Viewpoint

The Perfect Storm

Larry E. Patterson, MD
FROM THE CHIEF MEDICAL EDITOR

As I write this, news has recently come through that Congress finally, once again, temporarily patched the Medicare SGR problem and gave our 21% cut another six-month extension. Time to celebrate? Not at my practice. By my read of the situation, this means that in November — conveniently, after the mid-term elections — the politicians can do whatever they want, knowing it's another two years until the next election. The issue will get put on the back-burner once more instead of solved for good. Of course, in the meantime our checks have been held again, so that we'll get most of the owed money for our services late, and the rest will be delayed even longer. I don't know about you, but this whole debacle has wreaked havoc on our cash flow back home.

In the US, we pay roughly $3000 per person per year more on health care than the next most expensive country on earth — and that still doesn't bring in enough to compensate doctors fairly and on time. Unless things change in how health care reform is implemented, we will soon have a whole new segment of patients with insurance coming to see us. And with more baby boomers becoming Medicare eligible each year, we are about to have a perfect storm. Most physicians have said they will limit, in one way or another, Medicare patients if any more cuts take place. But I'm pretty sure, the cuts they are a comin’.

One of our main missions here at Ophthalmology Management is to give you the tools and ideas to help your practice thrive, especially in tough times. I've got a few ideas myself, and want to share a couple of things we are doing to enhance our practice's survival.

After using an outside retinal group for many years, my general ophthalmology practice is hiring a retinal specialist. We will start initially with an office-based practice, but in time will also do retinal surgery in our ASC. You could also insert plastics, glaucoma, pediatrics, etc. into the mix, depending on your needs and the demographics of your practice. We see this as only a positive development for our practice. Our patient's needs will be better met, and more of the income will stay home.

Secondly, my refraction fee has remained the same $20 charge for 15 years. I've talked with many of you with the same story. It's time to go up. Every consultant out there is preaching the same sermon. I'm probably going to go up incrementally, based on what Washington throws our way, but I've got to do something to offset the decreased revenue from all the third-party payers and my constantly rising overhead. Throw in the new unfunded health insurance mandates, time-consuming regulations and especially that budget-busting EMR requirement and you've got a perfect storm for financial distress. Plus my employees want, and deserve, a raise for all their hard work.

So here's what I'm asking. Each one of you probably has some pretty darn good ideas for saving money or enhancing revenue. Please send your ideas, be they big or small, to me at larryp@ecotn.com. If we get enough, we'll publish them as a separate article. As Benjamin Franklin famously said, “We must all hang together, or surely we'll hang separately.”