Adding ancillary services carries monetary benefits, but poses risks

ultrasound Independent physicians have the flexibility to add services and treatments to their clinic as patient or market demands change. Although a new procedure, test, or other service can mean more revenue and patients for your clinic, it is not a decision to be taken lightly. Each new service carries its own benefits and risks.


Gada 64“In the end, you will have more patients and more revenue and the satisfaction of serving society with better facilities for which otherwise patients may have to travel a long distance.”
—Dhiraj Gada, MD, DGO, DFP, FICMCH, reproductive endocrinologist and director of Gada Life ART Center, Indore, India, and a member of mdCurrent-India’s Editorial Advisory Board


“If my staff and I are not properly trained to provide the service, it may lead to a bad reputation and loss of revenue,” explains Dhiraj Gada, MD, DGO, DFP, FICMCH, who specializes in reproductive endocrinology and infertility in Indore. After careful consideration, Gada created a department of fetal medicine at his clinic to better serve his patients.“ It is an ongoing process as I have young, talented doctors working with me and they want to progress,” he says.

Before you add a new clinic test, treatment, or procedure, Gada and other physicians recommend the following:

Key Point: Adding services can boost your revenue, but requires a careful assessment of patient benefit and demand.
  • Study the market and patient demand for the service.
  • Ensure that the service or treatment will benefit patients.
  • Determine the financial impact on the clinic.
  • Assess your staff’s skill and workload level.

Study the market

Never add a service to your clinic without[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] determining that there is a significant demand for it in your area, or from your patients. Physicians who concentrate only on the potential profit of a service often end up providing the new treatment or test when it is not medically necessary.

Occasionally, however, an unmet need will be present in your market—without any other physicians noticing. Based on a trend he observed, Raghavendra D. Kulkarni, MD, professor and head of the Department of Microbiology, SDM College of Medical Sciences and Hospital in Dharwad, Karnataka, added the Rose Bengal plate test (RBPT) to physician requests for brucella slide agglutination tests. Kulkarni’s careful analysis of his market proved to be correct.

“We test the samples by RBPT even if that is not requested by the clinician,” he says. “With this approach we detect at least one case per month of brucellosis where the clinician has not suspected this rare infection.”

Assess benefits and risks

Before adding a new service to his clinic, Gada asks himself five questions and studies clinic data to determine the answers. Those questions are:

  1. Is there any need to add a new service in my area of practice?
  2. Will adding this new service be a cost-effective investment?
  3. How much will the extra service benefit my patients?
  4. Am I competent to manage this service, or is training available?
  5. Will it add to my reputation and offer my clinic an advantage?

“If the answer to all is yes, then I will add the new service,” he says.

Consider, too, whether your clinic has adequate staff to assist in performing the service. Adding employees or labor hours may offset any revenue the new test or procedure brings to your clinic.

Measure progress

Once the service is added, continually track how it is impacting your costs and revenue. While there may be significant patient demand, the service could be hindering your and your staff’s productivity on core tests, treatments, and other services.

In the long term, apart from the financial impact, consider how adding the new service is enabling you to improve the lives of your patients and save them time and money.

“You and your clinic will be first to provide services in your area that are beneficial to a large population,” Gada says. “In the end, you will have more patients and more revenue and the satisfaction of serving society with better facilities for which otherwise patients may have to travel a long distance.”

Adding ancillary services checklist:

  • Study your market to determine which services are lacking.
  • Confirm if the service is a logical addition to your clinic.
  • Determine how much your patients would benefit from the service.
  • Poll your patients to learn if they would request the service and how often.
  • Determine that you have appropriate staff to perform the new service.
  • Create a budget to assess how the service will help you increase profits.

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One Comment

  1. hariharan ramamurthy
    Posted May 2013 at 11:03 pm | Permalink

    ““We test the samples by RBPT even if that is not requested by the clinician,” ”
    Raghavendra D. Kulkarni, MD says

    this would be medical malpractice in USA!
    what if the patient or the clinician refuses to pay the charge ?

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