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Practice Builders

Elevating Patient Care And Ancillary Revenue With Online Product Fulfillment

Running a practice has many challenges. In a perfect world, our patients would be our only focus. However, as we know, there are many other issues vying for our attention. As if the day-to-day realities of managing staff and keeping a practice running were not challenging enough, there are factors that can actually set it back. These factors include rising overhead costs, shrinking insurance reimbursements and dwindling revenue.

   If you find yourself spending more time looking for ways to cut costs and less time reinvesting in your practice and your people, it might be time to consider a solution you may have previously avoided: ancillary income.

   Many of us have already dabbled in it, offering a few small retail items in the office and taking in a few dollars here and there. While patients definitely appreciate the convenience factor, it is easy to understand why a practice might resist expanding its retail offerings. On the face of it, the pros of ancillary income seem to be outweighed by the cons.

Exploring Potential Concerns And Issues

First, there is the space factor. Chances are you are already utilizing every square foot of your office. Do you really have the extra storage room you would need to showcase or warehouse the products you prescribe on a weekly basis?

   Second, do you really want to ask your office staff to switch back and forth between their current duties to managing inventory and processing orders? If it does not spark a full-scale rebellion, it could certainly lead to a lot of grumbling.

   Third, and perhaps most important, is the trust issue. As the media helps your patients become more aware of the nexus between business and medicine, it is even more important to avoid even the appearance of impropriety. No physician wants to be seen as profiting from prescriptions.

   All these arguments come down to a key question: How can ancillary income help my practice without hurting it?

   The good news is there are solutions that address all of the practical concerns of ancillary income and even help improve the level of care you provide to your individual patients. Let us look at some of the tools at your disposal.

A Closer Look At Online Resources

It should come as no surprise that the Internet has answered many of the concerns about ancillary income. Companies like, and have drastically changed the way we shop. In fact, it is hard to think of a purchase you cannot make online.

   There are specialty online retailers that cater to the needs of patients with foot and ankle conditions. Sites like offer more products than any practice could ever keep in stock on site. In fact, the selection is so vast, it is almost an impediment. But perhaps more important to our discussion, these sites don’t create a mechanism for a physician to generate income.

   To address that concern, there are sites that allow a physician to set up a virtual storefront. was one of the first resources to introduce this functionality. A patient could be directed to the site, written prescription in hand, and order a specific item from the practice’s online store. The physician realizes income in the form of a payment equaling the difference between the wholesale cost and retail price for any specific item.

   On the plus side, this solution allows the physician to have some measure of control over the patient’s purchase decision, and provides the physician an opportunity to see ancillary income should that purchase be made from the virtual storefront. Order fulfillment, including payment processing, inventory control and shipping, is also handled off-site.

   On the minus side, however, virtual storefront sites tend to carry products for the full spectrum of medical conditions, which can be overwhelming for the patient who is being treated for a specific foot and ankle condition. Further, these sites lack informational resources to help the patient better understand his or her condition nor do they afford two-way communication between the patient and physician.

   While a typical virtual storefront site helps answer the inventory, fulfillment and income questions, considering the advantages of the Internet, there is tremendous potential to do much more. is an online resource that takes to heart all the concerns physicians have about ancillary income and turns them into positives for both the practice and the patient. This site was created by foot and ankle specialists. (Full disclosure: I’m one of the founders of the Web site.)

   While there is some overlap in functionality between and some other sites I have mentioned here, this site was specifically designed to improve the patient-physician communication and keep the conversation going long after the visit and far beyond the office.

   The consumer-facing FootSourceMD. com makes shopping simple and intuitive. It is searchable by product and condition, and gives the user access to educational resources such as articles, videos and FAQs. The physician-facing component of is built around a dashboard, which allows the physician to create a profile for each patient. The physician can subsequently build a list of products best suited to that patient’s condition and e-mail the product recommendations directly to the patient.

   With a customized retail prescription in the patient’s e-mail inbox, he or she can simply click through to the product recommended by the physician, guaranteeing the patient will choose the right product. effectively eliminates the confusion that crops up when patients choose a product they assume is an equivalent to the one prescribed and it ensures the physician can give the best possible advice to the patient.

Final Notes

Every time you write a prescription or recommendation, you are sending dollars out the door. Now with emerging online resources, it is entirely within your means to keep some of that revenue in your office while giving patients a way to fill their prescriptions precisely as written. In the end, it is up to you and your practice to weigh the value and necessity of ancillary income. However, it is good to know there are powerful tools out there to boost your bottom line and help you and your practice deliver an even higher level of patient care.

   Dr. Hyer is a board-certified foot and ankle surgeon in Columbus, Ohio. He and his colleagues founded to provide patients across the country with convenient access to reliable resources and products recommended by physicians. Dr. Hyer also contributes to medical education and research through frequent presentations and publications. He also serves on the editorial boards of the Journal of Foot and Ankle Surgery and Foot and Ankle Specialist.

Practice Builders
Christopher F. Hyer, DPM, FACFAS
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