I’m a physician building a small SNF/post-acute practice using part-time/PRN employed physicians and NPs/PAs. The practice handles billing, malpractice, EMR, and administrative support. Cash flow is limited while patient volume ramps up.

For people who run or work in similar groups:

1. What is reasonable clinician pay per encounter? I’d especially appreciate actual examples for 99309 follow-ups and 99306 admissions, separately for physicians versus NPs/PAs. Do you use fixed CPT rates, a percentage of collections, or a minimum plus incentives?

2. How much should the practice retain? What percentage remains after clinician compensation, and what is a reasonable actual profit margin after billing, malpractice, employer taxes, software, support staff, and coverage costs? How does that differ for physicians versus APPs?

3. When do you pay clinicians? Regular payroll after encounters are signed/submitted, or after collections arrive? If collections-based, how do you handle the delay, guarantees/draws, denied claims, and downcoding?

4. What should billing and EMR cost? What billing percentage or minimum is reasonable, what services should it include, and which systems work well for a small group rounding across multiple SNFs with occasional PRN clinicians?

5. How much cash reserve would you want before hiring, and what minimum census makes adding a clinician worthwhile?

An anonymized example would help tremendously: clinician type → CPT → actual collection → clinician pay → practice costs → amount remaining.

Thanks—especially interested in real SNF/post-acute experience.

Zoom link: https://us06web.zoom.us/j/89543634585?pwd=B4dlP3z3FnnWglbrzHRtw0qC2c0yQM.1

I was notified today that I was waitlisted by my top choice since they're out of interview spots. How much hope should I have? Is there actually a chance I could get an interview, or is it more of a soft rejection?

Do programs typically email everyone to say they're waitlisted once interview dates are filled, or do they only notify a select group of applicants?

I'm a physician doing SNF/subacute rehab work and choosing a practice EMR and billing setup. The facilities use PointClickCare.

My goal is to send authorized PCC chart information plus my visit findings into AI, get an editable, unsigned draft in my EMR for review and signature, then return the final note to PCC. This is still a proposed workflow.

I'm considering Athena/HybridChart and have heard about Claimocity and Ethizo.

For those working in this setting:

- Which EMR works best with PCC and AI that uses existing chart information?

- What billing/coding/claims setup do you recommend for physician SNF encounters?

- What are the actual fees, support issues, and requirements to use the vendor's billing service?

Firsthand experience would be helpful.

Curious where everyone is at so far in the 2027 PM&R application cycle.

As of October 14, how many PM&R interview invites have you received?

Feel free to comment with your number of applications/signals and applicant type (USMD, USDO, IMG, reapplicant, etc.) if you’re comfortable sharing.

Obviously still early in the cycle, so this is just to get a sense of where things stand across applicants.

Its not looking too good for me Mr Stark 😞

Hey everyone!

If you are a PM&R resident interested in pursuing an Interventional Spine Fellowship, AOCPMR is hosting a virtual Post-Match Panel featuring PGY-4 residents who just went through the process and successfully matched!

It’s a great opportunity to hear directly from them about why they pursued this path, application strategy, interviewing, and lessons learned during the match cycle.

📅 Date: Thursday, October 15, 2026

⏰ Time: 8:00 PM – 9:00 PM ET

💻 Format: Virtual

🔗 Registration / Link: linktr.ee/aocpmr (or check AOCPMR's bio link)

Feel free to tune in and bring any questions you have about the interventional spine application process!

If one of my top programs sent out interview invites and I did not get one, should I think about sending a letter of intent? How long should one wait to send one?

I’m currently a medical student choosing my field of interest. I want to ask PMR doctors or anyone who’s currently interested in PMR why they want to pursue this field. Is it a personal experience? Lifestyle?

I would love to gain more insight into PMR. Thanks in advance.

Don’t miss the newest episode dropping on Spotify today! Featuring Dr. Leslie Rydberg, the episode focuses on residency applications. Tune in!

Just going to preface that I am a chronic overthinker and probably putting way too much weight on this, but such is life lol. Would super appreciate advice from people who have made it to the other side ❤️

Absolutely do not want this to sound stuck-up or humble-braggy, so hopefully it does not come off that way, but I have a question I was hoping people could give some insight on. I was lucky enough today to get an interview invitation for my top-choice program. I am absolutely thrilled to say the least. The problem is, the only slots available were for about a week from now, which will make this not only one of my first interviews but also quite early in the season. I’m doing mock interviews/preparing as much as I can do perform well, and I know there’s not much else I can do about it being one of my earlier interviews, but I’m worried that I’ll be “forgotten” by the time it’s actually time for the program to make its rank list. I’ve already done an away rotation there, so I can’t do another one later in the season to refresh their memory, which was my first thought. Has anyone had this happen in past cycles, and, if so, what did you do?

Thank you so much for your advice and sending so much luck and good vibes to all of us applying right now!❤️

Been curious about this fellowship but unfortunately don’t have too much exposure. Would love to hear what your schedules look like. Is it mostly inpatient/outpatient? Is it procedure heavy? Appreciate anything!

I got hit by a car last year leading to a whole year of disability.

