Adding cosmetic procedures lifts internists sagging incomes

A few years ago, Bill J. Johnson, ACP Member, was spending most of his day treating patients for hypertension, diabetes and other chronic ailments. But while he enjoyed his work, his income had stagnated amid tightening insurance reimbursements. That’s when he began to think about adding aesthetic procedures to his menu of services.

Dr. Johnson took the leap in 2005, starting by offering botulinum toxin injections and then dermal filler injections at his office in Grapevine, Texas, a Dallas suburb. Patients responded so well that he’s added more procedures and opened a second office, called Innovations MedSpa, devoted strictly to aesthetic medicine. In all, he’s invested about $600,000 for 11 pieces of equipment, but his aesthetics business is free of insurance hassles. Income is up “several fold.”

“When we first got into it, it was for the revenue, but it’s turned out to be very gratifying,” said Dr. Johnson. “Patients are very pleased with the results. I get more thank-yous and more positive patient feedback than I do from my internal medicine practice. No one ever thanks you for controlling their blood sugar or prescribing a cholesterol drug.”

“Fifty percent of our symposium attendees are internists,” said Jeff Russell, executive director for the International Association for Physicians in Aesthetic Medicine (IAPAM), an organization based in Las Vegas that offers support and training programs to doctors looking at adding aesthetic procedures to their practice.

“They are doing it because reimbursements are decreasing, along with working longer hours,” said Mr. Russell. “They are looking for a better quality of life, where they are actually paid.”

Investment pays off

Traditionally, dermatologists and plastic surgeons were the go-to specialists for wrinkles, unwanted hair or unsightly leg veins, said Mr. Russell. But internists, ob/gyns and even neurologists, urologists and cardiologists are moving into the business, often as part of their traditional practice.

With the potential to make $20,000 to $30,000 in profit a month on aesthetic services, “It’s quite lucrative,” Mr. Russell said, even taking into account the initial investment of upwards of $250,000, depending on what equipment is purchased.

“We had one doctor from Washington state who said she was forced to add aesthetic medicine because she was running a $10,000-a-month deficit treating sick people. Otherwise, she would have to lock the door,” Mr. Russell said. “Doctors figure that their patients trust them, that they’re going elsewhere for the procedures anyway, so why not have them done here.” read more