UO - Jan/Feb 2009 > FinancialFitness

Five Tips to Help Your Practice Flourish

Growing a healthy patient base that flourishes year after year is second nature to some physicians. They just have the touch. Just as the saying goes, when the going gets tough, economically, it becomes harder to keep the practice growing.

Patients often leave a practice because of their insurance plan or now—with patients paying more of the cost for their medical care with high deductibles—they may be going to the doctor less, contributing to a sinking bottom line for some physicians.

A healthy practice depends on a steady stream of patients, but it also requires physicians to be more efficient with their resources: improving productivity and making wise investments in the practice. Lets look at some of the things you can do to keep your practice in tip-top shape.

1. Honor time.

Honor the patient’s time, the staff’s time, and your own. Start by beginning your day on time and staying on schedule. If attempts to do this continue to fail it just might be that you have unrealistic scheduling patterns. Take a look at past schedules to see what impedes the ability to run through the day on time. Perhaps it’s back-to-back new patients, or maybe you aren’t allowing enough time for new patients or physical exams. Double booking to squeeze in symptomatic patients is a common cause for scheduling delays.

These things can be avoided if you examine historical patterns and address the problem. For example, if typically there are an average of six patients double-booked on the appointment schedule, start putting a hold on six appointment slots and release them at 4 p.m. the prior day. If starting late is an issue, instead of scheduling that first patient at 8:30, schedule him at 8:45 or make sure the first appointment of the day is a patient that will keep the nurse busy for the first ten minutes.

2. Communicate better.

Although physicians always introduce themselves to a new patient, I rarely see staff do the same. Teach your staff to introduce themselves to every new patient—this means everyone that comes in contact with the patient. A smile goes a long way. And when passing a patient in the hallway, nod and say hello.

Make sure a patient knows who she is talking to when she calls into the office. How you communicate with patients makes a huge difference in how connected they feel to the practice. When talking with patients, use their name often, give good contact and always be cheerful.

Get the phones off the front desk to improve service and communication. Think about it: Can you imagine being in the middle of a transaction with the bank teller and she takes an inbound phone call? It’s not a pretty picture, but it’s something many patients experience when they make a trip to the doctor.

3. Keep the office in tip-top shape.

Ambience is defined as an environment’s distinct atmosphere and surroundings. Make sure your office makes a positive statement. Have comfortable furniture, adequate seating, good lighting, and a broad array of current reading materials. Be sure the entire office is always clean and well-maintained. Look at your reception room as if it is the living room in your home. Does it pass muster? Keep the office furnishings updated, including the business office and clinical space and equipment. And give staff the tools to do their job right! It’s an investment that pays big dividends.

4. Watch the numbers.

A healthy practice examines performance by monitoring the numbers. Look at month end reports and measure:

• Number of new patient encounters

• Charges, receipts and adjustment activity

• Accounts receivable total and amount aged over 90 days

• Payer performance— When are claims being paid and how are they adjudicated? Drill down the A/R by payer class, and look at EOBs to see what is being denied, down coded or under paid.

• Income and expense reports

Review and analyze these reports to examine trends, monitor performance, and know when actions must be taken to improve a situation before it reaches a crisis level. Data is power, and making data driven decisions makes smart business sense!

Also, hold yourself accountable to a standard by comparing your performance to your peers’ around the country. Statistical information is available through Medical Group Management Association, (www.mgma.com) and the National Society of Certified Healthcare Business Consultants, (www.nschbc.com.) You can set performance goals based on a combination of the national data and your own historical performance.

5. Turn to technology.

Technology is no longer the wave of the future; it has become an essential part of doing business for the medical practice today.

The fear of change and loss of control, plus the cost of an electronic medical record (EMR) system, have played a major role in many physicians’ reluctance to adapt to EMR. Although implementing an EMR system requires a substantial upfront investment and a sometimes costly loss in production during the conversion, EMR proves to have a dramatic impact on improving workflow, cutting processes, reducing errors, saving time, and reducing staffing costs substantially.

Even without EMR, there are technology features physicians can implement that will save the practice thousands of dollars each year. I recently consulted with a six-physician primary care practice where 120 patient charts were pulled the first hour in the morning for prescription refills. E-prescribing alone will save this practice more than 100 hours of staff and physician time each week. Do the math. With the estimated staff cost of $15 to pull a chart, review it, complete the transaction and documentation, and return it to the file, this practice spends more than $75,000 a year for staff to manually manage the prescription calls during the year.

You don’t have to spend a fortune to have a technology-savvy office that saves time and money. There are many forms of virtual technology at your finger tips with a minimal investment and an immediate return. Start with getting your staff online and off the phone. Interoffice communication through email and instant messaging keeps people at their desks, saving steps and time, and it’s far more reliable, providing documentation for later reference.

The internet brings an enormous advantage to medical practices across the country: improving communication and cutting time by checking patient eligibility, obtaining authorization for treatment, tracking referrals and checking on claims status.

Take advantage of other opportunities to tap into technology. For example, use lock box banking to speed up deposits and reduce the opportunity for embezzlement. The payments are mailed directly to the bank and deposited into your accounts, saving many steps and improving accuracy. In addition, EOBs can be reviewed online. They can be retrieved and printed at any time from the desktop, eliminating the need to file and maintain hard copy EOBs in the office.

An automated telephone reminder system cuts the workload for staff and improves efficiency. It will improve revenue by reducing those missed appointments and, more importantly, increasing patient compliance. This becomes an even more important factor as we see pay for performance initiatives on the horizon. A sophisticated automation system will provide you with tracking tools and customized reports that make it easier and more consistent for you to monitor appointment activities and patient compliance.

These are just a few tips to help your practice flourish during difficult economic times. But in the end the most important factor to making the most of practice opportunities relies in your own actions and behavior. The employees’ performance and attitude will be based on how you treat each of them. Don’t be the physician or manager who walks in the back door and fails to say good morning to each person who serves you. Remember to thank each one when they go the extra mile. Always treat your patients with kindness and speak about them respectfully to the staff. Staff will model your behavior. So, if the patients aren’t happy or the employees’ productivity is sliding, it may be time to look in the mirror. END

Judy Capko is a healthcare consultant and speaker based in Thousand Oaks, California.