Wednesday, February 3, 2010

Physician Business Ideas: Learning To Do Procedures in the Office

A primary doctor in our town routinely biopsies skin lesions in his office. Patients to whom I have spoken swear by this physician and appreciate the simplicity, promptness, and convenience of this service. I have learned doing procedures in the office is not an isolated practice. Many primary care physicians around the country are doing more procedures in their office, and they are learning to do these procedures safely, appropriately, and well through the National Procedures Institute, a Michigan based organization.

John Pfenninger, MD, founded the Institute in 1989 and has since published a 2000 page text book, Pfenninger and Fowler’s Procedures for Primary Care (McGraw Hill, 2005, $149.50 on the whats, whys, whens, and hows of safely performing procedures in the office. In addition, he and his team give regional seminars on office-based procedures. See www.npinstitute .com

According to Pfenninger, “ Many of us who want to learn how to treat hemorrhoids, inject veins, do vasectomies, put in IUDs, apply casts, do dermatological surgery, perform the procedures needed for emergency and hospital care, and more. “

“Doing procedures makes so much sense. Many things can be performed in the office as opposed to the hospital. Surgeons are trained to do everything in the operating room but this markedly increases costs. Sebaceous cysts, lipomas, hemorrhoids, and many other conditions can be treated in an office setting. Patients appreciate this. So do insurers, because costs can be kept to a minimum. “

“Other advantages of doing procedures include a reduction in the delay of diagnosis. If a skin lesion looks atypical and the clinician in comfortable doing a skin biopsy, it is biopsied on the spot. The alternative is referring the patient away. This may take 6 to 8 weeks before another evaluation. In the case of melanoma, this puts the patient as increased risk.”

Dr. Richard Reece is author of Obama, Doctors, and Health Reform (IUniverse, 2009) and Innovation-Driven Health Care (Jones and Bartlett, 2007) Both books are available at www.iuniverse,, barnesand, and other book websites . The Innovation-Driven Health Care Book contains a section on the National Procedures Institute.

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