Make or Buy

Jane Rubin, M.D., is a general practitioner whose offices are located in the Lake Forest Professional Building. In the past, Dr. Rubin has operated her practice with a nurse, a receptionist/secretary, and a part-time bookkeeper. Dr. Rubin, like many small-town physicians, has billed her patients and their insurance companies from her own office. The part-time bookkeeper, who works 15 hours per week, is employed exclusively for this purpose.

North Avenue Physician's Service Center has offered to take over all of Dr. Rubin's billings and collections for an annual fee of $24,000. If Dr. Rubin accepts this offer, she will no longer need the bookkeeper. The bookkeeper's wages and fringe benefits amount to $20 per hour, and the bookkeeper works 50 weeks per year. With all the billings and collections done elsewhere, Dr. Rubin will have three additional hours available per week to see patients. She sees an average of four patients per hour at an average fee of $30 per visit. Dr. Rubin's practice is expanding, and new patients often have to wait several weeks for an appointment. She has resisted expanding her office hours or working more than 50 weeks per year. Finally, if Dr. Rubin signs on with the center, she will no longer need to rent a records storage facility for $200 per month.

Conduct a relevant cost analysis to determine if it is profitable to outsource the bookkeeping.

• Calculate the net advantage (disadvantage)of outsourcing the bookkeeping.