icebreakers said:
Are there feasible ways of augmenting a FP income significantly to that of a specialist, while still retaining the flexibility and lifestyle that is characteristic of FP?
In a nutshell, work your butt off. ;-)
Seriously...the more you work, the more money you can make. It's not hard to figure out. The best-paid FPs in my area are the ones who see the most patients.
If you're looking for an "angle" of some sort, there are a few things that come to mind. One is a retainer model practice. Done right, this can improve a practice's cash flow, reduce the number of patients that need to be seen in order to cover expenses, allow doctors more time with their patients, and improve the quality of care. However, in most states, retainer (or "concierge") models are under the microscope right now, so tread carefully, as it's a bit of a legal and ethical minefield.
Another is to increase volume through the use of physician extenders (NPs or PAs), but keep in mind that these highly-compensated employees along with the ancillaries needed to handle the increased volume of patients will raise your overhead considerably, and you may be held liable for any malpractice on their part if they're under your supervision.
Another approach popular these days is to incorporate cosmetic services (like laser hair removal, skin rejuvenation, etc.) into your practice, but there's a real art to doing this right (both from a marketing standpoint as well as an ethical one). Selling products in your office is almost universally frowned upon by medical ethicists and most professional bodies (e.g., the AMA, etc.)
Some FPs have tried to do more office procedures, since insurance companies generally reimburse procedural work at a higher rate than cognitive work. However, the list of procedures that an FP can do is rather limited, and not all insurers reimburse equally for them. Also, doing higher-risk procedures (e.g., colonoscopy, exercise stress-testing, etc.) in your office can increase your malpractice insurance costs, which, along with the costs of training, equipment, maintainance, and additional office space, could conceivably wipe out most or all of the profits generated by the procedures themselves. Generally, you have to do a lot of procedures in order to make it worthwhile, and in areas with a lot of competition from specialists, an FP may find it tough going.
Hope this helps!
Kent
