The dermatology practice of today is undergoing fundamental change at an increasingly rapid pace. There are many reasons for this process of change, both internal and external.
Externally, some of the more common reasons include increasing pressure from third-party payers with downward trending in both current and inflation-adjusted dollars, and increasing competition from non-traditional dermatology providers to include primary care physicians. These factors coupled with changing demographics and demands by existing customers for more desire-based dermatology treatments, such as Botox, Laser, Restylane, etc., have combined to increase demands on dermatology practices with limited capacity to absorb increased patient throughput.
Internally, dermatology practices have also undergone tremendous change. Some of this has been brought about by medical advances (biological therapy) and some by technological advances, such as lasers, fillers and toxins.
Another driver of change is the relatively limited supply of dermatology appointment availability. This supply issue has been reviewed, debated, analyzed and discussed at length, and there has not been a universally acceptable consensus reached as to why the problem exists, if it does, and how to most effectively deal with the impact of the dermatology shortage.
Meeting Demands
True to form, the market itself has developed coping mechanisms to compensate. Chief among these is the emergence of the dermatology specialist physician assistant, represented by the Society of Dermatology Physician Assistants (SDPA). The SDPA member is typically engaged in the full-time practice of either disease- or desire-based dermatology in association with a dermatologist. Market research indicates that the fastest growing segment of dermatology care service providers is the “Derm PA”.
So, just why do dermatologists decide to recruit help? Usually, it’s because they perceive themselves as being too busy, not having enough free-time, or some combination of both.
Most practice-management experts believe that ideal appointment wait times should not exceed 2 weeks. In dermatology, where wait times commonly exceed 2 months, there is general agreement that in many, if not most, regions of the country there exists a dermatology undersupply issue. Regardless of whether this is secondary to cosmesis, maldistribution, abbreviated work schedules, or anything else, the plain and simple fact is that dermatology is very busy and short-handed.
When this undersupply issue becomes chronic, any individual practice and physician will usually begin to respond initially by attempting to work harder. This, in and of itself, does not result in tangible long-term gains with regard to “catching-up” on the schedule, nor does it result in any qualitative improvement in quality of life for the dermatologist.
Long term, just working harder also results, paradoxically, in a busier practice secondary to the expanded production. This activity ultimately results in a vicious cycle of working even harder to fall further behind.
What remedies exist? While there are no simple solutions, an evolving market response is to expand production by adding another provider, and this is where the physician extender (PE) comes into play. Simply stated, the PE will buy additional income and/or additional free time for the employer physician.
By using physician extenders, practices can increase their patient base and total revenues while decreasing patient wait times for appointments.
Incorporating physician extenders can bring much-needed relief to the schedule for a physician spending an extensive and non-sustainable amount of time each working day seeing routine disease based patients or performing desire based treatments.
Physician Extender Options
A physician has limited time in each day to see patients, and a “highest and best use of time” would seem to suggest that those valuable hours be spent caring for the most complicated cases, regardless of the disease or desire nature of the complaint.
A simple example would be as follows: If you have a full schedule, do you devote an appointment slot for an acne follow-up patient who is doing well and needing refills, or for a newly diagnosed bullous disease patient? In a full-capacity analysis, you cannot do both, only one or the other. This is where PE’s can help to manage a physician schedule, mostly by seeing less complicated follow-up patients.
Although PEs are most commonly PA-Cs, they can also be ARNPs, RNs or even CMA/CNAs, frequently depending on state legal scope of practice issues.
States have specific guidelines that each licensed provider type must follow. NPs and PAs legally can see patients for any type of basic dermatologic need: general, surgical and cosmetic. PAs must be registered with the state under a physician license. RNs often perform some minimally invasive cosmetic procedures and assist in seeing routine follow up, especially post-procedure. Laser technicians depending upon the state, may be licensed medical providers or simply “certified” as trained on a LLRO (laser, light, radiofrequency or optical) device.
Except for NPs who practice independently, each state has its own rules and guidelines regarding physician oversight of these other types of providers. Some require the physician to be physically present when patients are seen; others simply require the physician be “available” whether by phone or physically within a reasonable time frame, usually 60 to 120 minutes. Some states do not have specific guidelines regarding operating a laser, others may state that only an NP, PA, RN or physician may be the operator.
Know The Laws of Your State
Before making a decision to hire a physician extender, find out what the guidelines are for your individual state.
