Monday, December 16, 2013

Selling the Medical Practice: Five Steps to Get Your Buyer to Say ‘Yes’

Selling a Medical Practice
Selling a medical practice certainly belongs in the age-old category of “easier said than done.” To begin with, much controversy surrounds the question of how to set a price. And in the end, it can be quite difficult to get your prospective buyer finally to sign on the dotted line. More than one retiring or departing physician has experienced the frustration of having a very interested buyer who can’t seem to seal the deal.

Experts in practice transition say that faulty reasoning on the part of the potential buyer often scuttles a deal. For that reason, you can increase your chances of closing a deal with an interested party if you take it upon yourself to educate potential buyers.

Wednesday, December 11, 2013

Reduce Liability Risk When Treating Elderly Patients

In addition to the risks common among almost all patients, certain populations bring their own sets of potential hazards to your office. Pediatric patients, patients with physical and mental disabilities, and patients with limited English proficiency bring some liability pitfalls unique to each group.

Elderly patients represent another group—a rapidly growing group—with a few extra challenges. Being sensitive to the needs of elderly patients, and adjusting your practice style to accommodate those needs will help keep you out of legal hot water. At the same time, you’ll provide better care for seniors who visit your practice.

Wednesday, November 27, 2013

Extending Credit in the Medical Office

Credit in Medical PracticeRising deductibles and co-payments among most health insurance plans demand that doctors' offices recognize that collecting patient balances will become more important. Not only will it become a greater part of your accounts receivable - that is, collectible revenue - but the amounts due from each patient will grow to unmanageable size. Full payment at the time of service will be impossible for many patients.

Rather than wait for debt to go bad and writing it off to an expensive collection agency, take control of the situation early in the process by providing payment plans that actually help honest, hardworking patients satisfy their medical debt.

Monday, November 25, 2013

Happy Patients Less Likely to Pursue Lawsuits

Fewer LawsuitsPhysicians with low patient satisfaction survey scores are sued more often than those receiving top scores. Other studies suggest that no more than 17% of malpractice claims really involve medical negligence resulting in injuries - the rest come from other motivations like overall dissatisfaction.

Patients who believe their physicians really care about them almost never give serious consideration to suing - even in the face of a bad medical outcome. Communicating to patients that they truly are your highest priority requires top-notch customer service.

Monday, November 18, 2013

Quality Care, Affordable Care. Book Offers Keys to Putting Doctors in Control

affordable healthcare
The topic of healthcare coverage is white-hot right now, but the real job of reducing healthcare costs needs to begin now as well. Reducing healthcare costs is an extremely difficult job, one which requires out-of-the-box thinking to succeed.

Fortunately, reducing variation in healthcare delivery offers a great deal of promise. In his new book, "Quality Care, Affordable Care: How Physicians Can Reduce Variation and Lower Healthcare Costs," Dr. Lawrence Shapiro explains how by using the simple but potent variation-reduction process, physicians can take charge of healthcare reform to improve health and reduce the cost of care.

Thursday, November 14, 2013

The Scientific and Objective Call Schedule

call schedulingExcessive Call continues to be a top reason that doctors seek other employment. It’s simply one of the biggest bones of contention in group practices of every size.

The arguments revolve around a call schedule’s fairness and the resulting volume for each physician. Even a plan perceived as “fair” by all participants won’t suppress physician turnover rates if the group’s size forces everyone to take call more often than desired for their individual lifestyle expectations.

Your call schedule must be as “scientific” and objective as possible, clearly communicated to all concerned, and managed by someone with authority supported by all participants.

Tuesday, November 5, 2013

Having Informed Patients Turns Out to Be a Positive Thing

Taking the time to encourage patients to study or “read up” on a health topic before the office visit can made the visit pay off in more dividends according to a recent study.  The study, published in JAMA Internal Medicine, Decision Making in Prostate Cancer Screening Using Decision Aids vs Usual Care: A Randomized Clinical Trial, shows that informed patient have more productive office visits.

Wednesday, October 30, 2013

Compliments in the Medical Practice are Welcome, But Make Sure You Follow These 5 Guidelines

A compliment from a practice manager or doctor builds self–esteem. Self-esteem helps employees feel confident in the work they do. Confidence in a job well done promotes job productivity. There needs to be some caution, however, when giving staff members compliments.

Here are 5 guidelines to memorize:

Friday, October 25, 2013

13 Rules of Leaders According to Colin Powell

13 Rules of Leaders
Colin Powell
Last evening I had the privilege of hearing retired four-star general Colin Powell speak to a packed house at Loyola University here in Baltimore. Powell was invited as part of the Hanway Lecture Series in Global Studies.

Without the help of a TelePrompTer or script, Powell talked about world events, politics, building a successful team.

As I was listening to I remembered reading his 13 Rules of Leaders, first published back in 1989 in Parade Magazine. I reprint them here:

Monday, October 21, 2013

What Is Professionalism? A 15-Point Training Tool for the Medical Practice Staff

Professionalism in Medical Practice
How often do we say, “I wish my staff members performed their jobs with more professionalism”? But what exactly do we mean when we say that? We recognize and appreciate professional behavior when we see it, but can we define it? Practice management advisor Dr. Laura Hills of the Blue Pencil Institute offers a comprehensive outline providing 15 characteristics of medical office professionalism.

