Are you an orthopedic surgeon wondering how to balance patient insurance and cash-based payments? Do you feel like your patient base is too reliant on insurance, making it difficult to introduce cash-only procedures? Or maybe you’ve encountered the common belief that patients won’t pay out-of-pocket for high-quality treatments like orthobiologics?
In this podcast, I tackle some of the most common questions orthopedic surgeons have about cash-based medical practices and patient insurance. One of the most frequent concerns I hear from surgeons is what to do when patients insist on using insurance for everything? It’s a valid question, but I want to help you break through the misconceptions that might be holding you back from offering valuable, cash-only treatments.
The conversation often starts with doctors telling me how different their patient base is. Some say they’re in a rural area, or that their patients are on Medicare and won’t be able to afford procedures that aren’t covered by insurance. I get it—those concerns are valid. But let me tell you this: I’ve worked with doctors across the U.S. and Canada, from rural upstate New York to metropolitan areas, and the results are often the same. Surgeons like Dr. Marc Pietropaoli in a small New York town are successfully charging $15,000 to $20,000 per procedure. Others, like Dr. Joshua Schachter in Wichita Falls, Texas, are doing the same. So, when surgeons tell me their situation is different, I challenge that idea—because we’ve seen time and time again that cash-based practices work, even in markets that seem challenging.
The key to success in cash-based healthcare lies in understanding your patients' true needs. Many doctors believe that patients, especially those over 60, won’t pay out-of-pocket. But here's the reality: Patients 60 and older are willing to spend four times more on treatments than younger patients. Those over 70? They’re willing to spend even more. They’re tired of being bounced around from appointment to appointment, dealing with endless referrals and waiting for approvals that never come. What they truly want is a solution—a direct, effective treatment that doesn’t involve dealing with insurance.
So, how do you, as an orthopedic surgeon, market your medical practice to appeal to these patients? First, you need to make the offer to every patient who walks through your door. It doesn’t matter if they’ve declined it before—keep presenting them with the option of orthobiologics or cash-only procedures. Most patients are not saying they want everything covered by insurance—they’re frustrated with the insurance system itself. They want a one-stop solution, a procedure that works without the insurance hassle.
Here’s the catch: If you’re underpricing your services, your patients might not trust the efficacy of the treatment. Think about it. If you charge only $750 for an orthobiologics procedure, patients are going to doubt its effectiveness. But when you charge $1,500, $2,500, or even $10,000, you’re communicating the value and the quality of the care you provide. And trust me, patients will pay for it, as long as they believe it will work.
When we work with doctors, we dig into their patient databases—not looking at sensitive medical details, but focusing on key factors like age and location. What we consistently find is that older patients, especially those 60-plus, are the best buyers of orthobiologics. These patients value their time and their health, and they’re willing to pay for a solution that doesn’t involve jumping through insurance hoops. And with cash-based practices, you’re giving them exactly what they want: a direct, effective option that works.
If you’re still unsure about how to start a cash-only medical practice, it all begins with patient education. Use tools like videos to explain the benefits of orthobiologics before you even step into the room. This approach not only cuts down on consultation time but also primes your patients to be more receptive to cash-based treatment options. When they see the value before you even begin discussing it, they’re far more likely to agree to the procedure.
By shifting your mindset and offering cash-based treatments to every patient, you create an environment where they have to say yes. This approach has worked time and again, with many of my clients earning between $200,000 and $300,000 a month, consistently.
So, if you’re still thinking your patient base is too different, or that they won’t pay for cash-based healthcare, let me assure you: They will. The key is in how you present the option and the confidence you have in your procedures. Patients are looking for solutions, and they’re willing to pay for them if you offer the right treatment at the right price.
To learn more about how to implement these strategies and grow your cash-based practice, watch the full video where I dive deeper into how to market your medical practice, set up patient education, and successfully charge self-pay patients. Trust me, it’s time to rethink how you’re approaching your practice—your patients, and your bottom line, will thank you for it.