Dr. Andrew Brown's comment from my last entry has a lengthy enough explanation where I thought it warranted an entry of its own. The question posed was, "What kind of competition is there in town?"
We are the only physicians in town, but a small group of nurse practitioners have a shop a couple of blocks away. I'm a little concerned about a new practice 10 miles down the road that is going to be staffed by a new mid-level. My big concern, however, is that people are leaving town and driving 30-40 miles to the big city, at least bigger than ours, to get their care because they don't know that there's a good group of docs right here. It is this segment of the population that I really want to capture because they tend to have better jobs with better health insurance plans than a local who works at the town diner or someone who can't afford the gas to get them to the big city.
I hope I do not leave the impression here that we are elitist in our search for the well insured, but we see just so many on Medicaid and Medicare because we do believe in serving the rural underserved population in which we practice that sometimes it makes it hard to run a business.