Sunday, March 27, 2011

Ancillary Income



Economic times are tough all around and the practice of Surgery is no exception. Falling reimbursement and a large population of uninsured patients make it difficult to make ends meet. In the true American spirit of entrepreneurship I’ve decided to expand my business. Of course, saving lives and stamping out disease will remain the primary focus of my practice, but it’s time for me and for my partners, Coastal Surgical Group, to look for new revenue streams.



Let’s start with something obvious, but, nevertheless, important and in great demand. Recent years have seen an explosion in the area of Bariatric Surgery, that is, weight loss surgery. The most popular, because it’s a quick and safe operation, is the adjustable gastric band. This simple device is wrapped around the upper stomach and then inflated to constrict that part of the stomach and create small pouch with a narrow opening. The patient feels full after consuming a very small amount and, over time, loses weight. This surgery is unique because the band is adjustable. A small fluid filled reservoir that sits just beneath the skin allows the band to be inflated or deflated, thus allowing more or less food to pass.



Currently bands are adjusted in accordance with the patient’s ability to eat or symptoms that may develop if the band is too tight. However, I think there is a huge market to attend to those individuals that desire the band to be deflated for specific events. For instance, if portly Uncle Jack is going to his niece’s wedding, shouldn’t he be allowed to enjoy the large buffet, featuring all the lobster and prime rib he can eat? And, what about the open bar? What about poor Sadie, who has already lost 20 of her 400 lbs? Shouldn’t she be rewarded with a night out at the “Golden Corral”? Thousands of our largest citizens are suffering under the torture of these devices. At $200 a pop, a huge market exists for the canny individual that seizes this opportunity.



Another new source of income could come from office souvenir shops. If you go to Disney World or Universal Studios or even your local art museum, the last part of the visit features a mandatory walk through the “Gift Shop”. Shouldn’t a postoperative visit include a similar venue? After all, undergoing surgery can be quite a ride and a souvenir of the journey certainly should be offered. Coffee cups featuring the Coastal Surgical logo, pens with blood red ink or gallbladder shaped wine glasses are only a few of the items that could be offered for sale. Plush stuffed organs such as liver, pancreas or spleen would undoubtedly be hot sellers. Samples of actual organs, salvaged from real operations could be offered as collector’s items, much in the way sea shells or various geologic wonders are sold now. Who wouldn’t want the complete endocrine system, freeze dried and mounted for display on the living room or dining room wall.



Of course, post cards featuring images from actual surgeries would be available. And the usual coffee table tome, designed to impress the boss’s wife would be on sale. “Colons and Hemorrhoids I Have Known: a Pictorial History of Coastal Surgical Groupis already in pre-production.



Beyond such souvenirs, extra income could be proffered from selling advertising space on the backs of scrub suits and/or white coats. Currently, I wear embroidered scrubs that feature my name and Coastal Surgical Group above the shirt pocket. There is plenty of space on the right side of the shirt and on the back to add announcements or logos.



“Miranda’s Massage”, if tastefully designed could be worn on Mondays; “Joe’s Diner” Tuesday and so on. I envision seven separate sponsors, one for each day of the week. There would have to be some discernment, however. “Evan’s Slaughterhouse” would probably not be appropriate, unless the price was right.



Finally, the most lucrative untapped market is in the area of internal tattoos. Think about it; how many people do you know that have said “I always wanted a tattoo, but I really wouldn’t want to display it or it’s too painful or I’m afraid of needles. The obvious solution? Why, internal tattoos, inscribed on the stomach or liver or elsewhere. The bearer would have the quiet satisfaction of knowing he had a tattoo, just like his friends, without any embarrassment should he meet that special someone years later and her name happened to be Lucy, not Sheila. Sheila would be safely tucked away inside on his stomach, instead of prominently displayed on his shoulder and Lucy need not ever know.



A few cautions however. For the man who tattoos a naked image of his sweetheart on his stomach; that svelte 36-24-36 figure would take on new dimensions after a very large meal when the stomach is stretched to massive proportions. General anesthesia would be necessary, but the latest minimally invasive techniques would be employed with minimal discomfort and no down time. I daresay that these internal tattoos would be less painful than their traditional cutaneous cousins.



But, the wearer wouldn’t be able to see it, you object. No worry. Everyone that purchases an internal tattoo would receive a portfolio featuring his or her tattoo and, as a bonus, surrounding organs in 4x6, 5x7, 20 wallet sized and a 16x20 suitable for framing. Additional packages would be available.



Unprofessional you say, not dignified? These are difficult times for health care with no relief in sight. These few suggestions are fully in keeping with the American free market system. So, stop by Coastal Surgical Group, get your hemorrhoids checked and pick up a souvenir mug on your way out.