Adding ancillaries: Boosting the bottom line

It's amazing. The same people who complain about a $25 copay will spend $1,500 out of pocket on a facial rejuvenation," says James Mirabile, who with his partner, Howard D. Ellis, added a laser center to their ob/gyn practice in Overland Park, KS.

As FP Frederic Porcase Jr. of Jacksonville, FL, puts it, "You can't afford to sit there and do nothing and hope to survive." Porcase's six-physician practice has a full lab and does X-rays and bone density testing. "All of these have proven to be profitable," he says. Other ancillary-service success stories abound:

First, some information on how to assess which ancillary services are right for you and your patients, and how to get an ancillary service up and running.

Deciding what ancillary is best for your practice

The best ancillary operations achieve that status because you've identified a real need or interest among your patients, and the service represents a clinically sound response to that, says Geoffrey T. Anders, an attorney and president of The Health Care Group, a practice management firm in Plymouth Meeting, PA. If you see a lot of diabetics, for instance, an in-office lab would probably make a lot of sense. If your patient roster consists mainly of middle-age women, you might want to look into adding bone densitometry or Botox services. (Anders cautions, however, that "given the inherent conflict of interest that self-referral represents, you have to be careful not to abuse the confidence patients place in you.")