Business of Medicine

By Steve Barrett
Tuesday, November 12, 2019

Plucking the Low-Hanging Fruit of Energy Savings

Reducing energy costs in a medical office needn’t require staff and patients to dress like Manitoban road crews in February.

In fact, some simple approaches help the bottom line and make for a more comfortable place to give and receive care, according to energy management services firm Direct Energy Business.

Start with an office self-exam and an external audit of energy use, the company advises. Focus conservation on whatever area — natural gas or electricity — has higher costs.

Use power strips that shut off electricity automatically during prolonged periods when microwaves, computers and other equipment are not in use.

Cut lighting costs up to 75% using LEDs in lieu of incandescent bulbs — a process that can also make the office more pleasant and productive through enhanced illumination. Optimize those savings by, yes, turning off lights when no one is using them.

Improve climate comfort by having HVAC checks performed semiannually.

Cash-Pay Discounts: Proceed With Caution

Newly minted physicians seeking patients may be more tempted than other providers to offer deep discounts to patients who pay cash, according to a post at, a website run by two ophthalmologists that focuses on solo practice physicians.

Think twice, the bloggers urge.

In the first place, physicians typically must bill insurance if a patient has coverage. And patients who pay cash because they are getting a discount may retroactively ask physicians to bill insurance if their medical costs wind up surpassing their deductibles, but the filing deadline could have passed by then.

Second, being perceived as a bargain provider may attract patients who are not particularly focused on your abilities and the courses of treatment you prescribe.

And third, if your cash-pay rate is lower than the highest amount insurance allows, you risk the insurer demanding rates similar to the reduced prices you charge cash-pay patients.

Leaving Behind Pricey Leave Policies

Any attempt to address unproductive or costly policies on sick leave, vacation pay and the like can seem crass.

But reining in policies that may, for example, pay a resigning employee for as much as a year of unused vacation is essential, according to an article in FPM, the journal of the American Academy of Family Physicians.

FPM recommends the following steps to reduce leave costs:

  • Allow carryover of unused sick leave to future years against the possibility an employee will face a long-term illness, but do not pay employees for not using sick leave.
  • Permit the conversion of some unused sick leave to vacation days.
  • Limit carryover of vacation days, especially if employees are paid for accrued vacation upon termination. This also has the benefit of encouraging staff to take needed time off.