Founder & CEO of Atlas Surgical Group, the largest privately owned ambulatory surgery centers group in the Midwest
It used to be certain you’d live a sweet life being a doctor. Then, when insurance companies realized that the less they pay doctors, the more money they could make, the profession changed, and not just in economic status. The profession was relegated to a trade. You became a “provider” — replaceable — and you were powerless to stop this degradation.
As the arithmetic of rising overhead and decreasing reimbursement waged its war of attrition on doctors in private practice, it became apparent that the third-party payers could be sidestepped by physicians, creating wealth that didn’t depend on their “blessing.”
More Than Just Practicing Medicine
Practicing medicine is hard. Total medical knowledge is doubling every 73 days, requiring the sweat equity needed just to keep up. Furthermore, time doing this takes time away from the real equity of earned cash from procedures, office visits and other professional services. There are two things you must realize: It’s likely not going to get better, and there are other ways to make money than what you do in your office.
Being a healthcare professional gives you an advantage over other ambitious entrepreneurs. That advantage is knowing about the healthcare profession. Making money from practicing medicine not only means knowing about commerce but also how a complication after a procedure will begin to erode the profit made in doing the procedure at all. It is an education only given by “walking the walk.” This means that, in the “business” of medicine, you have knowledge of esoteric things that can affect the business — things other entrepreneurs couldn’t know, such as designing a business to avoid complications altogether.
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For example, there’s a dermatologist on television making a lot of money popping pimples and reaming out sebaceous cysts, but the money isn’t from just submitting ICD codes. Television or not, she couldn’t do it without being a doctor. She also steers clear of needing expensive equipment, hefty malpractice premiums or even complications. Admittedly, while this may strike some as a strange career choice, the point here is that she has taken a special ability (being a doctor) and redesigned it in such a way to maximize income and minimize expense.
Other Wealth Opportunities
Your knowledge was expensive to acquire, so you should use its value according to what it’s worth. You can use your knowledge to consolidate and evolve what you do into bigger enterprises. Below are some examples:
• Build or acquire an ambulatory surgery center, dialysis center, infusion practice or other standalone medical service facilities. As the founder and CEO of an ambulatory surgery centers group, I’ve seen that the trend of such facilities is gaining momentum. Even the insurance companies can’t fight you because they’d be going up against the one thing that capitalism champions: convenience. Patients love boutique facilities and the efficiency of a bespoke medical experience. Build it and they will come. Yes, you must do it right, but when done so, I believe it’s a proven business model.
• Hire a bunch of qualified people to do what you do. If you are confident that you know the ins and outs of what you do, expand. It’s more efficient, so overhead can be diluted and more money can be made. The anesthesiologists caught on to this long ago, with one anesthesiologist supervising more than one ongoing case using nurse anesthetists. OBGYNs, having a long tradition of fighting the whole idea of midwifery, now embrace it to employ several for tallying more births per month than one obstetrician alone can attend. Recently, everyone has been getting in on this model, using nurse practitioners and physician’s assistants to do the rote work or flowsheet medicine for a practice.
• Rent out your brain. You have a lot to offer the medico-legal world as an expert witness. If you abhor what the plaintiff’s attorneys have done to medicine, you get to choose sides. For example, you can work for any attorney or you can choose to do only defense work. Either way, you can sell your time to render expert opinions for a hefty fee or a retainer for testimony.
You can write for other doctors. Doctors don’t have time to write and are traditionally tardy on deadlines, so if you like to write and are diligent in meeting deadlines, you can provide content for medical websites, hospital magazines and even the lay media. The nice thing about this exposure is that it’s free advertising for you. You become an “authority.” As demand for you grows, so too can your strategies to build a surgery center or hire others to do what you do — in a bigger more profitable practice.
The medical device industry is thriving. These companies need practicing doctors to provide and use their ideas. A contractual relationship in the medical engineering field can be lucrative in both salaries and stock offerings.
• Become a medical director. While I wouldn’t encourage becoming a medical director for a hospital, being a medical director for other organizations is a good idea. There is a wide variety, including insurance companies, hospital conglomerates, governmental (even foreign governmental) and non-government organizations.
• Join a Board of Directors. Being on the board of a company is usually a win-win: It attains bragging rights by having you, and it allows you a privileged insight into business trends and opportunities thanks to the education that comes with board membership.
Using Your Imagination
You have something not everyone has: a medical education and a license to do things others cannot. That is valuable. Above are examples of how to wear other hats that can fit only you, but your hat closet is only limited by your imagination. In medicine, busy breeds busy and wealth breeds more wealth, especially when buoyed by an imagination that can wield your privileged abilities to the maximum.