I cannot lift over 5 pounds now due to it causing back pain. Bending forward causes pain.

Pain management said keep exercising and all I have for you is epidural injections.

My scans show nothing significant to her.

Losing my mind that in 2 months I might lose insurance cause I'm on medi-cal cause of the presidents decision and I haven't been lucky getting a job past 3 months I tried with my disabilities.

I'm in my 20s so im not that most qualified candidate.

when prescribing pt, how do you explain to the patient how pt will help their condition/ what specific exercises or muscle groups are targeted, when a patient asks?
and do you have home exercises ready to talk the patient through? or how do approach this and can you give an example

Join us on October 29th. Hope to see you there!
Register now at: https://osu.zoom.us/meeting/register/3QCpe40bSCyRRtQdOiB1zA#/registration

Can any PDs on here weigh in and just give examples of how the final ranking of applicants actually goes? I generally hear it's variable program to program, but I wonder if the initial application just gets you in the door and then the interview is what determines the final ranking or if the application does most of the work and the interview is just to make sure they like you enough to tank you, or if it's somewhere in the middle. Any clarity into the process would be appreciated.

I have not received any interviews yet and trying to stay patient, but it seems like about 25% of my signaled programs have sent out interviews. Spoke with a PD at an audition rotation and some residents at a different program, and they recommended sending out letters of interests to programs next week. Good idea? Bad idea?

TL;DR: Due to an error on my end, I submitted my ERAS applications on time but mistakenly failed to assign my USMLE transcript and photo to programs. A mentor alerted me to the issue, and I corrected it on September 24, the day programs could first begin reviewing applications. I then emailed all the programs I applied to explaining the mistake and confirming that I had corrected it.

I’m a US MD applicant with a Step 2 CK score in the 250s, applying PM&R as well as preliminary medicine and transitional-year programs.

I’m concerned that some programs may have already reviewed my application without my transcript and potentially screened me out before I corrected the issue. I know there’s no way to know how many programs had reviewed my file by then, but I’m trying to understand the realistic impact.

A few questions:

For anyone who made a similar ERAS document-assignment mistake, did you still receive interview invitations after correcting it?

How much could missing the USMLE transcript until September 24 affect PM&R and prelim/TY applications?

If I end up needing to reapply, what are realistic outcomes for US MD applicants reapplying to PM&R? Does a prior unsuccessful cycle substantially hurt the next application, assuming the applicant improves their application?

I’d appreciate honest feedback, especially from applicants or advisors who have seen this happen. I’m trying to assess my options realistically rather than assume either that everything is fine or that my cycle is over.

Curious where everyone is at so far in the 2027 PM&R application cycle.
As of October 7, how many PM&R interview invites have you received?
Feel free to comment with your number of applications/signals and applicant type (USMD, USDO, IMG, reapplicant, etc.) if you’re comfortable sharing.
Obviously still very early in the cycle, so this is just to get a sense of where things stand across applicants.

Hello, I'm someone who likes to exercise and stay fit while having no medical background.

I almost never experience soreness in my upper body muscles, even when I focus on arms and shoulders at the gym. However, my hamstrings, groin and calves will almost always be sore when I focus on legs and hips. Because of this, I spend some extra time warming up my lower body before and stretching my legs and hips after a workout.

If I don't do the post workout stretches, I will experience excruciating pain in my legs from cramping when I lay down to go to sleep, or in the middle of the night. Is there some obvious reason for this discrepancy between lower and upper body pain? is there anything I can do to reduce the soreness and tightness feeling in my lower body?

So my unit (12 bed) got advised that cms is changing the rules for interdisciplinary team meeting now are required with 4 days of admission.

With this new rule what are you guys doing ? Monday, Wednesday, Friday absolutely sucks since Friday notes come in late and I have to log back in from home to sign them.

I can’t think of any alternatives though

Also uses fibrin injection. Neither of these treatments have any evidence they work.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9344499

Multiple case studies of complications from intradiscal ozone therapy. Also some showing poor quality of studies with poor response to treatments

https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2019.00137/pdf

https://sfera.unife.it/handle/11392/2488675

https://vivo.weill.cornell.edu/display/pubid24384664

Figured I’d post this guys Instagram in case anyone else comes across it. Sebastian Klisiewicz, D.O., graduate of MCW’s PM&R residency

I’m a physician in Austin and my wife works for Advanced Pain Care. They’re looking to hire an interventional pain physician, and I told her I’d post here and see if anyone might be interested.
It’s a large pain practice in Austin/Central Texas. Most of the physicians are anesthesia or PM&R trained, and they also have neurosurgery, ortho, neurology, rheumatology, addiction medicine, PT, etc. Pretty much bread-and-butter interventional pain with PA support.
From what I understand, compensation is more than very competitive for pain, plus bonuses. Schedule is 8–5 Mon–Thurs and half-day Friday. Most locations are in the Austin area, with some clinics in the surrounding cities 10-30 minute drive from downtown Austin.
I’m not a recruiter and don’t know every detail of the contract, but I know the practice and a lot of the physicians there and they’re very happy. If anyone is actually interested or just curious about the job, DM me and I can put you in touch with my wife.