Ear wax removal in general practice: identify, treat and bill in one appointment using iXope

Dr Marcus Fielding is running late. He’s already three patients behind when Yvonne, a 68-year-old with diabetes, walks in complaining of pain and muffled hearing in her left ear.  

Dr Fielding gently inserts his otoscope – but all he sees is a wall of wax.

• No view of the canal. 
• No view of the tympanic membrane. 
  
• No way to confirm what’s going on.

Is it otitis media? Impacted wax causing pressure? Or is Yvonne experiencing the first signs of diabetes-related hearing loss?

It’s probably an infection…should he prescribe antibiotics just in case? Refer her to ENT? Attempt syringing and risk perforation?

None of the options is ideal. Until the wax is removed, there’s no way Dr Fielding can diagnose Yvonne’s problem, let alone treat it. He’ll have to refer to someone who can help.

He explains the situation to Yvonne. “So I’ve got to wait a week, maybe longer, to see someone else – just to get my ears cleaned?” she asks. “And then I’ve got to come back to you to find out what’s wrong?”

Dr Fielding nods apologetically. He knows it’s not ideal.

Ear wax: a bigger problem than it sounds

As a GP, you can probably sympathise with Dr Fielding. Estimates suggest Australian GPs see at least 2 patients per week with impacted ear wax. As it’s impossible to assess for otitis media or investigate possible hearing loss if the drum’s hidden, your first task is to remove the impacted cerumen.  

In primary care, that has usually meant choosing between a referral or syringing. GPs are turning away from syringing as it carries a high complication rate (1 in 1,000) and has, historically, accounted for 1 in 5 medicolegal cases involving GPs. 

Microsuction is seen as the gold standard but, until now, it has required bulky, expensive equipment that doesn’t easily fit the reality of general practice.

Enter iXope

iXope is a compact, handheld digital otoscope with microsuction capability, allowing you to examine and remove cerumen in one visit.

• No more blurry views. 
• No more risky syringing. 
• No more unnecessary referrals and fragmented care.
  

Dr Fielding thinks beyond his current scope

After hearing about iXope from a colleague, Dr Fielding decides to invest. The next time Yvonne walks in with an ear complaint, he:

• Uses iXope to visualise the wax with sharp, magnified imaging
• Gently removes it via in-clinic microsuction
• Captures a post-treatment image of the now-visible eardrum and saves it to her file (if he does refer her for specialist care, this image can accompany the referral letter)
• Bills for micro inspection and toilet of the ear using MBS Item 41647.

With the canal clear, Dr Fielding can now properly assess Yvonne’s ear. He sees classic signs of acute otitis media and prescribes the appropriate treatment, much to Yvonne’s relief. 

Crucially, he also captures a high-resolution image of Yvonne’s ear and saves it to her file for both treatment tracking and medico-legal protection. Then he schedules a follow-up in 5 days where he will repeat the otoscopy and compare imaging with the saved record.

Without iXope, he would have:

• Prescribed blind or potentially missed the infection
• Delayed treatment by referring to ENT or hospital (without an accompanying image of the eardrum)
• Risked patient deterioration or complications
• Missed a billable opportunity for in-clinic ear toilet.
  

Instead, he:

• Treated the cause
• Documented everything
• Billed for an additional service (MBS item 41467)
• Gained patient trust with timely, comprehensive care delivered onsite. 

It’s a much better experience for both patient and professional. 

The business case: microscopic inspection of the ear drum, including ear wax removal with microscution is billable

Microsuction is a service that can be privately billed. Patients are increasingly willing to pay for in-practice solutions that are:

• Quicker
• More convenient
• Less time-consuming than a hospital visit and less costly than a specialist referral.

Ear wax microsuction is billed under MBS Item 41647: 

• Bulk billed: $109 per ear
• Private billing: Up to $165 per case.

Just two ear microsuctions per week at $100 each can bring in over $10,000 per year in retained revenue. That makes quite a difference to Dr Fielding’s practice. 

Factor in iXope’s other capabilities – skin checks, corneal foreign body removal – and it quickly becomes one of the most valuable tools in your clinic.

Plus, it doesn’t have to stay in your clinic. iXope’s small size makes it easily portable. Next time Dr Fielding does his rounds at the local nursing home, he takes iXope with him and is able to provide convenient care for several elderly patients. 

See it, treat it, bill it

With iXope, you can offer gold-standard ear care in your own practice, using a device that fits in your hand and integrates into your existing workflow.

🕒 Total time: under 10 minutes
📷 Documentation: done
💵 Revenue: earned
 😊 Patient: heard and helped.

Order iXope today.

Disclaimer

This information is intended for healthcare professionals.