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Medical Practice Business And Marketing Articles

Article #14 - Aug. 2010

“More Practice Income By Referring
Your Patients To Yourself”

Flaunt your creative ability to improve your practice income.
You know you can do many things you now refer out.

           I ask you, is this idea a mind twister or not?  For those medical professionals who haven’t found out about how to do it, most, no doubt, will think it’s another of those quasi-medical unethical strategies that gets physicians into trouble, or something pulled up from the past with a new name on it.

          Well, whatever your fears are, there are thousands of physicians without those fears who are pumping up their medical practice income, exponentially.  Sound too good to be true?  Let’s circle around the idea for a minute or two and see what comes up for you.

          It would not be farfetched to believe that primary care physicians are not only the lowest income earners in the medical profession, but are placed in a position of having to refer many of their own patients out to other specialists who make all the money off that patient referral.  And, the general practitioner is left holding their diagnostic code sheet wondering
how much income they just freely forked over to the other doctor.

          Many of your patient referrals could easily be kept right in your practice. If the physician spent a little time and money learning medical and minor surgical procedures that are easy to learn, easy to do, and easy to implement into their practices, these money-making additions will enable almost any physician to significantly improve their practice income.
          Such procedures as Botox use, fillers, anesthetics, pain management, liposuction, tattoo removals, breast biopsies, dermatologic surgical procedures, can skyrocket your practice income.  A great advantage today is that there are licensed medical organizations that teach physicians how to do all those things in a safe and competent manner. 
          Empire Medical is one of those.  Not only are these techniques legal and well within the parameters of normal medical practice, but also are well within the capabilities of any physician. 
           If you take a close look at the reasons you referred your last 50 patients to other doctors, and began tracking referrals, it’s likely that most of those medical problems were minor things you could do yourself, and probably you know that.  Why not do it yourself?  You would be sacrificing the time needed to see one or two patients for the more income productive time of doing special procedures that in the past you have chosen to refer out.  You judge for yourself.

          It’s obvious that surgical procedures can be billed for far higher fees than a simple office visit, or an extended visit.  You surely understand it’s sometimes a practice to nudge up the coding scale for a higher visit fee at a time when the government fee restrictions are increased each year, while you are trying to remain solvent.  Just, never admit it to anyone! 

          Wouldn’t it be better to convert those patients of yours into a surgical or special medical issue visit, where nudging wouldn’t be necessary?

          You also know that your patients would rather have you attend to their medical issues as opposed to a strange doctor in a strange office.  Imagine how many of your patients would have a procedure done if you would do it—and not have it done otherwise, especially if they had to be sent into your referral network. 
          Many patients of mine had minor problems, like a continuously sore skin lesion that fell right under their bra strap and kept putting up with it, until I noticed that it was a problem for them, and removed it—same with bothersome sebaceous cysts. You truly will be making your patients lives more tolerable by relieving pain and medical frustrations.

          From a medical practice marketing and business perspective, once you tell your patients you are now able to take even more care of more of their medical problems, you’ll be surprised at the number of your patients who will request things be done that they are sick and tired of tolerating.  And, they know that specialists charge a lot more than you do—often also with a
higher co-pay. 

          You build respect and loyalty with your patients when they are aware that you continue to learn more, train more, keep up in medical care, and are able to provide them with quality care beyond the ordinary.
          It’s not always the big things you do for your patients that they love you for.  Just your noticing small things while examining your patients, and can do something about if they approve, tells patients you care about them and their health... things they may have considered benign or never even had noticed... but you did.
          Physicians who step out of the ordinary medical practice methods and techniques will always be sniped at by other physicians who feel that their turf has been invaded.  I can remember back when liposuction done by a local gynecologist created a verbal war from the surgeons who felt that a gynecologist wasn’t competent to handle that procedure safely. 
          I happened to be the only gynecologist in town, out of 20 or so, that preferred to do breast biopsies on my own patients. Suspicious lesions removed under local anesthesia in a surgery center is something most physicians can do safely. 

          Of course, I was accused many times of doing unnecessary biopsies to earn more money. Even though I used the same criteria as the surgeons did for doing breast biopsies, it still upset them. I did my own biopsies because I found that many patients fit the criteria for a suspicious lesion, sent them to a surgeon, and the surgeon felt that a biopsy wasn’t needed. 
           After I had done biopsies on a few patients who had negative mammograms, lumps that persisted, sonography showed no fluid, and the biopsies came back with a breast cancer pathological diagnosis, I felt justified in doing what I did. I felt it was better to be accused of doing unnecessary breast biopsies than to have a patient die of breast cancer spread because of procrastination in doing biopsies. 

          Women die because of “following a persistent lump” and because of a “normal mammography.” Needle biopsies miss 10% of cancers. Biopsies (lumpectomies) are 100% diagnostic when done properly. 
          All those who throw cheap shots at you are either envious or insecure with their own practices. The one thing that should remain in your conscious mind is that fact that not one of those who criticize you gives a damn about you and what happens to you. If you are struggling as many physicians are, to earn enough to stay in practice, learn to disregard the insinuations
because you know you are doing the right thing by protecting your practice the best way you can without stepping outside ethical practice bounds. 

