One of the more interesting and potentially fractious topics in any pediatric group practice is the issue of income division between partners and associates. (This assumes, of course, that there is actually income to divide!) Pediatricians, like all medical practitioners, are faced with the classic squeeze: at the same time that insurance carriers are reducing payments to practitioners or creating confounding payment structures, expenses are continuing to increase.

What can a doctor do? The traditional approach—complaining to peers in the hospital cafeteria—is time-honored but futile. A more rational approach is to increase productivity, decrease expenses, or both. Pediatricians think they could not possibly see one more patient; the key is to work smarter, not harder. The following are concrete suggestions for accomplishing this:

This leads into a discussion of overhead issues. The average overhead for a pediatric office is 55% of gross revenue after taxes with a range of 45%...

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