Are you fed up with the trend toward lower insurance reimbursements?
Tired of waiting weeks or months to get paid for your services? There are alternatives. One strong option is to offer wellness- aging (sometimes called “anti-aging”) services with point-of-service payments.
Wellness-aging is a good choice from a business standpoint for several reasons:
- The field is broad and encompasses a number of disciplines with an opportunity to add many new procedures to your office.
- These services are not covered by insurance, so all payments are point- of-service payments.
- Many services work well as packages for which the patient pays up front for the service. For example, you might offer long-acting testosterone pellet therapy. Implanted pellets provide up to six months of testosterone replacement treatment and the patient pays in advance.
- There is substantial demand for many of these services, and while in some markets the competition is fierce and growing, the field still offers opportunity for those offering the right mix.
- You do not have to be present in your office to offer wellness-aging services because most are performed by physician extenders.
But wellness-aging medicine is not for every practice. You will definitely need to have an MD onboard, either in a supervisory role or providing direct patient care, depending on the procedure and the rules in your state that pertain to services performed by non- physicians such as nurse practitioners, medical assistants, and estheticians.
The patient demographic is important, too; wellness-aging services are not cheap nor are they covered by insurance. You need to have a population who can afford what you are offering. Middle- to upper-income patients will not go to an office in a downscale location. You will be far more likely to succeed if you start a practice from scratch in the right place.
For this type of practice, first impressions are probably more important than for other types. Start with the building: Is parking convenient? Is valet parking available? Are the valets polite and helpful? The building itself should be in good repair and preferably be a high-end professional facility. The landscaping should be well-kept. Even before a patient steps foot in your office, he or she should already have a good first impression of your practice.
Accordingly, your office should reflect the professionalism of your practice, as should your staff. For aesthetic practices, you will have to go even further. Granite countertops and water features are not unusual for this type of establishment. Go online and visit some of these medical spas and plastic surgery practices or go in person to get an idea of what your office should look like.
The right mix
Wellness-aging medicine is broadly defined and can include any procedure or discipline that seeks to slow, stop, or reverse the aging process. This can involve treating internal processes, such as food allergies, sexual dysfunction, and hormonal changes. Or it can apply to external processes, such as wrinkling of the skin, sagging of the breasts, etc.
Hormone balancing is an important component of wellness- aging medicine. If hormone levels in the thyroid or adrenal glands are incorrect, then it will be impossible to slow or reverse the aging process. Testosterone therapy for men is a big part of the business of hormone replacement.
Implantable pellets for long-term use are convenient for patients, less unpleasant than injections, and profitable for the practice. The same is true for women who may have an estrogen imbalance.
Most doctors can learn to do these procedures by observing a few. Courses are available online and through live seminars. Different states have different rules regarding dispensing and storing testosterone, which is a Schedule II controlled substance. Be sure to check with the appropriate authorities before initiating treatment with testosterone.
Human growth hormone (HGH) replacement therapy is controversial because it is considered a controlled substance and is only to be used if there is a true deficiency. Wellness- aging doctors contend that this is not correct and, as with testosterone, it is good practice to aim for HGH levels that would be normal for a younger person.
If you are planning to incorporate HGH therapy, be sure to speak with a knowledgeable attorney to see if that is a viable option. There are substances called secretagogues that stimulate the pituitary to produce HGH. Not only are they legal but anecdotal evidence supports their use. Probably the best known of these is Sermorelin.
Nutrition is a substantial component of this type of practice. Treatment begins with extensive testing of nutrients and micronutrients to determine if there are imbalances or deficiencies. Should there be any, these are corrected with supplements. Treatment progress is monitored by repeat testing. Nutritional supplementation is one part of the whole-body wellness approach to aging that seeks to return one to a more youthful state of health.
Nutrition is a profitable add-on to any practice. The profit centers are the testing and the sale of supplements. As with most wellness-aging modalities, you do not have to be present in the office when these procedures are being done.
Many chiropractors, however, are experts at treating nutritional imbalances and enjoy this type of practice tremendously. If this is the case, you can order and interpret the tests and follow the patients through the treatment instead of delegating these functions.
Food-allergy testing is an important part of nutrition. If patients are constantly bombarding an overtaxed immune system with substances they are allergic to, they will never achieve the optimum levels of energy, even after correcting any hormonal imbalances.
Blood tests are available for testing food allergies. These tests can also be used to follow treatment progress.
Allergy testing represents another significant profit center that you can add to your practice.
While the above treatments can make patients feel better, wellness-aging treatments can also address patients who wish to look younger, too. These types of treatments include facials and peels, skin tightening, microdermabrasion, varicose and spider-vein removal, Botox and skin fillers to eliminate wrinkles, phototherapy, and others.
These are extremely profitable and can be incorporated with or without med- spa facilities. It is important to check with the appropriate boards as different states have different requirements as to who may perform these procedures and what levels of supervision are required.
Wellness-aging medicine offers a tremendous opportunity for you to add cash-based services to your practice and reduce your exposure to the whims of third-party payers.
Marc H. Sencer, MD, is the president of MDs for DCs, which provides intensive one-on-one training, medical staffing, and ongoing practice management support to chiropractic integrated practices. He can be reached at 800-916-1462 or through mdsfordcs.com.