Friday, September 08, 2006

Would You Like Fries With That?

Half of the people Dr. Charles Hickey sees at his Columbus ophthalmology practice are Medicare patients. He makes little money on them, he says, because Medicare pays at or below his costs. Hickey, however, makes a profit when he performs surgery and sells eyeglasses. He plans on increasing this side of his practice. The Centers for Medicare and Medicaid Services have proposed cutting payments to doctors next year by 5.1 percent. Hickey and other physicians have done the math. Right now, many have quit adding Medicare patients or are cutting them. More are planning to do the same.

And many are turning to moneymaking procedures, such as cosmetic surgery, or are selling products, including beauty aids.

"I really didn’t spend 12 years in school to sell glasses, but that’s half our income right now," he said.

Medicare is 40 years old and showing signs of aging. What was once considered an alternative to high-priced health insurance from carriers is now coming apart at the seams. Not only is Medicare charging beneficiaries more and covering less, many providers are scaling back on the number of patients they will treat who have Medicare.

Others are hawking wares on the side to make up for the losses associated with treating Medicare patients.

Dr. Mary Beth Mudd, a family physician in Westerville, added a separate practice a couple of years ago to provide "nonsurgical beauty medicine," including Botox injections, laser skin-resurfacing and hair removal.

She said she spends 20 hours a week being a doctor — delivering babies, treating sick and chronically ill patients — and spends the rest of her time devoted to the cash-generating side of her practice.

Patients pay $200 for a 15-minute laser session to remove spider veins and $2,000 for six treatments of mesotherapy — injections to remove fat and cellulite.

Mudd said the beauty side of her practice is lucrative.

"If I saw a lot of patients in the … (beauty) practice, I got paid," she said.

Many docs have not only expanded the products & services offered on premises, but have moved in to other, non-related industries. One pediatrician who is a family friend started importing & selling oriental rugs (although that may not be the policitcally correct term any more) and did so well he abandoned his practice altogether.

The times are a-changin'
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