Large Expenses Just a Part of Running Your Own Medical Practice

Just when I thought a nice financial cushion was building in the practice checking account, here come the big annual bills.

There are monthly expenses that are fairly predictable - salary, rent, utilities, etc. There is a fairly steady influx and outflow of money each month. Fortunately, the influx exceeds the outflow most months. Oh, sure there are unexpected expenses. There are the occasional repairs. Sometimes things need to be replaced - items such as furniture, small appliances like the microwave; nothing big enough to make a big dent in the account.

There are also quarterly expenses that can take a big chunk out of the money on hand. For the most part, our big quarterly expense is my associate’s productivity bonus.

Somehow, I am always caught by surprise by the annual expenses. OK, maybe "surprise" isn’t the most appropriate word. After all, I know full well that I have to pay insurance premiums, but I still think, "Oh yeah, forgot about that" when the mail comes.

Since I opened the practice around this time (can it really be?) four years ago, there are certain expenses that crop up right around now. Malpractice insurance premiums are due now. In the last two years, I have decided to finance the premiums because insuring two docs is twice as expensive as insuring one, even though I would rather pay in full if I could as it costs less in total. But even though I finance, a fairly sizable first payment needs to made now.

It is also time for annual maintenance fees for the EHR. That cost has also gone up since there are now two physicians and a nurse practitioner in the office. Thank goodness for the meaningful use incentive. Don’t get me wrong, it’s still a pain the behind to apply, but at least it offsets some of the expenses.

I am fairly certain I will be receiving notice soon that fees related to our retirement plan are due. There are licenses and certifications that need renewing now, and I have to pay for our P.O. Box, and while theses are not big expenses, every little thing adds up.

So I guess I won’t be taking any extra money home this month. I knew I should have bought that Powerball ticket.