Consider those as you make the decision of which type of provider to hire. If you want someone to run a laser, perhaps an RN would be the best option for the practice. Alternately, if relief on the general dermatology side is required, choosing between an NP and PA is necessary; sometimes this decision is automatically forced upon you, for example, some states only allow a certain number of PAs per physician license. In this situation, an NP may be the better choice.
Additionally, remember that the best practices only use licensed or certified providers for any patient treatments; using unlicensed or uncertified staff to perform any type of procedure on a patient, regardless if the state allows it, is only asking for trouble and possibly a lawsuit.
Regarding your malpractice carrier’s policies, be sure to check if your insurer will allow coverage of PEs for the types of procedures you have planned. The carrier’s policies may conflict with state regulations in the sense that even though you are legally allowed to do something, you may not qualify for coverage. It is like having a really bad driving record, buying a Ferrari, and then finding out that your car insurance company won’t cover you in anything other than a Yugo.
Integrating a Physician Extender
Integrating physician extenders into an office will only be successful when this change is well planned and executed. Considerations must be made regarding training, introductions to staff and referring physicians, patient acceptance and insurance billing, if applicable.
Training
The amount of training the new physician extender needs is dependent upon his or her previous experience; some are seasoned dermatology practice providers, others might not have ever worked in dermatology before but have experience in another field, and others might be straight out of school. Each provider’s knowledge base and skills should be evaluated and a training plan designed specific to that person.
Often physician extenders work alongside the physician for the first few months while they are building their own schedule and learning the specifics of a practice. You can help build an extender’s schedule while giving yourself some relief by indicating to the routine patient that his or her wart or acne follow-up appointment will be with the NP/PA. As you become more confident in the level of knowledge and skill set of the NP/PA, he or she can begin to practice more independently, of course within state guidelines and malpractice policies.
Fitting The PE Into The Team
Introducing the new provider to the staff and answering questions regarding their role in the practice will speed integration.
Establish a plan of action and share it with the staff. Determine if the physician extender will see only follow-up patients previously seen by you or a another dermatologist in your practice, how new patients will be handled, and why type of appointment the new provider is ready to see. Should the receptionist only schedule follow-up warts, acne and laser hair removal patients in the beginning?
What about walk-in patients or those who call with urgent requests to be seen — what guidelines determine if these patients may be placed on the physician extender’s schedule? Providing answers to all of these types of questions will minimize staff confusion.
It is also important that referring primary care physicians are aware of the new provider and understand how the physician extender is relevant in the care of their patients. Usually a dermatologist sees the patient for the initial appointment and recommends any follow-up be done with the NP/PA.
Most primary care physicians are accustomed to working with mid-level providers and will be accepting of this plan. However, take great care to accommodate the wishes of a referring physician who requests that his or her patient only be seen by the physician.
Patient Acceptance
Since many primary care practices utilize NPs and PAs, many patients are accustomed to being seen by a provider other than a physician. Successful integration of physician extenders with patients is determined by the culture of the practice, the attitudes of the office staff and especially the physician.
First and foremost, you, as the physician, must express confidence in the new provider. This confidence will be reflected throughout the practice. Recommend to patients that they follow-up with the physician extender for routine appointments. Patients also sometimes self-select based on their preferences such as quick follow-up appointments, prescription refills and scheduling ease. For example, a physician extender may be the only provider offering a 7 a.m. appointment, which is what the patient desires.
Insurance Credentialing
In practices that bill insurance, the physician extender who is a provider of general or surgical dermatology will need to be credentialed with the same insurance companies as the physician. Each PPO company or organization needs to be contacted to see how the NP/PA should be billed. Some will allow them to bill under the physician name/number. Others, such as Medicare, require unique provider numbers. It’s important to think about this prior to hiring a physician extender, get the paper work required and get started on it immediately as it is often a lengthy process.
Practice Expansion
Once the physician extender has been trained and integrated into the practice, practice expansion can begin, or alternatively, an increase in your own free time may be achieved. This can include expanding the number of patients seen in a day or expanding days and hours open for appointments, or by introducing new services or procedures such as Botox Cosmetic, Restylane, Sculptra or laser offerings. You may not be interested in personally performing these procedures or the demand for these may exceed the amount of appointment availability.
Practice expansion in these ways will bring value-added benefits by incorporating physician extenders into the practice, and frequently do so in a way that your personal time is maximized.
In our next column, we’ll discuss compensation and incentives for physician extenders.
