Ophthalmologist in optical store !?

[LENNY]

I have been aproched by general Ophthalmologist asking me to work in my store.
She wants to collect the insurance pay for the exam and also do refractions for my private patients at no charge to me.
I am saving $300 for OD, increasing number of refractions and accept more private insuranses that i currently do.\
So my question is: do icharge her for using my office equipment, my staff, my copy machine, my bathroom or be happy she wants to do it for me???
Another question : do i get a % of her payments? surgeries that she got from my patients? (which is probably illegal)?????
Help

[mikeh]

By the strictest interpretation of tax law, the use of your premises, etc would be described as "unearned income" and is therefore taxable. You are supposed to determine a "fair market value" and issue a Form 1099. The IRS has announced that they intend to step up their investigations of "independent contractors" who don't declare these types of income. Such investigations are long overdue.

Chain opticals used to have big problems like this is states where they couldn't legally employ an OD. The OD would want a "handshake" agreement for a $50 per month rental (which of course they'd never pay). They would insist that the "landlord" pay all utilities, including phone, provide them with a receptionist (usually meaning hire their wife), provide all the latest equipment, and kiss their butt all the time.

In return for all of the above the would deign to see patients (at their convenience) but usually not at any time convenient for patients - no evenings or weekends. They often had their own office nearby where they would steer contact lens patients to see them at a different time. They usually weren't very good doctors either, but a chain office without exam capabilities is dead in the water.

The solution Lenny is to charge to Doc a rental based on the per square foot cost you're paying. Prorate it according to the size of the space utilized. You can make slight additions for the other stuff at your discretion. Use the 1099/unearned income argument as your justification. If the Doc is paying rent, those issues disappear - unless the IRS investigation determines that the amount paid was not comensurate with the value received by the Doc.

Of course, this is just the legal side. You have to make your decision based upon your business. I would certainly discuss "co-management fees." In effect the Doctor is "database mining" your patients.

[Jeff Trail]

Lenny,

Mike had some points worth mentioning.. but does anyone prorate a "rent" to a OD or MD and split the pay for receptionist etc. etc.. NOPE.. In the majority of cases I have dealt with most of the OD's and MD's want a "base" in fee so if you don't book enough people you make up the difference out of pocket.. I would rather do it that way any way for a number of reasons, one if you "rent" space to the OD or MD then its a binding contract..say you have an argument and he or she tells you to "stuff" your phoropter.. and out of spite pays your rent you agree'd to but just won't show up.. then you are stuck with no Doc and you can't let anyone use space that is already under contract :) You would be ahead of the game if you have no Doc now and let them come in and do it for a "token" say $50 a month or whatever and get the money they generate in RX's in your retail portion.. Although you would be better off with an OD instead of an MD in my opinion since you don't want the Doc using YOUR chair time for pre-op and post-op stuff.. but you know your situation better then any of us do :) Next.. you are not going to get ANY of that money for any of the medical things that the MD is going to do.. so you might as well hang that up.. you won't even get any of the ins. money either that is posted under his/her ID number (medc. or medc.) you will only get the "glasses" side of the stuff ... even if you could get it do you think it would be fair to the MD? are you going to GIVE a % of every RX you fill to the MD ? I doubt it..
I always found it best to never get into to tight of a binding contract with any OD or MD and its really to the benefit of both parties.. if they are making big money and you're keeping the chair filled then they'll stick around.. ever met a Doc that DIDN'T like money :)
The only thing I would recomend is to do a little research and make sure they are not a reject :).. call the state and see if they have any malpractice suites (state medical board) .. find out where they were at and call around and check on them.. You might be surprised with some of these OD's and MD's ethics and the way they practice.. I could tell you some stories that would make your hair stand on end

Jeff "Had an OD as a partner for years and was happy" Trail

[LENNY]

I currently have 2 OD working for me in this office.
So the MD is just an extra day for me.
Do i need an extra day?
Yes and no
I can catch somebody from the street wanting to check both of their eyes TODAY.
And basicaly i am not loosing anithing exept $10-$15 per patient that i dont get from third party insurance(but i dont pay to OD)
I think it sounds preety good for me

[Pete Hanlin]

Just a question... are non-MDs permitted to employ ODs and MDs in New York? Will the MD be providing only refractions and "92***" coded exams, or will s/he perform other medical procedures as well? Without exception, cases in which someone I knew entered into an arrangement with an MD have resulted in billing and legality problems.

If you want the extra day, you should have no trouble finding a young OD who is looking for work. You should be near PCO, which graduates tons of good Optometrists each year who are looking for work (I've known a few who had to work in 3 or 4 offices at a time to keep a full week).

Pete

[Texas Ranger]

Lenny, #1. what is this lady MD doing the rest of her time? #2. when your patients become her patients, and she has them come to her other office, with "her" dispensary, then you might regret the extra help. #3. dealt with a lady MD years back that was great, at everthing but refracting! that cost us a lot of money. had the doc been in "our" office, it would has reflected badly on "us". being seperate, people would just ask where they could go for an exam next time. Al.

[mikeh]

I forgot NY is an employable state Len. How will the OD'a feel about her being in the office on their day off? Most of the Docs I've known would figure that was "cutting" (pun intended) into traffic.