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Bringing Income Into the Practice
by Jarrod Shapiro, DPM
Joined practice July 2006 of
John K Throckmorton, DPM, PC
Lansing, Michigan
If you look in the podiatric management magazines like
Podiatry Management or
Podiatry
Today, you´ll see no shortage of articles about various
ways to supplement our income besides the traditional billing for office visits, follow-ups, and surgery. Why is this? Because
medicine isn´t as profitable as it used to be! Some physicians will do just fine seeing large numbers of patients in the office and doing surgery.
But others may not do as well. Consider, for example, that Medicare is working to decrease, yet again, our reimbursements.
For residents, this might not seem the most important topic to discuss, but I guarantee that once you enter practice, money (and alternate ways to make
it) will become important. I´d recommend starting now, regardless of what year you are, to pay attention to new ways to bring income into a
practice. Giving a couple of ideas to a potential employer is a great way to impress them while you´re looking for a job. Remember, you´ll be
practicing medicine, but private practice is as much a business as McDonald´s, Microsoft, or the florist
down the street.
What avenues, then, are available to bring extra income into the practice? I´ve listed a few below
that come to mind. For those of you in practice, if you have a unique service or product, write in with your ideas.
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1.
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House calls. For the person who enjoys seeing people in their homes, this may be a rewarding method of adding an additional service
that your homebound patients will greatly appreciate. I´d suggest this for the new practitioner for after-office-hours work. This is not, though, the
most efficient method of seeing patients.
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2.
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Nursing homes. Another good one for newer practitioners. This may be more efficient because you´ll be seeing a large number of
people in a relatively short time period. I´ve done some of this as a resident, and I´ll warn you it is hard work.
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In-office dispensing. I honestly don´t do a lot of this in the office. As an associate you will have certain limitations imposed by
your employer. Mine isn´t fond of dispensing products from the office to any significant degree (other than the standard cam walkers, pads, etc).
Some physicians argue they´re not salesmen. I disagree with this wholeheartedly. Ever go to a dermatologist´s office? They dispense all
manner of lotions, creams, and other treatments. Income is income, and you´re providing your patients with a necessary service. Be sure, though,
that you´ve investigated the products you´re dispensing.
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4.
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Orthotics. I´m preaching to the choir on this one. I can count on one hand the number of podiatrists I´ve met who don
´t prescribe orthotics. I should include products like the Ritchie and gauntlet braces here also.
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5.
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Diabetic shoes. It´ll be interesting to see how this shakes out with the Medicare mass bargaining changes. Hopefully, we´
ll win out on this one and continue to provide this most necessary service to our at risk diabetics. To digress a moment: I think the Medicare rules should
be changed to include patients with rheumatoid arthritis in the shoe program. It´s a struggle to fit a RA patient with a severe deformity into shoes
(and, no, they´re not all reconstruction candidates).
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6.
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Cosmetic services. This area has gained some notoriety of late with the International Aesthetic Foot Society. You might consider
attending one of their courses (although they are quite expensive).
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7.
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Hospital consultation. This may seem obvious to many, but in my community (of about 17 podiatrists) only 4 of us do any significant
amount of hospital work. If you love wound care then this, along with working at a wound clinic, is another option.
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What other income builders are you aware of? The potential is really limited only by your imagination. Write in with your ideas.
Good day.
Jarrod Shapiro, DPM
PRESENT New Docs Editor
[email protected]
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