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We asked a number of doctors around the country whether they are adding procedures, therapies or equipment to their practices this year, and how those plans are being impacted by economic conditions. While some dermatologists are being cautious, others are actually using the economic challenges to plan for the future of their businesses.
There have been signs of recovery, however: slight variations in employment levels, increased home sales and promises of increased availability of money for business loans. On Call wondered how dermatologists were reacting to the economy in making plans for their practices for the coming year.
"I would like to be able to provide the best opportunities for my patients. As it is, if I don't have a device I think someone needs, I will refer them to another practitioner," he says.
Having opened a practice shortly before the economy went into its slump, Dr. Greenberg says that this year, he is looking to "maximize what I already have, rather than putting out more dollars."
To do that, he says he plans to offer a cosmeceutical line and sell more products.
"That will take no major capital investment. People ask for different cosmeceuticals and medications, so we got our dispensing license and will be able to provide for our patients' needs," he says.
Economically, Las Vegas is one of the hardest-hit areas of the country, with the highest home foreclosure rate in the United States, according to Dr. Greenberg, clinical assistant professor, University of Nevada. That's one reason he's holding off on expanding his armamentarium of lasers.
"I have a hair removal laser and a pulsed dye laser, and hope to drive more business to those. If the economy were to turn around, I would like to get a CO2 laser. And because I do a lot with psoriasis, I would love to add a narrow-band, UVB light source, but that's $20,000," he says.
More than the economy
"With the uncertainty about the future of medicine, you wonder whether you need to diversify. We do a lot of dermatologic surgery, so it would be fairly easy to incorporate procedures like blepharoplasty and lifts - we already have the gear to do those things. Fillers and Botox are also easy to add, but right now, I'm so busy that I don't know where we would find the time to do that," Dr. Lewis says.
An associate professor at Tulane University, Dr. Lewis says he thinks the current economy actually encourages the addition of new procedures.
"If you diversify your practice, you won't be so pigeonholed, so that if one thing goes down - say the reimbursement of Mohs continues to drop - the whole clinic doesn't go down," he says.