Medical Physics Consulting
Transitions to a Group Practice
David L. Goff, Ph.D., FACMP
Medical & Radiation Physics, Inc.
San Antonio, Texas
Historical Path
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BS Chem Engr.,
g WU, -‘60 - MS Nuclear Engr.,
g SMU -’63
PhD RadHealth Engr., UT, Austin – ‘69
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Military Svc. (3 yrs) - US Army Nuclear Defense Lab
- Edgewood, Md
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Initial Work- ‘Hospital - Radiation Physicist’
• Santa Rosa Med Cntr
Cntr, San Antonio - 1968-1976
• Radiology Associates - 3 Offices/Labs - 1968-1976
• Radiation Oncology of San Antonio - 1977-1978
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Assistance From Colleagues• Domatti - Barnes - Krohmer - Shalek - Sampiere Waggener - Morgan & Others
• TRMP,
TRMP AAPM & SWChapter - ACMP(later)
• ABR Certification - Radiological Physics- 1973
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Jack Krohmer, Marvin Williams & Ted Webster
Initial Work Experience
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Hospital Based:
Rx: Cobalt, 2 Mv X-ray, Orthovoltage & Brachy -Radium & Radon
Dx: Rad, R-F, Special Procedures, Ultrasound & Teaching (X-ray)
N l M
Nuclear
Med:
d R
Rectilinear
tili
Scan.,
S
Gamma
G
C
Camera & I-131
I 131 Th
Therapy
RSO Responsibilities: RAM Licensing & Xray Registration
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Part Time Consulting:
Dermatologists- Superficial X-ray, Radium
Small
S
a Private
va e Clinics
C cs & Hospitals,
osp a s, Dx X-ray
ay & Nuclear
Nuc ea Medicine
ed c e
Shielding Design, Specifications & Testing
RAM Licensing & X-ray Registration Documentation
Ind strial Source
Industrial
So rce Leak Testing & Color TVs
TVs,
Pro/Cons - Employee vs Full Time
Consulting
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Income Stable vs Uncertain (but future positive)
B fit Insurance,
Benefits:
I
Defined
D fi d vs Affordable?
Aff d bl ?
Management by Admin (BCs) vs Self Management
Equipment, Supplies Provided vs Acquire- ?$s
Staff Directed Work vs Client Directed Challenges
Mainly Local Work vs Local & Some Travel
Frustrating Planning vs Forward (Hopeful) Planning
Fees Taxes & Record Keeping - Done vs Your Baby
Fees,
Decision -> Go For It! (Fall back: find another job)
Full-Time Consulting
g Begins
g
• Medical & Radiation Physics, Inc. - Jan. 1979
• C-Corp.(vs S) - Officers: Self, Wife & Mother-in-Law
 (How many of you would do that?)
• Start Up Challenges
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Equipment- Technical: Used & New: w/Cash & Depreciation
Equipment- Office: Typewriter, Copier, Desks, Supplies, etc.
Office Space & Address: Home-Rent to Corp & Corp PO Box
RAM License @ Home: Attic Closet & Garage- Inspected
Auto for Business: Miles reimbursed or Leased Car
Insurance: Life, Health, Disability & Professional Liability
Corp. expenses
• Keeping Records, Taxes (FICA withholding & payments)
Corporate
p
Growth: 1979-84
• Clientele: Small Hospitals,
Hospitals Clinics & Offices
• Diagnostic X-ray: Surveys, Registration, Shielding
• Nuclear Medicine: Surveys, Licensing, Calibrations &
Inventory & Leak Testing Sealed Sources
• Therapy: Hospitals & Private Clinics (sans physicists)
Calibrations,
lib i
Chart
h Cks
k , Calculations
l l i
& Dosimetry
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HELP NEEDED - WANTED!
• Prime Problem - How to go from
One to More - If Salary & Benefits
are from one’s production?
