Medical Procedures: Fun and Lucrative

Small-practice, general internists are "dinosaurs" on the verge of financial extinction but they can help themselves by adding procedures to their "black bag" and have fun doing it, said Ted Sussman, MD. "Performing additional procedures such as exercise treadmill testing, screening colonoscopies, dexa scans, screening endoscopies, and endometrial aspirates can be a service to our patients and add value to our practice," said Sussman, a general internist from rural Houlton, Maine.

While procedures definitely "supplement income," Sussman believes that there's more than finance involved. "Performing your own procedures improves patient care and makes the results more meaningful," he said.

Performing procedures also diversifies a physician's work life. "We all know that working in an office with patients is satisfying but hard. Performing procedures is a break from office visits and helps to financially support that work," he said.

Office- and hospital-based procedures vary in difficulty and reimbursement value. "Some are low cost, easy-to-do and get reimbursed ridiculously well such as event recorders, which is also a very valuable clinical test."

The idea that internists will increasingly perform medical procedures raises questions for the profession, though, said Sussman. "Are newly trained general internists comfortable with a procedure-oriented practice where subspecialty referral is an exception?" he asks.