From American College of Obstetricians and GynecologistsPhiladelphia, Pennsylvania - May, 1999
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Dr. Jeff Levy: "Hi, I'm Jeff Levy, and we're here in Philadelphia, at the ACOG national meeting. We're at the IMET booth - IMET stands for Innovations in Medical Education and Training, and we're an education business. We've had several educational seminars in our booth during the ACOG meeting, and one seminar was with Skip Sands, who is sitting to my right. Skip is the head of the Women's Health Care in Pottstown, Pennsylvania. He's a private practitioner, and he's been working on some fairly innovative programs in his office setting. He's has recently started an osteoporosis center in his office, and I'd like Skip to tell us a little bit about that."
Dr. Skip Sands: "Jeff, it's an interesting process in that osteoporosis is going to become a very, very important prospect or problem associated with a menopausal woman. It's expected that probably 13-18% of all post-menopausal women presently have osteoporosis. Obviously as the aging population increases, that number is going to increase dramatically, and we need to be able to take care of those patients because we're the ones who see those patients. It's far more convenient for the elderly population to come to one physician than it is to go to a physician then have to go to another physician, and then have to go to another institution like a hospital or a radiology center. They're very uncomfortable with that, and that develops a lot of problems associated with travel and transportation. So we needed to go through an evaluation specifically in our own practice to see whether it was financially feasible to develop an osteoporosis screening center. We went through the steps of evaluating the entire practice just on the number of patients that we had, trying to decide the percentage of patients that would be applicable to being screened, and then simultaneously looking at what their insurance was to see whether or not there would be an adequate reimbursement to cover the costs. What we found out was not only would there be more than adequate coverage but that it would actually turn out to be a profit center. This was not something that was not needed, it was just something that should be done, and if done correctly would obviously add to the profit center of the practice, which was what we were looking for."
Dr. Jeff Levy: "Skip, what types of things do you include in your osteoporosis center?"
Dr. Skip Sands: "Obviously we have a screening facility so we have equipment to do bone densitometry. We also have significant nutritional counseling and also exercise programs so that patients can work on the full aspects of treating their osteoporosis. We're not dealing with just the idea of developing a profit center, we're looking at the total care of this post-menopausal population."
Dr. Jeff Levy: "If you had one pearl to give private practice physicians about how to start an osteoporosis center, what would you say?"
Dr. Skip Sands: "Crash the numbers - I mean it's very, very important for you to know what your reimbursements are going to be and simultaneously to know what the volume in your patient population will be. It's a simple thing to do, we did our own analysis, and then what we did was we actually kept a record of every patient we saw for a month that we thought would be applicable. We realized shortly after the first week that we had more than enough patients to make this thing profitable, and the last three weeks were just confirmatory. So I would say to you - do your homework, and it will work."
Dr. Jeff Levy: "Do you have any specific machine - densitometry machine - that you would suggest?"
Dr. Skip Sands: "The argument always exists between whether or not a peripheral machine is adequate or you need a central piece of equipment. We opted for a central piece of equipment which was able to do peripheral scans also. I would tell you that it has to do more so with volume than it did with the issue of one machine being actually better. We also are involved in a few pharmaceutical studies, we really did need a central machine, so it was important for us to do that. But if your practice is small and you don't have a significant volume, there's less of a cash outlay for the peripheral machines, and they will get you started. They will also help the patient population because in a lot of places central machines just are not available."
Dr. Jeff Levy: "Thank you very much, Skip, we appreciate the interview."