Weighing The Pros And Cons Of Podiatry Supergroups

Lowell Weil, Jr., DPM, FACFAS, MBA

   When an organization is large enough, a call center becomes a beneficial necessity. Instead of your front desk person checking in two patients and trying to book an appointment for the new patient calling on the phone, a call center has dedicated people talking to the new patient. Usually, the first contact a patient has with a medical office is a phone call and if the person answering the phone is not competent, distracted and/or multitasking, the result can be a poor experience for the prospective new patient, who may then decide to go elsewhere. With a call center, the people answering the calls have training on proper telephone technique and can not only make the call a better experience but can extract important information such as insurance information, e-mail address and other things. This will make the initial visit more seamless and give the practice the upfront information necessary to be more efficient.

Why Larger Practices Have Greater Purchasing And Negotiating Power

Economies of scale also manifest through purchasing and negotiating power. When purchasing office supplies, durable medical equipment (DME) and orthotics, pricing can definitively improve when there is a larger account. Furthermore, it is not uncommon for larger groups to negotiate improved malpractice rates that can save 10 to 40 percent on premiums in comparison with the sole practitioner. As health insurance costs continue to rise, small businesses allot a huge amount of money toward this. However, in a larger group, real savings can occur in health insurance rates. Other aspects of negotiating power can be evident in profit sharing plans, electronic medical records (EMR) and digital radiography purchases.

   For a supergroup to be truly successful, ancillary revenue needs to be something that a practice creates and nurtures. The overall benefits of an ancillary revenue program are what supergroups are based upon. Some key ancillaries that podiatry supergroups can establish are magnetic resonance imaging (MRI), computed tomography (CT), physical therapy services, bone growth stimulators and pathology labs. Legal provisions are in place to provide these services lawfully within a podiatry practice.

   These are necessary services that patients need on a daily basis and most would prefer receiving these services within the podiatry practice. Patients prefer “one-stop shopping” where they can get all of their foot and ankle care. Patients are continually thankful for the ability to get an MRI right at the time of their doctor’s recommendation to avoid having to set up a visit to the hospital or MRI facility.

   Technology has advanced to such a degree that MRI studies have excellent diagnostic benefits that are actually more cost-effective than an MRI machine owned by the hospital. Patients and insurance companies appreciate upward of 50 percent savings by having an in-office MRI while the podiatry practice can realize significant profits by offering these medically necessary studies. Similar alternatives are available with in-office CT scanners.

   Providing physical therapy services is a common success story with supergroups. There are a number of ways to set up physical therapy within a practice by employing therapists, having a PT group rent space and provide the services within the office. There are other legal, creative ways that physical therapy consulting groups are now establishing themselves around the country. Once again, patients would rather stay within the confines of their physician’s practice to receive the comprehensive care they need and desire.

   Bone growth stimulators can be a source of revenue for supergroups. Practices can purchase the devices in quantity from the bone growth stimulator manufacturers, dispense the stimulators and bill for them.

   Supergroups make these types of capital expenditures more realistic. First, the cost of these ancillaries is often prohibitive to the individual or small practice. However, when a large group absorbs those costs, it is not so daunting. Furthermore, financing is much easier to attain in a supergroup with favorable interest rates and no personal guarantees needed. The return on investment is also more realistic when there are enough physicians involved to refer these ancillary services.


I really appreciated this wonderful info and guide to work better as group or working with partners-friends in Mexico.

Have a good day! Thanks again.


Alberto Rivera, MD

One of the perks about working in a multispecialty supergroup medical clinic (of more than 10 physicians) is that if you represent podiatry as a minority in a sea of many MDs, MBBSs, and DOs, it is inevitable how much you, as a BE/BQ/BC licensed podiatrist, have to educate the BE/BQ/BC licensed allopathic and osteopathic physicians about your profession. I myself have the unique experience of doing this. It is the best part of my job!

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