Business Mastery 3, by Cherie Sohnen-Moe, 2005 edition is a business manual for the wellness professional and health related practitioners. Ms. C. tells why, in a 40 hour week, the self employed professional has only 25 billable hours. The rest of that 40 hours goes into record keeping, practice management, continued education, consultations and other administrative and business activities. Those non-billable hours do not earn any income.
Ms. C. then provides a table of how much your annual income will be according to how much you charge for services for those billable hours. According to that chart, if you run your business at 40 hours a week, with 25 billable hours and charge $19.25 per hour for your services, you will earn $25,000 per year. If you charge $77 per hour for your services under the same conditions, your annual income will be $100,000. Out of this you must pay taxes, insurance, payroll, office/building expenses, and all other expenses of operating a business.
As a remedy for this surprisingly low return for health related practices, Ms. C. recommends selling products from the office to your clients during their visits.
Now you know why for many decades Doctors have given their flu patients anti-biotic shots and vitamin B shots, even though those things do nothing for the flu.
One doctor I remember was fond of writing prescriptions, with no allownces for generic versions, for drugs manufactured by a drug company in which he owned stock.
If you can increase the number of visits by your clients without increasing your business expenses to find new clients, you can boost your bottom line. That's how Miss B became a diabetic cash cow for the industry. At the age of 35 she began taking water pills, prescribed by her doctor. Overweight by nearly 100 lb, she used them to lose water weight. In the first few days she announced proudly that she had lost 7 pounds. So she gladly went for another office call when she needed a new prescription. It's not uncommon for even small women to try to shed a few pounds by taking water pills. And it's easy income for the doctor.
No one told Miss B that the use of water pills could lead to gout and/or diabetes. Ms. B. hit the jackpot and got them both. Neither of them exists in her genetic family. Now she is over 80 and has been a lucrative source of income to the medical industry for nearly 40 years. All at the expense of her insurance company.
A young pregnant woman, in 2005, went to her doctor, at a southside family practice office in Columbus on Buena Vista Road, because she was pregnant. She was on medicaid. She announced to the doctor that she was pregnant. He gave her the stick, the common pregnancy test. Then he told her to come back for another appointment to get the results. She said why can't I get it now? I have a part time job and two preschool children I have to get ready and bring with me every time. She said one of the nurses even interceded with the doctor, to give her the results now and save her a lot of trouble. The doctor insisted she would have to come back. She then lost her temper and told the doctor there was a Dollar Tree store 2 miles up the road where she could buy her own stick for $1 and have the results in 15 minutes. She told him that was the last fee he would get out of medicaid on her behalf. She kept her word.
The indigent care clinic through a Columbus hospital also found a way to generate more office calls without increasing the number of patients. They started making separate visits for their diabetic patients to get their blood sugar levels tested. Normally this would be done by a nurse during a scheduled doctor visit and takes about a minute. By making a second office call out of all the diabetic patients in the clinic, imagine the “increase” in office calls the clinic could report on it's grant applications. Imagine the hardship to the already-indigent patients. A visit to the clinic was already an hours long affair, eliminating any possiblity of earning money for most of the day. Adding a second office call just to read their meters destroyed what little was left of their day. It clearly was not done for the benefit of the patients.
Another way to ramp up the income is to continually test the patients for anything and everything. If you can do it in the office so much the better. But even if you have too send them to the hospital for the actual test, you can still charge them for informing them of the results. Think of all the tests that come back negative. Especially that list of tests you should ALL have every year after you pass forty. Negative, negative, negative, at a couple hundred bucks each. But well worth it, says the medical industry, just to be sure. But then come to find out, you can't even get certainty for your money, because of the high percentages of false positives and false negatives. And nearly all paid for by insurance, medicaid and medicare. People who don't have coverage or cash don't get all those annual tests.
This is not to say that all doctors and medical personnel are corrupt. But all of them have to twist their services and care around a corrupt medical industry. To the extent that they want respect for their professions, and pride in their own contributions, they need to stand up and fight for it. The first and best chance of reform for those professions come from within the professions themselves. If they don't do the job, someone else will have to step in and do it for them.

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