Specialty practices, especially those that are independent, are boxed in by flat reimbursement and are often guided toward increasing patient volumes to relieve their margins.
John Garner, CEO of Southwest Ohio ENT Specialists in Dayton, is testing a different lever by capturing revenue from services patients already need but currently get somewhere else.
He told Becker’s that the strategy borrows a concept from his years in hospital business development: same-store growth, or generating more revenue from an existing patient base rather than adding locations or square footage.
The independent ENT group sees roughly 10,000 patient visits a month, Mr. Garner said, with physicians already seeing about 50 patients a day, but it hadn’t systematically applied that lens to its own operations until recently.
“I got some of the physicians together and said, let’s sit down and look at what same-store growth looks like, because we’re kind of pigeonholed with our spaces and the rising costs,” Mr. Garner said. “Are we maximizing our ability to treat patients for the needs they have and capture the revenue associated with it?”
One example Mr. Garner pointed to: patients referred for sleep apnea surgery who don’t qualify because of their weight.
“We’re sending people out for sleep apnea because we do a lot of surgical procedures for sleep apnea, but they come in with a BMI of 40. That’s too high for surgery, so we turf them back out and say go lose weight,” Mr. Garner said. “So we’re saying, well, what if we just manage them on GLP-1s and try to capture that revenue?”
The same logic extends beyond sleep apnea, Mr. Garner said. The practice is examining biologic treatments and buy-and-build programs for services patients currently seek elsewhere.
“We’re looking at the biologic space. We’re looking at buy-and-build programs, where we can actually capitalize,” Mr. Garner said. “These people are going elsewhere for these services, but they’re seeing us for ENT, for allergies and all these other things. It makes sense for us to try to grow some of these programs.”
For Mr. Garner, the approach reflects a broader shift in how the practice thinks about growth: not simply seeing more patients in the same rooms, but capturing more of the care those patients already need.
The push comes as Southwest Ohio ENT Specialists has already grown into an unusually large independent practice. Mr. Garner said the group is approaching 200 employees, a scale he described as rare for a private practice.
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