The low hospital census does hurt us in one way however. Both the hospital and our medical group are owned by one corporation making us an integrated healthcare delivery system. The decision was made some years ago to use the ancillary services (x-ray, ultrasound, laboratory, etc)of the hospital rather than keeping them independently in our offices. That means that the traditionally profit making part of the clinics were taken away leaving only the income generated by us seeing patients. Since our margins are so thin, as they are in any medical practice these days, most of the time we barely break even or even lose money but the business we send to the hospital more than makes up for that. Now, if the hospital has a low census also that puts a double hit on our regional balance sheet. Amazingly, our medical group is managing to break even at the present time and our family practice team in particular is in the black. This is in stark contrast to a lot of large clinics across the country which are currently going broke and breaking up due to the effects of continuing lowered reimbursements and higher overhead costs. We know of one clinic in Olympia, which is about fifty miles north of here, which has been in business for fifty years but is in the midst of bankruptcy now. The individual doctors in the clinic can either take jobs with other groups like ours or try and borrow a few hundred thousand dollars to open their own office and try to make that way.

Our group is on very solid financial footing because it is a multiregional healthcare delivery system. If one region is not in the black then the others can support it until that region is back in the black again. Our region currently has the pressure of the debt service on our now one year old sixty million dollar building project. That will decrease over the next few years and we should return to the black again. It would also help if we could stop the migration of 15-20 hospital patients per month to Portland area hospitals. That would be enough to keep the hospital in the black every month and make our regional year end figures look better.

I called about my Compaq Pocket iPaq today. My order is in the top thirty orders waiting to be shipped as soon as they get their next shipment of iPaq's from Compaq. The customer support person could not tell me how many iPaq's were expected to come in shortly but it was anticipated to be very shortly. They did promise to call me if the shipment was delayed. I am hoping to have the iPaq within the next two weeks but that may be too optimistic. I see where Compaq is coming out with a 64mb version sometime this year. That model will probably ship right after I get my 32mb version.

I am still getting my tax information together and probably will be the rest of this week. I am trying to locate one record which I know we have but in moving offices may have been misplaced. I need it before we can send the information in. Hopefully, it will turn up later tonight. See you later.

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Tuesday February 20, 2001

No meetings today which meant I got some work done. My schedule was packed and I saw work-ins as well and still got finished fairly close to on time. Most of the patients today who were sick had upper respiratory infections. I did see three children from one family, only two of who had appointments. I didn't protest as they are all foster children and the total number of children in that family is eight, all but two foster children. The mother in the family is also going to college in Portland, I do not know where she gets the time. I asked today who does the dishes for the ten family members and she told me that the three oldest children do all the dishes. I did not ask how she kept up with all the laundry that crew must generate. I am only too happy to help them any way I can, even if it means fitting one of their children into an already overcrowded schedule.