Besides surgery, what specialties generate the most revenue for hospitals?

[synecdoche]

I realize the answer to this may be in flux.

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[Frazier]

RadOnc?
HemeOnc?
Rads?
Cards?
GI?

Look at salaries and extrapolate a bit.

 

[ChrisMack390]

Oncology comes to mind due to the clinical trials, though obviously that would only apply at larger/academic places.

 

[tymont12]

It'd be interesting to know the ratio of net collections per actual pay, per specialty. Of course, it'd be employment structure/practice specific, with overhead heavily influencing it.

 

[Kaustikos]

Rads is changing. Their RVUs have dropped a lot.

 

[ACSurgeon]

It'd be interesting to know the ratio of net collections per actual pay, per specialty. Of course, it'd be employment structure/practice specific, with overhead heavily influencing it.

Rads is changing. Their RVUs have dropped a lot.

The hospital generates money mostly independent of what the professional fee is for the physician. E.g. Facility fees, medications, imaging and laboratory studies etc. So the reason a surgeon at a rural hospital might be the reason it stays afloat isn't because he/she bills a lot. It's because having a surgical practice at a hospital nets that hospital a good amount of money (assuming insured population).

 

[Kaustikos]

The hospital generates money mostly independent of what the professional fee is for the physician. E.g. Facility fees, medications, imaging and laboratory studies etc. So the reason a surgeon at a rural hospital might be the reason it stays afloat isn't because he/she bills a lot. It's because having a surgical practice at a hospital nets that hospital a good amount of money (assuming insured population).

Well, yeah.
Hence why they work cardiothoracic surgeons and radiologists to death 😛

 

[tymont12]

The hospital generates money mostly independent of what the professional fee is for the physician. E.g. Facility fees, medications, imaging and laboratory studies etc. So the reason a surgeon at a rural hospital might be the reason it stays afloat isn't because he/she bills a lot. It's because having a surgical practice at a hospital nets that hospital a good amount of money (assuming insured population).

I get that there's a slew of ancillaries and facility fees to be billed, but hospitals still must make more from certain specialties when solely looking at provider RVU's / collections.

 

[doc05]

I get that there's a slew of ancillaries and facility fees to be billed, but hospitals still must make more from certain specialties when solely looking at provider RVU's / collections.

don't confuse RVUs with hospital collections. The value a surgeon brings to the hospital is much greater than the few RVUs generated for physician payment. Keep this in mind when you sign your contracts.

 

[jdh71]

Critical care.

 

[slopes23]

Critical care.

ICU's are the most revenue generating but also the most expensive to run. Quite literally feast or famine for them.

 

[jdh71]

ICU's are the most revenue generating but also the most expensive to run. Quite literally feast or famine for them.

That's the ICU itself - at baseline. The critical care specialist though drives the bulling in the ICU. So which non-surgical specialty makes the hospital a lot of money? Critical care.

 

[slopes23]

That's the ICU itself - at baseline. The critical care specialist though drives the bulling in the ICU. So which non-surgical specialty makes the hospital a lot of money? Critical care.

I wasn't disagreeing with you, just talking out loud.

 

[jdh71]

roger that

 

[Chemdude]

Interventional cardiology. I recently watched a documentary on Netflix called "The Widowmaker". It's basically about how hospitals prefer PCI over other treatment/preventative methods because it generates a lot of money. The documentary claimed that 1/4 of Mayo Clinic's revenue comes from stenting

 

[cylondoctor]

Not sure in community setting but for large centers, general surgery isn't the moneymaker. Had an "econ" type of lecture from an attending last month and says the true money makers are Ortho bone and joints, Spine, cardiac interventionists, anything with an _ICU in it. The previous hospital I was doing an away was apparently going to adopt the cleveland clinic model for service lines. For example they wanted to separate ortho from being an academic department under surgery and one of the reasons was the money it generates is so great that they're fighting to have more control over that revenue rather than being part of the umbrella of surgery, hence they're going to have their own service line under "bone and joint".

 

[ACSurgeon]

Interventional cardiology. I recently watched a documentary on Netflix called "The Widowmaker". It's basically about how hospitals prefer PCI over other treatment/preventative methods because it generates a lot of money. The documentary claimed that 1/4 of Mayo Clinic's revenue comes from stenting

Because patients are super motivated to be healthy and prevent disease. It's the doctors and medical systems that force people to be unhealthy and develop diseases that require interventions. It's part of the "secrets that doctors don't want you to know" conspiracy.

 

[Chemdude]

Because patients are super motivated to be healthy and prevent disease. It's the doctors and medical systems that force people to be unhealthy and develop diseases that require interventions. It's part of the "secrets that doctors don't want you to know" conspiracy.

I don't deny that patients are dumb as ****, but it would be pretty naive to deny that hospitals are increasingly run on the basis of corporate greed. A lot of docs think that hospitals and medical systems are our friends...hospital administrators, who know nothing about medicine, are the ones calling the shots on hospital policy. As a result, they are making more money while we are forced to become cheap labor. I doubt that the scientific process in medicine (or in any other field) is completely transparent; there are guidelines and recommendations that are made solely for the purpose of monetary gain. Some very common practices in medicine are based on faulty scientific evidence...

 

[J ROD]

In general, I would say the ICUs..........lot of important stuff going on in there.