The dermatology practice of today is undergoing fundamental change at an increasingly rapid pace. There are many reasons for this process of change, both internal and external.
Externally, some of the more common reasons include increasing pressure from third-party payers with downward trending in both current and inflation-adjusted dollars, and increasing competition from non-traditional dermatology providers to include primary care physicians. These factors coupled with changing demographics and demands by existing customers for more desire-based dermatology treatments, such as Botox, Laser, Restylane, etc., have combined to increase demands on dermatology practices with limited capacity to absorb increased patient throughput.
Internally, dermatology practices have also undergone tremendous change. Some of this has been brought about by medical advances (biological therapy) and some by technological advances, such as lasers, fillers and toxins.
Another driver of change is the relatively limited supply of dermatology appointment availability. This supply issue has been reviewed, debated, analyzed and discussed at length, and there has not been a universally acceptable consensus reached as to why the problem exists, if it does, and how to most effectively deal with the impact of the dermatology shortage.
Meeting Demands
True to form, the market itself has developed coping mechanisms to compensate. Chief among these is the emergence of the dermatology specialist physician assistant, represented by the Society of Dermatology Physician Assistants (SDPA). The SDPA member is typically engaged in the full-time practice of either disease- or desire-based dermatology in association with a dermatologist. Market research indicates that the fastest growing segment of dermatology care service providers is the “Derm PA”.
So, just why do dermatologists decide to recruit help? Usually, it’s because they perceive themselves as being too busy, not having enough free-time, or some combination of both.
Most practice-management experts believe that ideal appointment wait times should not exceed 2 weeks. In dermatology, where wait times commonly exceed 2 months, there is general agreement that in many, if not most, regions of the country there exists a dermatology undersupply issue. Regardless of whether this is secondary to cosmesis, maldistribution, abbreviated work schedules, or anything else, the plain and simple fact is that dermatology is very busy and short-handed.
When this undersupply issue becomes chronic, any individual practice and physician will usually begin to respond initially by attempting to work harder. This, in and of itself, does not result in tangible long-term gains with regard to “catching-up” on the schedule, nor does it result in any qualitative improvement in quality of life for the dermatologist.
Long term, just working harder also results, paradoxically, in a busier practice secondary to the expanded production. This activity ultimately results in a vicious cycle of working even harder to fall further behind.
What remedies exist? While there are no simple solutions, an evolving market response is to expand production by adding another provider, and this is where the physician extender (PE) comes into play. Simply stated, the PE will buy additional income and/or additional free time for the employer physician.
By using physician extenders, practices can increase their patient base and total revenues while decreasing patient wait times for appointments.
Incorporating physician extenders can bring much-needed relief to the schedule for a physician spending an extensive and non-sustainable amount of time each working day seeing routine disease based patients or performing desire based treatments.
Physician Extender Options
A physician has limited time in each day to see patients, and a “highest and best use of time” would seem to suggest that those valuable hours be spent caring for the most complicated cases, regardless of the disease or desire nature of the complaint.
A simple example would be as follows: If you have a full schedule, do you devote an appointment slot for an acne follow-up patient who is doing well and needing refills, or for a newly diagnosed bullous disease patient? In a full-capacity analysis, you cannot do both, only one or the other. This is where PE’s can help to manage a physician schedule, mostly by seeing less complicated follow-up patients.
Although PEs are most commonly PA-Cs, they can also be ARNPs, RNs or even CMA/CNAs, frequently depending on state legal scope of practice issues.
States have specific guidelines that each licensed provider type must follow. NPs and PAs legally can see patients for any type of basic dermatologic need: general, surgical and cosmetic. PAs must be registered with the state under a physician license. RNs often perform some minimally invasive cosmetic procedures and assist in seeing routine follow up, especially post-procedure. Laser technicians depending upon the state, may be licensed medical providers or simply “certified” as trained on a LLRO (laser, light, radiofrequency or optical) device.
Except for NPs who practice independently, each state has its own rules and guidelines regarding physician oversight of these other types of providers. Some require the physician to be physically present when patients are seen; others simply require the physician be “available” whether by phone or physically within a reasonable time frame, usually 60 to 120 minutes. Some states do not have specific guidelines regarding operating a laser, others may state that only an NP, PA, RN or physician may be the operator.
Know The Laws of Your State
Before making a decision to hire a physician extender, find out what the guidelines are for your individual state.
