Most desired patients/procedures

[OtoHNS]

For those out in practice, what are your top 2 or 3 moneymakers? In other words, if you had to advertise to a few specific types of patients, what would you want?

For me (ENT), I'd say:

1. Sinus patients, especially balloon procedures in the office
2. Allergy patients who want testing and immunotherapy
3. Snoring patients

Of course, cosmetic patients pay very well too, though they're almost more of a headache than they're worth...

What about some other specialties? I'm curious.

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[doc05]

you aren't embarrassed to post this question?

 

[OtoHNS]

you aren't embarrassed to post this question?

No.

 

[Butler]

you aren't embarrassed to post this question?

Medicine is a wonderful career and a calling, but at the end of the day it's also a business. Docs have to keep the lights on. In my opinion, nothing wrong with some friendly musing concerning the hypothetical best "moneymakers" in different surgical fields. As a medical student, I am personally curious about this. Furthermore, as PP, what's wrong with analyzing your payer and procedure mix to determine what makes money and what doesn't. How much will it effect your actions, who knows, but maybe a little advertising here and there based on consumer data couldn't hurt could it?

As Lord Beckett would say, "Nothing personal Jack-it's just good business."

 

[dpmd]

Allergy patients who want testing and immunotherapy

I didn't know ENT's did this.

I have no answer for general surgery.

 

[OtoHNS]

I didn't know ENT's did this.

I have no answer for general surgery.

Yep, a lot of us do allergy and it's tested on our boards.

I wouldn't have had an answer to this question as a resident either (other than knowing that cosmetic procedures pay well of course).

I think it's a good idea for all physicians to know at least something about the business side of medicine, and honestly it's becoming a requirement to have this knowledge if you want to run a successful private practice. If you can memorize the Krebs cycle, clotting cascade, causes of hypocalcemia, and the 100000 other bits of trivia to become a doctor, you can certainly learn some basic principles of business.

Being a good physician/surgeon and running a profitable and efficient business don't have to be mutually exclusive.

There's a big difference between A. Marketing to patient populations that are likely to yield lucrative procedures and B. Doing unindicated procedures and tests just to make a buck.

Doing the right thing for the patient should always take precedence over doing the most profitable thing for you. The goal is to draw the types of patients where doing the right thing also pays you well.

 

[gudog]

For urology it would be:

ESWL
Ureteroscopy for stones
Prostate brachytherapy

All pay well, outpatient, minimal risk of complications

 

[gooze]

For urology it would be:

ESWL
Ureteroscopy for stones
Prostate brachytherapy

All pay well, outpatient, minimal risk of complications

hey, kind of curious about urology. what about other in office procedures like cystoscopies, prostate biopsies, laser therapies, vasectomies? do they not pay well?

and for bigger procedures, like partial nephrectomies and others, do these surgeries like pay enough to justify the time it takes and risk for complications?

thanks.

 

[gudog]

I was mainly thinking of out of office procedures.

In general, any procedure done in office is reimbursed better - so, yes, I do many cysto's, prostate biopsies and vasectomies. I have done some in office laser in the past, and they paid well, but none are readily available now that can be done in-office (prostate lasers, that is).
In office prostate microwaves pay OK, but I have not done very many - still waiting to see if they are going to be really that effective.

Regarding in hospital big surgeries, if you just factored time spent doing them versus reimbursement (compared to what you could be doing elsewhere), then it probably would not be the most effective use of your time. However, reimbursement doesn't control everything I do.
If I feel competent to do something that someone needs done, I continue to offer the service.

There are some major things I send out to the tertiary center (like continent diversions), but that is more to do with my abilities than purely monetary reasons.

 

[gooze]

I was mainly thinking of out of office procedures.

In general, any procedure done in office is reimbursed better - so, yes, I do many cysto's, prostate biopsies and vasectomies. I have done some in office laser in the past, and they paid well, but none are readily available now that can be done in-office (prostate lasers, that is).
In office prostate microwaves pay OK, but I have not done very many - still waiting to see if they are going to be really that effective.

Regarding in hospital big surgeries, if you just factored time spent doing them versus reimbursement (compared to what you could be doing elsewhere), then it probably would not be the most effective use of your time. However, reimbursement doesn't control everything I do.
If I feel competent to do something that someone needs done, I continue to offer the service.

There are some major things I send out to the tertiary center (like continent diversions), but that is more to do with my abilities than purely monetary reasons.

hey thanks for the response!! one last thing, are you happy with your career choice of going into urology?? i'm very interested in it but am also considering orthopedics and really don't know what to do. I wanted to ask you as a uro attending what you like best about urology and what you like worst?? i just need some help deciding between uro and ortho...so any insight/advice would be appreciated. thanks so much!

 

[ESU_MD]

In cv surg, i look for elective aortic valve replacement as the easiest bang for the buck, followed closely by carotid endarterectomy

 

[gudog]

hey thanks for the response!! one last thing, are you happy with your career choice of going into urology?? i'm very interested in it but am also considering orthopedics and really don't know what to do. I wanted to ask you as a uro attending what you like best about urology and what you like worst?? i just need some help deciding between uro and ortho...so any insight/advice would be appreciated. thanks so much!

Many good questions here, I will try my best.

Am I happy with urology - yes

What I like best - urology is a small enough field that I, as a community practitioner in a small city can pretty much do 90% of what anyone can do anywhere. There is a great mix of medicine and surgery. A lot of the procedures we do, no one else can do. Most of our patients get better and are very grateful. I like the typical patients we see, little kids, old guys with great stories to tell mostly.

What I like worst - nothing much unique to urology, but the growing intrusion of the govt and 3rd party payors into what we can and can't offer is annoying. The shrinking reimburesement pie is also annoying, but not limited to urology.

You have a tough decision - don't think you'd go wrong with either uro or ortho

 

[gooze]

Many good questions here, I will try my best.

Am I happy with urology - yes

What I like best - urology is a small enough field that I, as a community practitioner in a small city can pretty much do 90% of what anyone can do anywhere. There is a great mix of medicine and surgery. A lot of the procedures we do, no one else can do. Most of our patients get better and are very grateful. I like the typical patients we see, little kids, old guys with great stories to tell mostly.

What I like worst - nothing much unique to urology, but the growing intrusion of the govt and 3rd party payors into what we can and can't offer is annoying. The shrinking reimburesement pie is also annoying, but not limited to urology.

You have a tough decision - don't think you'd go wrong with either uro or ortho

hey gudog, thanks for the insight. really appreciate it. i sent you a PM that i thought you can answer when you get a chance. thanks again.