I overheard a discussion at a local medical practice about how medicine is not like any other industry. Frankly I thought that was obvious, but as I tuned in to the way this OB/GYN explained what she meant, I realized that although the problem is real, the solutions are also real simple.
The provider’s complaint was that in industries outside of medicine, the longer you work the easier your job becomes and the more money you make. For example, if you work in hospital administration, you start out as coordinator and can be promoted to manager, director, vice president, and the C-suite level. At each level your job involves more responsibility and more time sitting behind a desk, while others take care of the day-to-day tasks, leaving you to manage the big picture.
In medicine it is the opposite because your rates are federally regulated and determined by the insurance companies. With the changes over the years, providers work harder, see more patients, and earn less money each year.
On the surface, this OB/GYN is exactly right. And this post began as a rant for why medicine is this way, but after letting this story percolate for a week, I came to a different conclusion.
When someone moves up in the hospital administration example, they take on less of a hands-on role and more of a supervisory role. This could be compared to a single physician practice adding advanced practice providers or junior physicians to work in the practice.
It would suggest that falling prey to the "more work for lower pay" conundrum results from staying stagnant for years, and not pushing yourself professionally or growing your practice — just like any other business.
How do you grow your practice? Let’s look at a few ways:
Work to use marketing as a service to your community. Educate patients about your specialty and the importance of wellness. Become a resource so that you stay top of mind when the need for your expertise becomes necessary.
2. Ancillary services
There are many ancillary services available for almost any specialty. Not all of them are good, but many are phenomenal from a patient-care perspective, as well as a new revenue stream.
3. Think bigger
Are you scheduling patients several weeks out? Is there a waiting list to see the physicians at your practice? Then it is time to think bigger. This is where you should add more providers — either physicians or advanced practice providers to disseminate current patients and bring in new patients (and revenue) to the practice. You should expect growing pains, but in the end, it is the equivalent of "moving up the ladder," as in my hospital administrator example.
The bottom line is that your practice is what you make it. You can slow down under an escalating number of patients and falling reimbursement, or you can step up and create a practice and pay scale that is rewarding for you.