• Prior Planning - Save Capital (Expansion
Fund)
• #2 - Brings Clientele Along or Accepts
P t Time
Part
Ti (Retiree)
(R ti )
• Employee vs Partner with Stock Shared
• Overhead Increases - ~30% of Salaries
• Equipment
E i
t & Space
S
~2Xs
2X
• Scheduling & Travel - More Complex
• Agreements - Workup a Contract
 Benefits
B fi Package
P k
- Salary,
S l
V
Vacation,
i
Insurance, etc., Stock Repurchase
Work Contract - Example
p
Base Salary - Paid 2x/mo., 24x/yr;
~230 work days/ year
f(degree(s), experience & certifications)
& what you can afford
Benefits Package for Full Time Employment
Vacation: 10 d/yr - 1st 5 yrs, pro-rata
pro rata 1st year after 2 months:
+5 d/yr - for 5 ->15 yrs continuous, 20d/yr after
Holidays: 10 /yr- some flexible w/ Management OK
Sick Leave: After 60 days,
days 0.5
0 5 days/mo.
days/mo - accumulates to
45 days max carryover @ year end, unused bought
back @ x% of current base salary
Work Contract- Insurance -cont
• Insurance
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Coverage
C
- Options
O ti
• Group Term Life - Policy Premium Reimbursed for up
to $50K
• Added Coverage @ Employee expense
• Disability - Reimburse Premium for 1000$/mo,
• 30 day waiting period
• Added
Add d C
Coverage @ E
Employee
l
expense
• Medical - Group/Comprehensive Major w/1000$
deductible.
• Employee pays 1st $500,
$500
• Corp reimburses remaining deductible
• Liability - Corp. Prof. Coverage $1M / $3M (AAPM)
 Corp.
Corp General Liability for Property Damage.
Damage
 All Premiums Paid by Corp.
Work Contract - cont - Professional Svc
Support of Professional Staff
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Office Space- Desk, Phone, Parking, Computer & Server
Technical Equipment- Needed for Job Performance
Office Support Staff - Billing, Scheduling & Message Svcs
Membership Dues Paid for Approved Professional/Scientific Org.
 Limited @ 0.?% Of Base Salary
• Cont. Ed. Allowance- 10 days (max) for CE purposes
 Management Approval R’wd & Limited ?% of Base Salary
• Car Usage Allowance: Business Miles- Reimbursed @ $0.50+ /mile
 Employee logs & reports mileage monthly & reimburseda work related expense not reported as taxable on a W2
Work Contract - cont - Professional Performance
• Management Expectations for Worker
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Professional Work Attitude & Dress
Respectful Attitude to Clients & Co-workers
Timely & Accurate Performance of Work
A Professionally Produced Work Product
No Missuse of Corp Benefits Provided
Compliance with Professional Licensing & Continuing Ed
Requirements
Finally
y - Retirement Planning!
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• A Profit Sharing Plan - Tax Sheltered
• Enrollment After 1 Year Full-time- January 1 or July 1
• Corp. contribution- up to 15% of Base Salary, if the Corp earnings
(from profits) are sufficient to fund it • Fully vested after 6 years,
years full-time
full time employment
• Optional Enrollment for Company Sponsored (JH) 401k plan
• Corp. Matches employee contributions up to 3%, and
• 50% off employee
l
contributions
ib i
between
b
3% & 5%5% off B
Base Salary
S l
• 401k employee contributions are 100% vested.
Thanks -To Past and Current Participants
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Transition from 1 to 2 or 3
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Most Problematic due to
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Salaries Requirements and
Benefits & Overhead
Computers & Equip Need
Space & Administration
Advance Planning Needed
• Help From Prior / Early Staff in
Future Developments - Thanks
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Family
Dave Kopp
Charles Payne
Ron Watts
Bernie Hranitsky
Beth Dodge
Bujhanga Lankipalli
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Professional Staff@ MARP Inc
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David Lee Goff, Board Chairman
David Lloyd Goff, President & CEO
Carl R. Keener, Vice-President
Antonio Dominguez
Maria D. Gonzales
Janet Ching-Mei
Ching Mei Feng
Bahadir Ozus
Curtis L. Volgamore
Annie Tipton
• Support Staff
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Alicia Goff, Sec-Treasurer
Sue Sauer - Office