For Dr. Omar Davis and Dr. Natarsha Grant, business is a matter of life and death. Since 2007, the two have been helping to extend the lives of patients with kidney failure from their facility in Memphis, Tennessee: Interventional Nephrology Specialists Access Center (901-726-1130). And they’ve had no shortage of patients.  As a result, the center generated revenue of $5.5 million in 2009, and Davis and Grant expect to finish 2010 and 2011 with $6 million and $6.5 million in revenues respectively.

The kidneys’ job is to clean the blood. When a person’s kidneys fail, he or she undergoes hemodialysis, a process in which the blood is drawn so it can be cleaned of toxins and then returned to the body through an access point, typically a connection between an artery and a vein called a fistula. As interventional nephrologists, Davis and 42-year-old Grant create and maintain those access points, dealing with challenges such as blockages and blood clots that can impede the dialysis process. A relatively new specialty, interventional nephrologists do the work that general nephrologists or kidney doctors have typically had to refer their patients to outside surgeons to do.

Davis went to the University of Tennessee Health Science Center College of Medicine; Grant studied at the Medical University of South Carolina. “We took an oath to take care of patients,” recalls Davis, 36, who met Grant when both were finishing fellowships in Memphis. But as owners of their own practice, the two doctors have had to learn different skills to ensure its survival.

Because of their training, Davis and Grant caught the attention of Lifeline Vascular Access Inc., a company that provides funding and administrative back office support to interventional nephrology centers. Lifeline Vascular funded the $1.5 million needed to open the center in 2007. Davis and Grant, who each own a 50% stake in the practice, will pay the money back to Lifeline Vascular, over 10 years.

Medical practices have a slew of ongoing challenges. In addition to competitive pressures, Davis and Grant must contend with mandatory malpractice insurance, which costs the practice roughly $10,000 per year, per doctor. And like other medical practices across the country, the nine-employee center must negotiate with health insurers, which determine how much they will pay for procedures in return for physicians being included in their plans.

With approximately 75% of the center’s patients being covered by Medicare, the greatest challenge has been the decreasing reimbursements from the federally administered health insurance system, which today typically pays about 80% of what the center bills for procedures. “The only way to combat that effect is to get more patients through the doors,” Grant says. And they have.

The facility services approximately 2,400 patients annually. Though there is a lag between the visit and pay out, Grant says, “our volume is high enough where money is always coming in.”

Despite the practice’s success, Davis and Grant both say their top priority remains giving patients a better quality of life. “A lot of patients just go where their doctor sends them,” says Davis. “We want people to know that they’re the customer and they have a choice of where they want to go and who they want taking care of them.”