Friday, October 18, 2013

Medical Office Design and Systems Concept for Patient Management

Medical office design
Medical office design expert Richard C. Haines Jr., invites us to see the medical practice as a business that dispenses a scarce commodity: access to the physician’s intellect, judgment, and skill. You can picture practice operations like a machine with a conveyor belt: items (patients) come in the front, the staff pre-assembles them (works them up), and the doctor finishes by treating them and sending them out the back.

Therefore, it might be helpful to step back occasionally; set aside the idealism and heroism associated with practicing medicine; and take a cold, analytical look at “the machine.” How can you repair, redesign, or fine-tune the operation to make your scarce commodity more available to patients who need and want your expertise?

Monday, October 14, 2013

Reminder: Pay Attention to Details to Theft-Proof Your Practice

prevent theft in the medical practice
Smart business ownership dictates that you put good cash controls in place and monitor those controls diligently—or prepare to pay dearly. We hear stories monthly of embezzlement and theft in medical practices.

The key to theft-proofing your practice lies in setting (and abiding by) commonsense rules covering issues like hiring practices and day-to-day cash-handling procedures. Properly structured and consistently followed, procedures like these won’t spoil your relationship with employees. In fact, they might preserve it.

Friday, October 4, 2013

Taking in a Show: Leverage Vendors for Education

get the most from tradeshow
With the MGMA Annual Meeting (Medical Group Management Association) kicking off this weekend, I want to take a moment to remind you of how beneficial the Exhibit Hall at an educational conference can be to you. Make sure you don’t pass up opportunities like these afforded you during a well-planned exhibit hall visit:

Monday, September 30, 2013

The Ultimate Partnership: Getting Patients on Your Side

Getting Patients on Your Side
An interview with Judy Capko of Capko & Company discussing strategies on developing and maintaining patient loyalty.

NC: Judy, we hear that patients are more demanding these days. Why do you think this is the case?

JC: I think it begins with the fact that patients are less loyal. Years ago patients kept the same doctor for 10, 20 years. Now, at the drop of a hat, a patient changes doctors or, more importantly, at the drop of an insurance company. So, the way we pick our doctors today is to look at the panel of doctors that our insurance plan has, do a bit of online research, and talk to friends or relatives about our choice. Patients seem to be more demanding because they feel they have lost control and they don’t like it. It makes them insecure and more fearful too. That’s a recipe for a more demanding patient.

Friday, September 27, 2013

Employee Appearance and Dress Code in the Medical Practice: A Touchy Topic

staff appearance in the medical practice
Practice management guru Jeff Denning takes a straightforward approach to the challenging and controversial subject of employee appearance. The idea of “business casual” seems to have gone to extremes even among some Fortune 500 companies. Consequently, some medical office staff members want to push back the boundaries of what you might consider "professional appearance." But you can’t really afford to ignore the issue in your practice—everyone knows how staff appearance influences the way patients and referrers view your practice. First impressions are still lasting impressions, and they’re critical to establishing a good physician-patient relationship. Denning’s article helps you think about what’s appropriate for your practice image and provides advice for enforcing a reasonable dress code.

Although developing and enforcing a dress code  comes under the general topic of “human resources management,” the fact of the matter is that it’s an internal marketing issue. It’s an important part of providing your patients with a comfortable, convenient environment in which they can find reassurance that they’ve chosen the right place to receive their healthcare. But in an era of self-expression and widely varying personal tastes, physicians and their managers find themselves doing battle with staffers who have individual definitions of “professional appearance.” But there’s no need to run away
from the issue; you can define an appropriate dress code and enforce it in a positive environment if you follow these principles:
  • Determine what’s appropriate. Capitalize on the wide range of professional appearance recognized in today’s business world. Ask yourself what image you want to project to the community. A successful plastic surgery practice with an exclusive clientele may express its professionalism with a more tailored look. But an orthopaedic group with an emphasis on sports medicine may decide to dress the staff in polo shirts, khakis, and athletic shoes. Pediatric patients and their families expect something different than those who frequent a geriatric practice. To start out on the right foot with your staff members, bring them in on the discussions about the image your practice wants to project. Discuss why it’s important to patients and referral sources; ask for their ideas and input, but don’t try putting it to a vote. It’s a business, not a democracy.
  • Fine-tune your practice “look.” Remember that not everyone looks good in the exact same style, color, and cut. Go for a uniform look that allows enough variation to help staffers feel comfortable while compliant. Determine how narrowly you will define the dress code. In some ways, a true “uniform” is easiest to enforce.
  • Enforce your policy. Start with a written policy that clearly outlines your dress code. Make it unambiguous and as detailed as necessary: Don’t neglect issues such as skirt-hem length, blouse necklines, and other questionably appropriate issues like visible tattoos or piercings. Providing an actual uniform may prove a worthwhile investment just to reduce the hassles that accompany individual interpretations of even the most clearly written guidelines. When a staffer shows up inappropriately dressed, consider it a challenge to authority. It’s a test of wills, and you dare not ignore it. A “minor” infraction may require a simple comment from you to remind the staffer that you’re serious. A more serious violation requires at least a warning that the next time it happens, you will send the noncompliant worker home. It takes only one or two such incidents to convince your staff that you mean it.
Finally, as you consider the appearance of your support staff, take a long reflective look (a mirror will help) at your own outward image. Do you convey a picture of what patients expect to see in a professional? Will they take one look at you and say, “I’ve come to the right doctor.”?

