Have you ever thought it would be nice to serve families and not have just adding another birth to the monthly delivery list as the only option to bring in more revenue? There are so many wonderful services midwives can do and many are quite profitable when looking at the time and initial costs for implementation.
I have talked with so many midwives that had to stop doing births for medical reasons or family demands. Their first thought were the income will really be hindered from not having the birth charges part of their care. Most midwives don’t realize how much more money comes in for time proportion with primary care and gynecological services. Most of the midwives that transitioned into well women clinics made more money doing this services than obstetrics. Unfortunately, our midwifery services are paid based on RVU (revenue value units) that insurance companies determine our time is “worth.” Labor support, being on call 24/7, and additional time spent during prenatal visits aren’t typically paid any extra compared to a traditional medical system approach of short prenatal visits and coming to catch baby after nurse has done labor support in hospital setting. Gynecological and primary services are an easy service to add into practice to increase the revenue potential. Add a couple extra hours of office time each week to see women for paps, pelvic exam, STD screenings, birth control counseling, menopausal therapy, or breast exams.
Some midwives do the newborn care and some don’t. I strongly encourage midwives to do care within the full scope of their practice. There are so many benefits to having the same philosophy of care for mother and baby first month of life. I have had so many times where mother is given education on breastfeeding and pediatrician gives opposite advice. It creates anxiety, confusion, and poorer quality of care to the family. There is an average of $500 lost revenue purely from not servicing the baby as well as the mother.
Do you have a room that can be rented out a couple days a week when you aren’t there seeing ladies? Starting offering breastfeeding support with a great local lactation consultation (LC). Do a cross referral system in your birth center and get a commission of services rendered with LC. This isn’t adding any extra time to your schedule and women are getting a specialist that can help with those unique breastfeeding challenges within your practice umbrella of care. The same cross referral system can done with almost any business that serves pregnancy and newborns. You could connect with chiropractor, doulas, massage therapists, childbirth educators, physical therapist specializing in pelvic floor, and family practice providers wanting another satellite office to be part of.
You could add a store to your birth center that sells local artworks, remedies, and supportive equipment for women and their families. Anything can be bought on the internet, but think of personalized items and things that women can’t just buy online. If time is of the essence (sore bottom, cracked nipples, and lower milk supply), families are going to want an easy way to access those herbs and tinctures to help with those challenges.
CNMs can add many procedures to their care (first assist, circumcisions, ultrasounds, endometrial biopsies, colposcopies, IUD removal and insertions, nexplanon removal and insertions, diaphragm fittings, pelvic floor therapy, urinary incontinence therapy, and menopausal therapy) as a very lucrative ancillary service for their practices. You can support a niche in the community not being fulfilled and brand yourself as the expert in those services. It won’t be long before your office schedule and bank account are full.