The big idea, the overall strategy for a financially successful ObGyn practice is:
1. Do as much in the office as possible, spend as much time in your office as possible, do as many diagnostic and therapeutic procedures in the office.
Reason: This way you get paid for the procedure plus you receive the "facility fee". You also save yourself the wasted time of patient change over in the OR. It is YOUR office, you are in command and you can streamline all procedures to maximum efficiency. I heard it again and again from successful colleagues: if you can work most of the time in the office and avoid going to the hospital, you earn more.
2. Top procedures to do in the office at this time (May 2007) are:
a. endometrial ablation by Novasure, balloon, free water ablation
b. hysteroscopy, possibly with ultrasound
d. sonography, e.g. saline infusion hysterogram
3. Should you have to go to the OR, then try not to have block time, but try to get the first slot in the OR in the morning for one procedure. This way you avoid the loss of time involved with changing patients, whihc usually takes longer than you need to talk to the relatives and dictate you op note.
Do your surgeries on your on-call weekends, where you can't do much else anyway or have to be at the hospital anyway. Many hospitals allow scheduled surgeries on Saturdays.
4. Learn ultrasound and get AIUM certified, many HMOs require that certification for being able to bill the interpretation of sono pictures. Besides that: the optimal information comes from doing the ultrasound yourself. No still picture can replace that.
5. Learn coding well to maximize your reimbursement, attend courses, listen to your colleagues, and remember - the HMOs are using sophisticated, expensive, highly specialized software to aggressively downgrade your reimbursements no matter what you do. Visit an ACOG coding and billing course (one of those courses that are always sold out)
6. Market your practice like crazy, it pays off tremendously. Read the book by Neil Baum "Marketing your Clinical Practice - Ethically, Effectively, Economically" and follow the advice. You might also consider hiring a professional marketer for developing a marketing plan and for carrying it out. Consider Healthcare Success Strategies. Try the CD set for 200, then the course for 1000. Then you'll know if it works for you.
&. As soon as financially feasible, fire the HMO with the lowest reimbursements and with the biggest hassles (it is usually the same HMO). Repeat as often as possible.