Consider those as you make the decision of which type of provider to hire. If you want someone to run a laser, perhaps an RN would be the best option for the practice. Alternately, if relief on the general dermatology side is required, choosing between an NP and PA is necessary; sometimes this decision is automatically forced upon you, for example, some states only allow a certain number of PAs per physician license. In this situation, an NP may be the better choice.
Additionally, remember that the best practices only use licensed or certified providers for any patient treatments; using unlicensed or uncertified staff to perform any type of procedure on a patient, regardless if the state allows it, is only asking for trouble and possibly a lawsuit.
Regarding your malpractice carrier’s policies, be sure to check if your insurer will allow coverage of PEs for the types of procedures you have planned. The carrier’s policies may conflict with state regulations in the sense that even though you are legally allowed to do something, you may not qualify for coverage. It is like having a really bad driving record, buying a Ferrari, and then finding out that your car insurance company won’t cover you in anything other than a Yugo.
Integrating a Physician Extender
Integrating physician extenders into an office will only be successful when this change is well planned and executed. Considerations must be made regarding training, introductions to staff and referring physicians, patient acceptance and insurance billing, if applicable.
Training
The amount of training the new physician extender needs is dependent upon his or her previous experience; some are seasoned dermatology practice providers, others might not have ever worked in dermatology before but have experience in another field, and others might be straight out of school. Each provider’s knowledge base and skills should be evaluated and a training plan designed specific to that person.
Often physician extenders work alongside the physician for the first few months while they are building their own schedule and learning the specifics of a practice. You can help build an extender’s schedule while giving yourself some relief by indicating to the routine patient that his or her wart or acne follow-up appointment will be with the NP/PA. As you become more confident in the level of knowledge and skill set of the NP/PA, he or she can begin to practice more independently, of course within state guidelines and malpractice policies.
Fitting The PE Into The Team
Introducing the new provider to the staff and answering questions regarding their role in the practice will speed integration.
Establish a plan of action and share it with the staff. Determine if the physician extender will see only follow-up patients previously seen by you or a another dermatologist in your practice, how new patients will be handled, and why type of appointment the new provider is ready to see. Should the receptionist only schedule follow-up warts, acne and laser hair removal patients in the beginning?
What about walk-in patients or those who call with urgent requests to be seen — what guidelines determine if these patients may be placed on the physician extender’s schedule? Providing answers to all of these types of questions will minimize staff confusion.
It is also important that referring primary care physicians are aware of the new provider and understand how the physician extender is relevant in the care of their patients. Usually a dermatologist sees the patient for the initial appointment and recommends any follow-up be done with the NP/PA.
Most primary care physicians are accustomed to working with mid-level providers and will be accepting of this plan. However, take great care to accommodate the wishes of a referring physician who requests that his or her patient only be seen by the physician.
Patient Acceptance
Since many primary care practices utilize NPs and PAs, many patients are accustomed to being seen by a provider other than a physician. Successful integration of physician extenders with patients is determined by the culture of the practice, the attitudes of the office staff and especially the physician.
First and foremost, you, as the physician, must express confidence in the new provider. This confidence will be reflected throughout the practice. Recommend to patients that they follow-up with the physician extender for routine appointments. Patients also sometimes self-select based on their preferences such as quick follow-up appointments, prescription refills and scheduling ease. For example, a physician extender may be the only provider offering a 7 a.m. appointment, which is what the patient desires.
Insurance Credentialing
In practices that bill insurance, the physician extender who is a provider of general or surgical dermatology will need to be credentialed with the same insurance companies as the physician. Each PPO company or organization needs to be contacted to see how the NP/PA should be billed. Some will allow them to bill under the physician name/number. Others, such as Medicare, require unique provider numbers. It’s important to think about this prior to hiring a physician extender, get the paper work required and get started on it immediately as it is often a lengthy process.
Practice Expansion
Once the physician extender has been trained and integrated into the practice, practice expansion can begin, or alternatively, an increase in your own free time may be achieved. This can include expanding the number of patients seen in a day or expanding days and hours open for appointments, or by introducing new services or procedures such as Botox Cosmetic, Restylane, Sculptra or laser offerings. You may not be interested in personally performing these procedures or the demand for these may exceed the amount of appointment availability.
Practice expansion in these ways will bring value-added benefits by incorporating physician extenders into the practice, and frequently do so in a way that your personal time is maximized.
In our next column, we’ll discuss compensation and incentives for physician extenders.