          Where I practiced, several general practitioners were trained to do, and commonly did, major gyn and ob surgical operations themselves. In this age of medical care it would be wise for all primary care doctors (not Internists) to seek training in major gyn-ob surgery. Some primary care residencies offer that in their curriculum. 

          In small towns, surgeons are the ones doing the major gyn procedures and there is no reason that a primary care physician can’t do the same. Isn’t it true that surgical specialties bring in the most income? So, having a surgical side to your practice is a great advantage... no matter how
small it seems.

          Another mysterious practice effect I became aware of as a result of my patient referrals, points out a good reason for you to refer your patients to yourself. It became clear to me that every patient of mine that I diagnosed a malignancy in, then referred to another physician for proper treatment, never came back to my office again. I lost those patients permanently... and not because they all died from the malignancy.

          There is a small but significant attrition rate among the patients you refer out to other physicians.

          Perhaps, the few general practitioners who complain about their insufficient income would be well advised to follow some of my advice within this context.

          Remember, even the specialists may need to expand their skills in new procedures as well to fight against the increasing healthcare restrictions on practice income. It would be far better and less expensive than moving a medical practice elsewhere. 

“Wherever you see a successful business, someone
once made a courageous decision.”    ---
Peter Drucker

The author, Curt Graham, is a highly experienced business and marketing expert, copywriter, and entrepreneur who has been published in various media over 50 years while in medical practice and after.
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© 2004-2011, Curt Graham M.D., All rights reserved.

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Article #14A


photo Dan kenney riding on a bull

Why People Fail

A series of No B.S. articles from Dan Kennedy

 "Mystery Solved"

 “There is nothing more deceptive than an obvious fact”
said Sherlock Holmes.

You are presumably reading this because you are intrigued – for self-interest, not just academic exercise – with the mysteries of achievement and success. I have spent more than 30 years examining these mysteries. Before me, a long list of authors, lecturers, consultants, psychologists, researchers.

Napoleon Hill one of the most famous, whom you’ve probably read. Many before him, after him.  All sorts of theories; 7 steps; 17 steps; blueprints; and explanations have been produced, all aimed at solving the mystery of why so few do so very well, while the majority achieve comparatively little.

This is true of any general population, or any given industry’s or profession’s population, or any company’s sales organization, even any school or town. Pretty much without exception, only about 4% do well, 1% super-well, 15% okay, the remaining 80% divide between struggling and spending entire lives running in place or never even getting out of the starting gate at all. Why do few rise and most, at best, flounder? I’m afraid it’s not as much of a mystery as everybody in the 80% group wants it to be.

The specific reasons people fail are many and varied, and range from tragic to comical. But there is only one underlying reason: the choices they make. About study, about association, about initiative, effort, persistence. There is no shortage of opportunity. There is some worthy opportunity accessible to everyone, regardless of their education or location or other factors.

Every “reason” for failure can be de-bunked. Oh, the poor fellow had no good examples to follow or mentors to inspire him. Neither did Og Mandino, an alcoholic hanging out at the public library because it was a dry, warm,
safe place.

There he discovered mentors in books available free, with their help confronted his demons and pulled himself together. Became a success in business and became one of the all-time bestselling self-help authors. Space here does not permit similarly de-bunking all the other “reasons”, but I can. Every one.

The argument then disintegrates to insisting my examples are all of exceptional people and cannot be applied to large numbers. But why not? The fact is: the people whose stories I cite in de-bunking the majority’s reasons for not doing well are very ordinary people who chose to be exceptions, to do exceptional things, to make themselves exceptional. Chose. 

In my world, people bump up against significant-sized groups of people who are all doing well in their businesses or professions. The top industry advisors I work with, including the one who has published this article for you to read, have hundreds; some have thousands of top performers around them.

When someone new comes into such a rarified place, he sometimes runs back out the door as fast as he can– to avoid confronting the obvious fact that there is no real reason for not doing exceptionally well. 

If you feel that way, I’m sure the exit is clearly marked. A small number stay and dig in and determine that they will get all there is to get about how to succeed and prosper, and use it. In this way, the percentages never change no matter what I or the person who published this article or a legion of us say, write or do. Because, ultimately, success or failure is an individual, personal choice no one can make for you. We wind up helping winners win.

The WHY PEOPLE FAIL articles are provided by Dan S. Kennedy, serial entrepreneur, from-scratch multi-millionaire, speaker, consultant, coach, author of 13 books including the No B.S. series ( ), and editor of The No B.S. Marketing Letter. WE HAVE ARRANGED A SPECIAL FREE GIFT FROM DAN FOR YOU including a 2-Month Free Membership in Glazer-Kennedy Insider’s Circle, newsletters, audio CD’s and more: for information and to register, visit:

Articles © 2010/Glazer-Kennedy Insider’s Circle LLC. All rights reserved.

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