee situations - PT's have a choice).
I don't think I'd consider being subcontracted out - might as well go into business for myself OR into a company that would allow me to take a risk and own some percentage of the company.
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