The dermatology practice of today is undergoing fundamental change at an increasingly rapid pace. There are many reasons for this process of change, both internal and external.
Externally, some of the more common reasons include increasing pressure from third-party payers with downward trending in both current and inflation-adjusted dollars, and increasing competition from non-traditional dermatology providers to include primary care physicians. These factors coupled with changing demographics and demands by existing customers for more desire-based dermatology treatments, such as Botox, Laser, Restylane, etc., have combined to increase demands on dermatology practices with limited capacity to absorb increased patient throughput.
Internally, dermatology practices have also undergone tremendous change. Some of this has been brought about by medical advances (biological therapy) and some by technological advances, such as lasers, fillers and toxins.
Another driver of change is the relatively limited supply of dermatology appointment availability. This supply issue has been reviewed, debated, analyzed and discussed at length, and there has not been a universally acceptable consensus reached as to why the problem exists, if it does, and how to most effectively deal with the impact of the dermatology shortage.
Meeting Demands
True to form, the market itself has developed coping mechanisms to compensate. Chief among these is the emergence of the dermatology specialist physician assistant, represented by the Society of Dermatology Physician Assistants (SDPA). The SDPA member is typically engaged in the full-time practice of either disease- or desire-based dermatology in association with a dermatologist. Market research indicates that the fastest growing segment of dermatology care service providers is the “Derm PA”.
So, just why do dermatologists decide to recruit help? Usually, it’s because they perceive themselves as being too busy, not having enough free-time, or some combination of both.
Most practice-management experts believe that ideal appointment wait times should not exceed 2 weeks. In dermatology, where wait times commonly exceed 2 months, there is general agreement that in many, if not most, regions of the country there exists a dermatology undersupply issue. Regardless of whether this is secondary to cosmesis, maldistribution, abbreviated work schedules, or anything else, the plain and simple fact is that dermatology is very busy and short-handed.
When this undersupply issue becomes chronic, any individual practice and physician will usually begin to respond initially by attempting to work harder. This, in and of itself, does not result in tangible long-term gains with regard to “catching-up” on the schedule, nor does it result in any qualitative improvement in quality of life for the dermatologist.
Long term, just working harder also results, paradoxically, in a busier practice secondary to the expanded production. This activity ultimately results in a vicious cycle of working even harder to fall further behind.
What remedies exist? While there are no simple solutions, an evolving market response is to expand production by adding another provider, and this is where the physician extender (PE) comes into play. Simply stated, the PE will buy additional income and/or additional free time for the employer physician.
By using physician extenders, practices can increase their patient base and total revenues while decreasing patient wait times for appointments.
Incorporating physician extenders can bring much-needed relief to the schedule for a physician spending an extensive and non-sustainable amount of time each working day seeing routine disease based patients or performing desire based treatments.
Physician Extender Options
A physician has limited time in each day to see patients, and a “highest and best use of time” would seem to suggest that those valuable hours be spent caring for the most complicated cases, regardless of the disease or desire nature of the complaint.
A simple example would be as follows: If you have a full schedule, do you devote an appointment slot for an acne follow-up patient who is doing well and needing refills, or for a newly diagnosed bullous disease patient? In a full-capacity analysis, you cannot do both, only one or the other. This is where PE’s can help to manage a physician schedule, mostly by seeing less complicated follow-up patients.
Although PEs are most commonly PA-Cs, they can also be ARNPs, RNs or even CMA/CNAs, frequently depending on state legal scope of practice issues.
States have specific guidelines that each licensed provider type must follow. NPs and PAs legally can see patients for any type of basic dermatologic need: general, surgical and cosmetic. PAs must be registered with the state under a physician license. RNs often perform some minimally invasive cosmetic procedures and assist in seeing routine follow up, especially post-procedure. Laser technicians depending upon the state, may be licensed medical providers or simply “certified” as trained on a LLRO (laser, light, radiofrequency or optical) device.
Except for NPs who practice independently, each state has its own rules and guidelines regarding physician oversight of these other types of providers. Some require the physician to be physically present when patients are seen; others simply require the physician be “available” whether by phone or physically within a reasonable time frame, usually 60 to 120 minutes. Some states do not have specific guidelines regarding operating a laser, others may state that only an NP, PA, RN or physician may be the operator.
Know The Laws of Your State
Before making a decision to hire a physician extender, find out what the guidelines are for your individual state.
