Physicians only have their time to sell. They can only see so many patients in an hour, and the fees they can earn are limited. If one is doing a procedure, whether surgery or a diagnostic test, the fees can be much higher, even for the same amount of time. To maximize income, then, a physician would do more procedures and spend less time in the office.
But simply doing more procedures is not something physicians can necessarily control. This thinking can become a perverse incentive that could find you practicing in an unethical and unprofessional manner. There has to be a better way.
Office focused physicians can also increase their income by finding services that will earn income without their direct attention. Lab and other diagnostic tests can often be done by technical staff. While the physician is seeing a patient in an exam room, a tech running a test is also bringing in income – and profit, resulting in higher income per physician hour. Nurse practitioners are well received by patients, enable you to see more patients and more quickly than by relying solely on physicians. Nurse practitioners are in demand and well paid – still, they are less expensive than physicians, can handle many follow-up care, call backs and less intensive care. A nurse practitioner can bring in more revenue that they cost, and help improve and maintain your ability to be very responsive to patients.
Your ethical compass has to be kept pointed on sound clinical practice. What I am suggesting, and what many practices already do, is to bring in house what someone is going to be doing. In doing this, monitor the use of the new in house services to insure that you are not over referring. These kinds of referrals, although legal, are still a concern to regulatory authorities, and, unfortunately, for good reason. Document your guidelines, and audit samples of referred patients as part of your own internal compliance program.
Ancillary testing, treatments that you are referring to other practitioners – these are the kinds of expansion of services that can improve services to your patients in some cases and earn income for you in an difficult time.