By Specialty
Every Specialty Leaks Margin Differently
A GI group loses money in the endoscopy suite. An orthopedic group loses it between the clinic and the ancillaries. A behavioral health practice loses it to no-shows. The method is the same; the places we look are not.
Find Your Specialty
Each page covers how the economics actually work, the specific levers that move margin, the symptoms we hear most often, and how we would approach the work.
Gastroenterology
GI economics are procedural economics. Most of the recoverable margin in a gastroenterology group sits in the endoscopy suite schedule, the ancillary lines attached to it, and the recall engine that keeps the suite full.
Where gastroenterology margin leaksUrology
Urology has one of the richest in-office procedural mixes in medicine, which means the margin question is usually about site of service, ancillary utilization, and whether the office is built to run procedures efficiently.
Where urology margin leaksOrthopedics
Orthopedics carries the widest ancillary footprint in ambulatory medicine — imaging, physical therapy, DME, and often an ASC. Each one is a business with its own utilization curve, and most groups run them as departments rather than as businesses.
Where orthopedics margin leaksDentistry
Dentistry runs on production per chair hour, hygiene reappointment, and case acceptance. When margin thins, one of those three has usually drifted — and drift is almost always invisible on the monthly production report.
Where dentistry margin leaksOrthodontics
Orthodontics is a contract business. Revenue is committed at the consultation and delivered over eighteen to thirty months, which makes conversion rate and appointment efficiency the two numbers that decide the practice's economics.
Where orthodontics margin leaksCardiology
Cardiology margin lives in diagnostics and monitoring. Echo, nuclear, vascular studies, and device monitoring are the contribution lines, and each one depends on utilization, documentation, and an access pathway that gets patients in before they go somewhere else.
Where cardiology margin leaksENT (Otolaryngology)
ENT groups sit on a broad set of in-office service lines — allergy, audiology, imaging, and office-based procedures. Whether those lines contribute or drift is almost entirely a question of workflow and follow-through.
Where ent (otolaryngology) margin leaksPlastic Surgery
An aesthetic practice is a consumer business attached to a surgical one. Consultation conversion, OR utilization, and the economics of the non-surgical menu determine whether strong revenue turns into strong margin.
Where plastic surgery margin leaksMental Health
Behavioral health economics are clinician-hour economics. Utilization, no-show rate, and documentation lag decide the margin, and all three are usually managed by hope rather than by process.
Where mental health margin leaksPrimary Care
Primary care margin is a function of panel size, access, and how well the practice performs on the contracts it has already signed. All three are measurable, and most practices measure none of them.
Where primary care margin leaksNot listed? The method still applies.
Access, capacity, revenue cycle, staffing, and operations are where margin hides in any physician-owned practice. Start with a conversation or run the diagnostic.