What Good Is A Broke Doctor?

Screen Shot 2015-02-22 at 1.45.24 PMI was invited a few years back to give a talk on vaccine management. The audience was mainly adult doctors from various specialties. My assignment was to pull back the curtain on how our pediatric practice managed vaccines.

In preparation for the talk I spoke to several family practice and internal med practice managers to understand what were the obstacles that steered their practices away from giving vaccines.

The practice managers I spoke with said that the time, risk, cost and poor return on their investment made it difficult to justify carrying vaccines. It wasn’t worth it to them.

With that information, I structured my presentation with the message that “vaccines are good for patients and good for business.”

One of the sponsors of the event was a vaccine manufacture and a representative from the vaccine company was present during my talk. I received word afterwards that the sponsors did not like my “…vaccines can be good for business” tone and I should tone it down in that regard.

Let me get this straight, I said to the messenger, a pharmaceutical company, which makes billions of money ON VACCINES, is telling me that I can’t talk about making money with vaccines? The messenger said, yes. They want you to focus on storage, logging refrigerator temperatures, proper vaccine handling, etc.

A few weeks later, the issue of profitability centered around the flu vaccine came up in a discussion. I shared with the group that the flu vaccine is profitable for our practice. Not huge margins, but certainly not a loss.

A primary care physician announced to the group, that we ought to be careful what we disclose because insurance companies may find out. The gentleman was implying that this profitability “revelation”may be harmful to physicians in the form of lower payments.

I find these two incidents disconcerting. This implicit taboo-like mentality that shuns people away from discussing healthcare is a business (thus profitability needs to exist) needs challenging. Talking about cost, revenue, margins should not be kept quite or even discussed discretely. On the contrary. We need to make people aware.

Besides doctors, who in healthcare does not embrace profitability? Pharma? EMR vendors? Malpractice attorneys? What about Welch Allen or McKesson? BCBS? United Health Care?

I believe private medical providers have an obligation to be profitable. Profitability allows us to buy the best technology, hire the best doctors, nurses, staff, buy the best equipment so that we can offer the best pediatric care. Does the grocery store apologize for making a profit by fulfilling a biological need? No. Of course not. Then why should doctors?

Simply put, we can’t help people in need, if our practices are in need ($$) too. Profitability allows us to continue providing healthcare services.

Here is a challenge. Let’s talk openly, candidly and honestly about making a profit. Our livelihood depends on it.



  1. Deal! No Money, No Mission.

    You make such good points, Brandon. Everyone is allowed to make money OFF doctors, but doctors are not to make money. What’s wrong with this picture?


    • Mary,

      We like to say, No Margin, No Mission. In fact, the no margin, no mission mantra is a core company value. It is so important to us that we embed it into our company culture.

      Appreciate the comment.