Then, I would say what the hospital may be known for. Like I know one that is known for Oncology, another for Ortho, and another for Cardio in my area.

So, like most things I think it depends.

 

[Esquire]

No need to speculate. Actual numbers from 100+ CFOs show:

1. Ortho
2. Cards
3. FM

http://www.beckershospitalreview.co...n-salaries-vs-hospital-revenue-generated.html

 

[gudog]

Hospital board member here - last time we looked - general surgery generated the most profit (mainly due to volume), per case revenue was the best for GYN, inpatient Ortho was break even (the only profit there is from outpatient procedures)
No medical specialties generated any profit at all - interventional cardiology was break even, as was the GI lab.
Didn't have Rad Onc in house then, so don't know about them

 

[calvnandhobbs68]

No need to speculate. Actual numbers from 100+ CFOs show:

1. Ortho
2. Cards
3. FM

http://www.beckershospitalreview.co...n-salaries-vs-hospital-revenue-generated.html

That's pretty eye opening if it's true...basically means hospitals are straight up lying to a lot of the lower paying specialties about the amount of revenue they bring in relative to their salaries. Considering this is coming from the CFOs themselves though, I wouldn't doubt it on the face of things. Intuitively it kind of makes sense as a lot of the primary care jobs refer tons of lab tests, imaging and medication filling within the system itself (as opposed to direct revenue generation from a surgery or cath), generating a lot of facility and ancillary fees for the hospital.

 

[PhillyMed777]

That's pretty eye opening if it's true...basically means hospitals are straight up lying to a lot of the lower paying specialties about the amount of revenue they bring in relative to their salaries. Considering this is coming from the CFOs themselves though, I wouldn't doubt it on the face of things. Intuitively it kind of makes sense as a lot of the primary care jobs refer tons of lab tests, imaging and medication filling within the system itself (as opposed to direct revenue generation from a surgery or cath), generating a lot of facility and ancillary fees for the hospital.

But is it weighted for the number of people in that specialty? For example, there are many more family med docs...

EDIT: it seems like it is revenue per physician. So no.

Also, interesting to see that family med has such a high revenue to earnings ratio at almost 11/1. ENT on the other hand has the lowest at 2.
What's going on here? Family med also has such a nice job market. If I'm reading the article right, either somethings up with the article, or family med physicians are straight up being gyped with their 11/1 ratio.

 

[Kaustikos]

Then, I would say what the hospital may be known for. Like I know one that is known for Oncology, another for Ortho, and another for Cardio in my area.

So, like most things I think it depends.

Agreed. When you can sell curing testicular cancer to Lance Armstrong... People come like crazy

 

[doc05]

But is it weighted for the number of people in that specialty? For example, there are many more family med docs...

EDIT: it seems like it is revenue per physician. So no.

Also, interesting to see that family med has such a high revenue to earnings ratio at almost 11/1. ENT on the other hand has the lowest at 2.
What's going on here? Family med also has such a nice job market. If I'm reading the article right, either somethings up with the article, or family med physicians are straight up being gyped with their 11/1 ratio.

ENT is so low because so many of them are still in private practice, and they do lots of office-based work.

One reason FM gets paid at such a terrible ratio (compared to neurosurg, for example) is that the supply of FM docs is so much higher than certain specialties. If you are one of 50 FM docs in the hospital system, for example, you don't have much leverage.

 

[PhillyMed777]

ENT is so low because so many of them are still in private practice, and they do lots of office-based work.

One reason FM gets paid at such a terrible ratio (compared to neurosurg, for example) is that the supply of FM docs is so much higher than certain specialties. If you are one of 50 FM docs in the hospital system, for example, you don't have much leverage.

One question...isn't this hospital based data, such that ENTs are hospital employees I thought.

 

[calvnandhobbs68]

ENT is so low because so many of them are still in private practice, and they do lots of office-based work.

One reason FM gets paid at such a terrible ratio (compared to neurosurg, for example) is that the supply of FM docs is so much higher than certain specialties. If you are one of 50 FM docs in the hospital system, for example, you don't have much leverage.

For the revenue generated at least, this is healthcare system based data so all the revenue they calculated would be generated by a theoretical physician within their own hospital system.
"The CFOs indicated the combined net inpatient and outpatient revenue generated annually for their facilities by a single, full-time equivalent physician across several specialties. Revenue was represented by procedures performed at the hospital, tests and treatments ordered and other factors. (For primary care physicians, hospital CFOs were asked to determine revenue generated from direct admissions, procedures performed, lab tests, etc., but not from indirect revenue primary care physicians may have generated from patient referrals to specialists utilizing the hospital.)"

However, I think the median 2012 hospital compensation data they're getting is their own Merritt Hawkins data, not necessarily median data for only the hospital systems surveyed. So the actual compensation may be lower or higher in some of these systems. I doubt it's enough to explain the 3, 4, up to 5x difference between some of these specialities though.

 

[mercaptovizadeh]

ICU, cardiology, GI, heme-onc

 

[VA Hopeful Dr]

There is a reason that hospitals are buying up family practice offices to the degree that they are...

 

[Gadofosveset]

- parking services
- food court

 

[seminoma]

Every specialty orders imaging, so rads unless the rads dept doesn't get credited for all of the imaging.