Open any trade journal, and you’re bound to see it: a headline touting how adding service ‘X’ to your office will increase your bottom line. While this can be the case, you have to look at all of the factors, particularly if you’re a solo operation. I have stated before and will state again that there is too much focus on the numerator when practices should be focusing on the denominator—specifically reducing overhead.
Take optical, for example. Typical optical shops may bring in $50,000 a year per provider. Keep in mind you’ll need space for the optical, and you’ll also deal with patients complaining if they’re not happy with their eyeglasses. Furthermore, you may lose referrals from local optometrists if their patients start purchasing eyeglasses from you. Another example is hearing testing. The reimbursement can be good, but you may need to hire another person to be able to offer this service. Femtosecond laser cataract surgery is another direction you can head in. If you personally purchase the laser, however, you may find yourself pushing the technology to cover your costs.
So, let’s say you’ve analyzed your options and decided that add-on ‘X’ is something that will be profitable to your practice. That’s not the whole evaluation. You also have to decide if this is actually something you want in your practice. Electroretinography (ERG) in the office has now become an affordable option and can significantly increase revenue, but do you feel comfortable reading ERGs? Do you get satisfaction from reading ERGs?
Work will always be work, but, as the head of your corporation, you have the ability to shape it the way you want it. Starting from day one, you should decide which patients/practice modalities make you happy and stick to that. If you don’t like treating glaucoma, don’t. If you don’t like children, set an age limit for your practice. If, at the end of the day, you’re seeing the patients you want and providing the care you believe in, you’ll achieve the highest level of personal satisfaction. I decided on some ancillary services and passed on others, but ultimately I’m excited to go to work every day and feel great after finishing clinic.