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Practicing out of my home?

  • 1.  Practicing out of my home?

    Posted 07-12-2017 18:53
    After 10 years of employed medicine as a family physician, I recently lost my job and want to make good on my desire to be independent. I live in a rural community with a doctor shortage and have been trying to open a clinic from my own home after seeing that option mentioned on an IMP site. I love the idea of very low overhead, so I can practice slow medicine. Is anyone practicing this way?
    My county has no problem with zoning and the community is very supportive, but I would like to bill insurance and don't know if it's a no-go. Medical suppliers have already balked when I ordered some supplies to set up. I'm ready to try to start credentialing; there are only a few big insurance players out where we live, besides Medicare (not taking Medi-Cal). I have an ideal location and set-up, working on ADA accessibility. Would love any advice, I'm in the California Sierra foothills.

    Kelly A. Sharrar, M.D.
    Mariposa CA

  • 2.  RE: Practicing out of my home?

    Posted 07-13-2017 09:31
    I think Sharon did it out of her house in SoCal.  I'm not sure she's still doing that.

    I recommend against it.  I don't want patients coming to my home.  And I want work and home separate.  The legal issues are immense.  You need to make sure the office is functionally completely separate from the home.  If a family member uses the copier in your office, the IRS can come down on you.

    MUCH easier to find someone who has an extra room to sublease (technically it's an "office use agreement") you.  Any specialists in town with an extra room?


    Craig Ross, M.D.
    Family Medicine/Owner
    South Arbor Family Care
    Ann Arbor, MI
    M: 734-756-8446
    W: 734-707-7075

  • 3.  RE: Practicing out of my home?

    Posted 07-13-2017 17:10
    If you practice as ("My name"  or "My Name medical clinic")  you don't need a DBA or to tell the MBC.  If you practice as "Foothill Medical," you will.

    I practiced in a fairly small community for 20+ years.   My home phone was listed.  In all that time, the only time someone called me at home was to tell me the answering machine at the office had failed, and wasn't picking up.  (Power failure =>UPS for the ans machine, after that.)

    Everybody in a small town knows where you live anyway.  If you have usable/functional space, I'd say go for it.
    If you grow enough to need more space, you'll know it.

    If you have your home address on your DEA (need to change it within 10 days, btw) and NPI, then you can tell the suppliers that's where you practice (tell them to look it up!)   You MIGHT want a separate po box but most of your checks should be electronic anyway.  Keep us posted about insurance companies giving you a hard time-they're all abusive.  Of course you can bill them.
    You do want a separate checking account, and possibly a separate TIN as a DBA.  A "corporation" doesn't protect you from much, and isn't worth the extra expense, IMO.

    ANd if you tell someone to meet you at the office at 10:00 at night, it's not a long trip for you!

    Peter Liepmann MD FAAFP MBA
    My mission is to fix US health care
    Bakersfield CA

  • 4.  RE: Practicing out of my home?

    Posted 07-13-2017 19:09
    Thanks, Craig and Peter. I'll see if I can look up Sharon in SoCal and see what she has to say. Our home used to be a bed and breakfast, so it's actually set up well and our county is very business friendly so they have no problems. It would be in my name. I'm going to go for it and see what insurance says, like you say Peter, I can still bill. Good reminder about DEA, I changed address for NPI but I hadn't changed for DEA. I did get a P.O box per a billers recommendation that it is a major hassle to change address with Medicare, so if I move to another location I won't have as many issues. There are no specialists out here to share space with, unfortunately. And yes, most here know where I live already!

    Kelly A. Sharrar, M.D.
    Family Practice
    Mariposa, CA

  • 5.  RE: Practicing out of my home?

    Posted 07-15-2017 17:35

    I agree with Peter.  Go for it.

    Keep your overhead low.  If you have a nice personality, you should do fine..   You can earn as much as a salaried doctor and enjoy medicine and the relationships it provides.

    Do some urgent care once or twice a week until your volume picks up.

    Not sure what difficulty you are having with medical suppliers.    Can you elaborate?

    Mike S

    Michael S. MD