It's the last week of the month in a two-doctor skin clinic. One dermatologist spends the day on clinical consults: acne, eczema, hair fall, follow-ups. The other runs the procedure room: peels, lasers, hair and skin procedures. Then someone asks how much each doctor brought in, and the conversation turns awkward.
The consulting doctor saw the patient first, diagnosed the pigmentation and suggested the laser course. The procedure doctor did every session. The package was paid in full on the day of the consult, so the whole amount sits in the consulting doctor's month. The procedure doctor's month shows four sessions delivered and almost no money against them. Neither number is fair, and both doctors know it.
Why the split goes wrong
Most skin clinic bills are built to collect money, not to explain who earned it. A bill records a total, a payment mode and maybe a doctor's name at the top. That name is usually whoever opened the bill, so it says nothing about who actually performed each line.
Three things make it worse in a dermatology practice:
- Two roles on one patient. The doctor who recommends a procedure and the doctor who performs it are often different people. A bill with one doctor field can't hold both.
- Packages are paid before the work is done. A six-session course paid on day one puts months of future work into one day's takings. If you credit revenue when cash arrives, the seller looks brilliant and the performer looks idle.
- Mixed lines. Consultation, clinical procedure, aesthetic procedure and product lines sit on the same bill, and each one raises a different question about who gets the credit.
None of this is a software problem first. It's a recording problem. If the information isn't captured on the line when the work happens, no month-end report can rebuild it later.
What to record on every bill line
A fair doctor-wise report needs a few fields on every line, not on every bill. Here is the minimum:
- Line type: consultation, clinical procedure, aesthetic procedure, product, package sale, or package session.
- Recommending doctor: who advised the procedure or prescribed the product.
- Performing doctor: who actually did the work. For a consultation, it's the same person.
- Date performed: the day the work was done, which isn't always the day it was paid for.
- Net amount: after any discount, before tax, so you aren't splitting tax between doctors.
- Package reference and session number: for example, session four of a six-session Q-switch laser course.
Keeping amounts net of tax matters because consultation, procedure and product lines can be taxed differently. Report doctor revenue before tax, and confirm the treatment of each line type with your CA rather than guessing. We cover how to keep those lines separate in billing consultation, procedure and product lines.
Packages: count the session, not the sale
The single rule that fixes most arguments is this: package revenue is earned when a session is done, not when the package is sold. Until then, it's money the clinic is holding for work it still owes.
For example, suppose a patient buys a six-session laser package for ₹30,000 in March on the consulting doctor's advice. In this example, each session is worth ₹5,000 of earned revenue, and the procedure doctor delivers two sessions in April, two in May and two in June. Under a cash view, March shows ₹30,000 against the consulting doctor and the next three months show nothing; under a session view, the procedure doctor is credited ₹10,000 in each of April, May and June in this example, and March shows a package sold with nothing yet earned.
Discounts follow the same logic. Suppose the same package was discounted from ₹36,000 to ₹30,000 in this example; spread the discount evenly across the six sessions so each delivered session carries its share, rather than loading it all onto the first or last one. The sessions still owed at month end are your prepaid balance, and it's worth checking on its own; see why prepaid sessions are a liability.
What about the consulting doctor who sold it? Give them credit, but in a separate column. Count packages advised and package value sold, so their contribution is visible without double-counting the money.
Agree the rules before the first report
Write these down and get both doctors to agree before anyone sees a number. Changing the rules after a report has come out always looks like changing them to suit someone.
- Procedures are credited to the performing doctor. Recommending doctors get a referral count, not a share of the money, unless your partnership agreement says otherwise.
- Products are credited to the prescribing doctor, or to the clinic. Pick one. Many partners prefer to keep product revenue as clinic revenue so nobody is tempted to push products.
- Package sessions are credited at the per-session value on the date performed.
- Expired unused sessions go to the clinic, not to a doctor. Nobody performed them.
- Refunds and voids reverse in the month they happen, against whichever doctor had the original credit for delivered sessions; undelivered sessions never had a doctor attached.
The monthly report layout
Keep it to one page. One row per doctor, with these columns:
- Consultations: count and net value
- Clinical procedures performed: count and net value
- Aesthetic procedures performed, outside packages: count and net value
- Package sessions delivered: count and earned value
- Products: net value, if credited to doctors
- Referral column: procedures and packages advised, by count and value sold
- Total earned revenue
Below the doctor rows, add a short clinic block: package sales this month, package sessions delivered this month, expired sessions, refunds and voids, and the prepaid balance still owed at month end. This block is how you check the report against the bank. Cash collected won't match earned revenue in any month you sell packages, and that's expected; the prepaid balance explains the gap.
Running it without software
A spreadsheet works if the discipline holds. Make one row per bill line with the fields above, filled in by the front desk at billing, not reconstructed on the thirtieth. At day end, check that every procedure line has a performing doctor and every package session has a package reference and session number. At month end, filter by performing doctor and line type, and build the one-page table from a pivot.
The weak point is package sessions. A session done on a busy Saturday and never deducted vanishes from the procedure doctor's month and inflates the prepaid balance. The day-end routine in tracking the sessions owed on a package is the habit that keeps this column honest.
A system helps by recording these fields at the moment the work is done. In MyCliniCore, a treatment package is sold as a course, sessions are deducted during the consultation by the doctor seeing the patient, and the prepaid sessions still owed are shown on a dashboard tile and in a report, alongside invoices and the rest of the clinic's reports. You can see the full list on the features page.
A fair report changes the conversation
Once both doctors trust how the number is built, the month-end conversation moves from who deserves what to what the clinic should do next: whether the procedure room needs another slot, whether consults are feeding enough packages, whether too many sessions are expiring unused. That's a far better use of the last week of the month.
If you run a skin or dermatology clinic and want packages, sessions and doctor-wise reports set up properly from day one, MyCliniCore is in early access for skin clinics, priced per doctor, and the team sets it up with you. Tell us about your clinic.