What to do?

[ljl1460]

Hi, I am one of 3 CNMs currently providing full scope care in a 6 physician practice at one of the local Private Hospitals in California. Our doctors have started to become greedy :angryfire and now want us to refer our women to them if they become slightly above normal risk ie. mild hypertension etc. Most of these women have transferred to us specifically in mid pregnancy from other offices as well and now our docs no longer want to co manage anything! We bring in most of the business by the way despite having 6 doctors!

So, we have decided to find new doctors to supervise us in our practice. My question is what should we do, find another practice to replace our doctors, start our own practice and have the new physicians supervise us and we pay them a fee for service etc., or shall we try to get the hospital to employ us (they have never had any mid level providers on staff)?

Help!!

It is very mind blowing to know which way to go - we dont want to jump into another fire

[zahryia, LPN]

Wow! My option would be to move to a state where you don't need physician oversight! However, that's not a likely option, so my 'I'm not an CNM yet' advice would be to set up a new practice and find new docs. However, I would secure the new docs before I get rid of the old ones.

Good luck and keep us posted.

[ljl1460]

Thanks! We are probably going to do just that and are in the process now of securing the other docs without letting on to the current ones!

I hope we will survive on our own though as setting up a practice is a huge undertaking but I will keep posting as it is a very exciting time for us and perhaps others will get some help as we progress.

If there is anyone out there who has already done this perhaps you caould share your experiences especially on the insurance & billing front!