Due Diligence

Due Diligence (Full Version)

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Cam -> Due Diligence (September 10, 2007 8:50:34 PM)
Hey all, Any ideas on what are the "must-do's" of due diligence? I am in the process of buying an existing clinic, but will go on site in a few days to conduct due diligence. Just want to be sure not to miss out things on my checklist. Also what about reimbursement for dry needling in Canada with MVA patients, has anyone used this as a modality with this patient population and run into reimursement issues. Thanks Cam

Cam -> RE: Due Diligence (September 12, 2007 8:56:48 AM)
Hey all, Hello is anyone out there? Any takes on dry needling? Sebastian, I notice you are from ON, do you do dry needling and have you had any issues with payment esp. with MVA's? Thanks Cam PT, MSPT

Sebastian Asselbergs -> RE: Due Diligence (September 13, 2007 7:02:46 AM)
Cam, I had NO idea you were in Ontario. The rules and regulations are different in each province. Reimbursement for acupuncture for MVA patients is not an issue - that's why they have it in their billing codes. Check this for further info about billing under MVA insurance - they use the ICD-10-CA and CCI code system http://www.cihi.ca/cihiweb/dispPage.jsp?cw_page=codingclass_e As long as you have acupuncture (or dry needling) certification acceptable by the College of Physiotherapists. The paperwork is very important to check: check the lease for the space for the clinic - what are the details, length etc. What is the accessibility? What is the status of the maintainance of the equipment (ask for records of yearly check-ups)? Is there software, and is it leased? Are upgrades and (online) support included? What ARE the outstanding leases on equipment (including office computers etc)? If not leased, ask to see the invoices of purchase. (just letting it flow here) How about manuals for equipment? How about business taxes and licenses for the city it is in? Who pays? (I have to pay my own city tax fior registration of my business - each year - $50.00; but this can be much more in other places). Who does the snowclearing at the entrance and at what time of the morning? And of course the logical stuff: ask to see the books for the last five years.......There is much more, but I need to actually work now....

Cam -> RE: Due Diligence (October 3, 2007 12:41:07 PM)
Thanks for the input Sebastian. Unforutnately the deal did not go through. They never let us perform due diligence. 6 Months of dealing with the sort of people that I just dealt with has left my morale bruised. So here I am looking to set up or buy an existing pratice all over again!! I have looked at certain areas in ON. In an area that has established clinics what may be the population to clinic ratio in order to sustain a decent flow of patients? Thanks Cam

Sebastian Asselbergs -> RE: Due Diligence (October 8, 2007 10:04:01 AM)
Cam, that is very hard to say. In Ontario, there are so many variables determining clinic visits. On one of our city streets here, we have 4 - yes, FOUR! - PT clinics in a 1/4 kilometer stretch. One is private/OHIP mix, one is very heavily sports-oriented and has two sports-MDs attached (not owners) with their own offices, one is sports/acup oriented, one has PT and OT - and all are doing alright..... I am down the road from a more assembly-line LARGE clinic - and both of us are doing fine. Barrie has 125,000 people and our PT clinic number is, I think, 14 excluding the hospital-PT dept. Success is obviously NOT just related to location and population; it is related to quality of care, your SECRETARY (the first contact of anyone calling - the most important selling aspect of all!), your geographical location and ease of access, your target group of patients etc etc. When you settle in an area with a lot of bsinesses, it pays to simply visit their HR dept. or health=and-safety people to let them know they now have a handy close-by option for their workers - less loss of time etc. No clear answers, but really, you need to set your PT goals high - your financial goals realistically low in the beginning - and your marketing goals fully focused on quality! Not on gizmos, not on "we do everything best", but on quality PT. Now, DON'T set up next to me! [:D]

Cam -> RE: Due Diligence (October 10, 2007 10:52:44 AM)
Thanks Sebastian, Barrie is too cold for me so you can be rest assured you won't find me there[;)] Yes there's no better truth to providing qulality care and I know I will have some people jumping down my throat for saying this, but the trend that I have seen in the gazillion PT clinics in ON: booking upto 3-4 patients an hour, hooking people up on modalities, spending 15 min and then getting the PT aide(s) to do the rest is not quality. I have also had some PT's at a time when I interviewed for jobs tell me that if I saw initial evals for anymore than 30 min, then I am doing something wrong!!!!! The other day I was speaking to an MD in a town that I am considering setting up, and I was asking his opinion and he tells me if I have the latest "gizmos" then maybe people will come, he did not care to be curious about my qualifications( I am in the last leg of my post prof clinical doctorate..will be done in spring 08) nor experience. This really scares me, I don't expect them to know what I do, hopefully they will feel better once they see the results, reports etc, but then my challenge is how do I get the first patient through the door through them. Is it true that MD's within a medical centre that has a PT clinic, refer only to the clinic and will not refer outside? Sebastian, how about a primarily residential location for a clinic, what are your thoughts. How do I get the MD's to note my qualifications and credentials to get that first referral from them? Thanks Cam

Sebastian Asselbergs -> RE: Due Diligence (October 13, 2007 4:12:25 PM)
Hey Cam. "Is it true that MD's within a medical centre that has a PT clinic, refer only to the clinic and will not refer outside?" In many cases, YES. But as patients ask for more convenient locations to their residence, this is changing. They don`t care travelling to their MD quite a ways, but for a few repeat visits, they prefer close to home. So: `how about a primarily residential location for a clinic, what are your thoughts.`` Yes, you can choose residential, but do not be too far from schools (high school esp.) and commercial-industrial. Be prepared to be open some odd hours until you are established. ``How do I get the MD's to note my qualifications and credentials to get that first referral from them? `` - You don`t, really. Most really don`t give a rat`s arse what credentials you have, unless it is VERY specific like incontinence treatment. You will get referrals AFTER patients have mentioned you to the MD - AFTER they have walked in for assessment and treatment without a referral. You still need to drop off referral pads (with a map on the back of each page!) - it will generate a bit. Sebastian PS: I thought I sent you a private message - but it seems I didn`t.

SJBird55 -> RE: Due Diligence (October 13, 2007 7:11:37 PM)
My private message deal may not be working correctly either.

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