Consider those as you make the decision of which type of provider to hire. If you want someone to run a laser, perhaps an RN would be the best option for the practice. Alternately, if relief on the general dermatology side is required, choosing between an NP and PA is necessary; sometimes this decision is automatically forced upon you, for example, some states only allow a certain number of PAs per physician license. In this situation, an NP may be the better choice.
Additionally, remember that the best practices only use licensed or certified providers for any patient treatments; using unlicensed or uncertified staff to perform any type of procedure on a patient, regardless if the state allows it, is only asking for trouble and possibly a lawsuit.
Regarding your malpractice carrier’s policies, be sure to check if your insurer will allow coverage of PEs for the types of procedures you have planned. The carrier’s policies may conflict with state regulations in the sense that even though you are legally allowed to do something, you may not qualify for coverage. It is like having a really bad driving record, buying a Ferrari, and then finding out that your car insurance company won’t cover you in anything other than a Yugo.
Integrating a Physician Extender
Integrating physician extenders into an office will only be successful when this change is well planned and executed. Considerations must be made regarding training, introductions to staff and referring physicians, patient acceptance and insurance billing, if applicable.
Training
The amount of training the new physician extender needs is dependent upon his or her previous experience; some are seasoned dermatology practice providers, others might not have ever worked in dermatology before but have experience in another field, and others might be straight out of school. Each provider’s knowledge base and skills should be evaluated and a training plan designed specific to that person.
Often physician extenders work alongside the physician for the first few months while they are building their own schedule and learning the specifics of a practice. You can help build an extender’s schedule while giving yourself some relief by indicating to the routine patient that his or her wart or acne follow-up appointment will be with the NP/PA. As you become more confident in the level of knowledge and skill set of the NP/PA, he or she can begin to practice more independently, of course within state guidelines and malpractice policies.
Fitting The PE Into The Team
Introducing the new provider to the staff and answering questions regarding their role in the practice will speed integration.
Establish a plan of action and share it with the staff. Determine if the physician extender will see only follow-up patients previously seen by you or a another dermatologist in your practice, how new patients will be handled, and why type of appointment the new provider is ready to see. Should the receptionist only schedule follow-up warts, acne and laser hair removal patients in the beginning?
What about walk-in patients or those who call with urgent requests to be seen — what guidelines determine if these patients may be placed on the physician extender’s schedule? Providing answers to all of these types of questions will minimize staff confusion.
It is also important that referring primary care physicians are aware of the new provider and understand how the physician extender is relevant in the care of their patients. Usually a dermatologist sees the patient for the initial appointment and recommends any follow-up be done with the NP/PA.
Most primary care physicians are accustomed to working with mid-level providers and will be accepting of this plan. However, take great care to accommodate the wishes of a referring physician who requests that his or her patient only be seen by the physician.
Patient Acceptance
Since many primary care practices utilize NPs and PAs, many patients are accustomed to being seen by a provider other than a physician. Successful integration of physician extenders with patients is determined by the culture of the practice, the attitudes of the office staff and especially the physician.
First and foremost, you, as the physician, must express confidence in the new provider. This confidence will be reflected throughout the practice. Recommend to patients that they follow-up with the physician extender for routine appointments. Patients also sometimes self-select based on their preferences such as quick follow-up appointments, prescription refills and scheduling ease. For example, a physician extender may be the only provider offering a 7 a.m. appointment, which is what the patient desires.
Insurance Credentialing
In practices that bill insurance, the physician extender who is a provider of general or surgical dermatology will need to be credentialed with the same insurance companies as the physician. Each PPO company or organization needs to be contacted to see how the NP/PA should be billed. Some will allow them to bill under the physician name/number. Others, such as Medicare, require unique provider numbers. It’s important to think about this prior to hiring a physician extender, get the paper work required and get started on it immediately as it is often a lengthy process.
Practice Expansion
Once the physician extender has been trained and integrated into the practice, practice expansion can begin, or alternatively, an increase in your own free time may be achieved. This can include expanding the number of patients seen in a day or expanding days and hours open for appointments, or by introducing new services or procedures such as Botox Cosmetic, Restylane, Sculptra or laser offerings. You may not be interested in personally performing these procedures or the demand for these may exceed the amount of appointment availability.
Practice expansion in these ways will bring value-added benefits by incorporating physician extenders into the practice, and frequently do so in a way that your personal time is maximized.
In our next column, we’ll discuss compensation and incentives for physician extenders.
