Your parents always wanted you to be a doctor. So, imagine that you are one, an orthopedic surgeon, in fact, specializing in knee and hip replacements. Life is good. The aging baby boomers will continue to need new knees and hips, assuring that you will always be in demand. Nevertheless, you know that healthcare’s percentage of the gross domestic product cannot keep increasing, and that both the private insurance companies and the public system will surely be tightening up on their compensation for your surgical procedures.

How are you going to cut costs so that your annual income can be maintained? There are not a lot of options. The knee and hip implants themselves are billed separately by the hospital. The surgical instruments that you use are owned by the medical device company that supplies you with your knee and hip implants. You’ve got your surgical team to pay and the staff in your office. There are office expenses and insurance premiums, but your costs are overwhelmingly personnel costs and they aren’t going down.