The receptionist will want to be paid, as will the biller. If you're lucky, one of them will have time to be the designated person to call and argue with the insurance companies every time they deny a payment because it was a waning gibbous moon that day, but realistically, if you have providers seeing 40 patients per day, that's another full time person.
The EMR system will be quite a few thousand dollars up front, plus another several thousand per year.
You'll have to provide health insurance for all of your employees, and worker's comp, and an office liability policy.
And finally, great insurance (from the billing physicians POV) will pay about 40% of the allowed amount. Really crappy insurance, like Medicaid, is basically a write-off. BTW, Medicare has decent reimbursement. Not great, but several times more than Medicaid will pay.
In my experience as being the one who's written the checks for medical practices in a couple of different states over the last 2 decades, you are grossly overestimating revenue and underestimating expenses.
Like you said, most of these clinics have 2 assistants who do pretty much everything (accepting calls, submitting prescriptions, etc.) Sometimes, the doctor will also bring in an aspiring resident (mostly international medical graduates who cannot find clinical experience in the US easily due to their visa status/restrictions) as a volunteer or a paid-under-the-table-for-$12-per-hour to do some miscellaneous stuff around the clinic. But that volunteer's hours are sometimes on a need-base planning (meaning, the doctor will call the volunteer a day or two before if the clinic needs extra help).
Malpractice insurance for internal medicine (general medicine that I'm referring to) is ~$33K-$34K in NY area based on the link you've provided.
Now let's do the math to readjust my estimates.
One full time staff with $30/hr * 2080 hours in a year = $62400 => let's just double that to cover everything like their health insurance and liability insurance so each full time staff costs = $125000/year
2 staff * $125000 = $250000
Rent = $60000 (the doctors sometimes own the practice, but let's just assume it's a rental)
Malpractice = $35000
EMR system like eClinicalWorks = $10000 (amortized for upfront and yearly costs; software like eClinicalWorks costs ~$600/month on average)
The total expense of running a primary care (internal medicine) clinic = $250000 + $60000 + $35000 + $10000 = $360000 (let's just say $400K/year)
When I said these clinics on average make $1MM/year (of course, they are all near NYC/NJ metro areas), I truly am underestimating the income these doctors get from each patient visit. As an example, if I visit my physician at NYU Langone for my yearly check-up (at most a 10-mins encounter), the net reimbursement from my insurance they get for my visit (after the insurance company's discount/rate negotiation) is ~$250 without including the lab fees. Out of emergency and convenience, I happened to visit one of these primary care clinic doctors where my wife used to work at, and the doctor charged me $80 (that was back in 2019) in cash for an ear infection check (total of 5-minute encounter) and that's because I paid in cash and because my wife used to work for her. All of these doctors that my wife volunteered at or worked for (she got paid $15/hr max from some of these docs) are making a load of money from these clinics because we know a couple of them personally as well.
Again, I'm not saying you are understating the profit margins. You probably have been working with the clinics in some economically depressed or low-cost-of-living areas. I am only sharing what I know for truth in terms of the income of these primary care clinics in NY/NJ area.
Malpractice insurance can be way the hell more expensive than that: https://www.nerdwallet.com/article/small-business/how-much-i...
Rent will probably be another $60K per year.
The receptionist will want to be paid, as will the biller. If you're lucky, one of them will have time to be the designated person to call and argue with the insurance companies every time they deny a payment because it was a waning gibbous moon that day, but realistically, if you have providers seeing 40 patients per day, that's another full time person.
The EMR system will be quite a few thousand dollars up front, plus another several thousand per year.
You'll have to provide health insurance for all of your employees, and worker's comp, and an office liability policy.
And finally, great insurance (from the billing physicians POV) will pay about 40% of the allowed amount. Really crappy insurance, like Medicaid, is basically a write-off. BTW, Medicare has decent reimbursement. Not great, but several times more than Medicaid will pay.
In my experience as being the one who's written the checks for medical practices in a couple of different states over the last 2 decades, you are grossly overestimating revenue and underestimating expenses.