Unlikely to top busy total joint and spine docs…. All else is fair game and doable.
A general orthopedist can not hang with a moderately busy pain doctor who is mostly doing clinic procedures, with
some ASC.
Not all orthopedists do well BTW, especially trauma (they eat **** on collections, but make up for it with call pay). Too many cases in the hospital IMO, and the payor selection often sucks when they do cases in our surgical centers. Sports is not great either, but many sports guys supplement sports with general ortho cases and that helps.
In my group, if you separate out facility fees and compare me against everyone else, I am very competitive and the only thing that makes it close with a lot of my colleagues are the DME they Rx day in/out. Braces all day, and post op PT.
I do virtually zero DME, so their ancillary collections added into their nonfacility clinic collections adds a huge boost to what they collect.
If I am doing 200-240 spine injections per month, and I am doing roughly 37% of those in an ASC (I own 4% of that 100% physician-owned ASC and do not have a clinic procedure space at that location). I do around 500-600 patient encounters per month (6300 last year), and those numbers put me in the top half of my group before you add in facilities.
End of Feb this year, I was set to end the year around 7000 total patient encounters and have a huge year, but we went live with Athena in March, and this has literally sabotaged my practice. I am F'd right now, but I'll figure out how to fix it.
I'm doing 37% of my procedures in an ASC, but even with just that number of procedures/cases in the ASC I'm competitive. If all of my procedures were ASC I'd be extremely competitive in the facility numbers because of the fact some people seem to forget that collections are just that - collections. That does not include the cost for a case. Ortho cases are expensive.
It's when you add in the outrageously efficient total joint and hand guys that I fall way behind, and I cannot imagine how a pain guy could keep up with them. Bob and GDub sound like they're outliers capable of cranking huge amounts of volume, but I do NOT believe my practice would be able to keep up with that.
Every time I bring a new "thing" to our practice it has a been nightmare. I'm rolling out Intracept now, and this has been quite smooth this time around. Our old ASC director was an ignorant *****, but she's gone.