If you enjoy reading the blog entries in "Solving Problems in the Medical Practice" you may want to check out all the great products at Greenbranch Publishing.

Monday, September 23, 2013

Your Personnel Manual: Policies and Rules for the Medical Practice

Employee Handbooks in Medical PracticeSmaller practices notoriously neglect their employee handbooks. That disregard tends toward one extreme or the other: Either the practice never got around to putting a personnel manual in place, or it has allowed an old manual to languish without update in the back of a file cabinet. While a well-crafted and properly utilized handbook documents policies, builds trust, and helps you comply with federal and state laws; an inadequate or neglected handbook can work against you. Further, the latter type of handbook often surfaces as prime evidence in court when an employer faces a plaintiff who happens to have been his or her employee. A physician or practice manager can find numerous tools for building a practical and effective employee handbook, but it also takes the commitment to review the document once a year to keep it up to date and relevant to your staff.

Wednesday, September 18, 2013

Your Medical Practice’s SWOT Analysis

SWOT in Medical PracticeNow part of basic business vocabulary, the term “SWOT analysis” has its origins in research conducted and published by the Stanford Research Institute back in the 1960s. Fortune 500 companies funded the research in an effort to understand why corporate planning often resulted in failure. Its success as a “forensic” tool led to its adoption as a strategic tool, and eventually it became the standard process for Western business planning.

Monday, September 16, 2013

The Patient-Centric Practice: Practicing Compassion

Patient Centered Practice
Physicians and others in the “caring professions” risk suffering from a special type of burnout called “compassion fatigue.” Physicians are expected to demonstrate compassion toward every  patient they treat—regardless of the pressures facing them day after day. Maintaining high patient numbers makes it very difficult to show each person that you genuinely care.

Friday, September 13, 2013

Don’t Misfire When You Have to Fire

How to properly fire in the medical practice
Firing a staff member ranks near the top of most personnel managers’ list of dreaded tasks. The emotion and drama can unnerve you and shake your self-confidence; you may wonder, "Am I doing the right thing?" Diligently following clear policies and procedures when hiring, training, and supervising staffers will shore up your confidence and protect your practice from sometimes serious legal consequences.

Wednesday, September 11, 2013

Chart Audit: Is Your Practice Billing What It Should?

Medical Coding Audits
Missed lab charges, understated injection units, and missed office surgeries can subtract tens of thousands of revenue dollars from your income every year. Conducting an internal chart audit can help you discover and correct flaws in your system that allow costly omissions like these. You don’t have to spend thousands of dollars on an outside consultant to perform an effective review. Using an orderly procedure and recording your findings in a spreadsheet to track anomalies, you can quickly see:

Monday, September 9, 2013

10 Ways to Lower Your Overhead (But Be Careful When It Comes To Your Knowledge Workers)

Lower overhead carefully
To stay ahead of today’s unstable financial curve, physicians need to cut costs. Financial advisors recommend the “two-thirds” rule during a down economy: Put two-thirds of your effort into cutting costs and one-third into increasing revenue. A collection of practice management consultants offers a top-10 list of cost-cutting strategies:

Friday, September 6, 2013

Tips to Avoid Malpractice Suits

avoid medical malpractice
More often than not, documentation will make or break a malpractice case. Too often these days,physicians seem to obsess over the relationship between documentation and E/M coding levels fearing a Medicare audit and potential financial penalties. But the threat of a chart being examined by a plaintiff attorney far overshadows the damage you might sustain from an audit! When charting patient visits, aim for consistency and thoroughness.

Wednesday, September 4, 2013

Appraising a Practice: The Art of the Deal for Buyers and Sellers

Selling a medical practice
Most physicians and their managers will likely face buying and selling their medical practice (or shares in it) at least once in their careers. Healthcare financial advisor David Marcinko offers straightforward advice for anyone wondering what a medical practice is worth.  Arriving at a satisfactory price presents a daunting challenge to everyone involved - buyers and sellers alike must understand that an appraisal will produce only a price range - a starting point for final discussions. All the math and science, due diligence, and top-level appraisers’ fees will only create an environment for good old-fashioned negotiations. In the end, the only accurate valuation is the amount written on the buyer’s check.

Friday, August 30, 2013

When Recruiting Physicians, Consider the Generational Issues

Hiring New Physicians
Presently, four generations are practicing medicine at the same time: The “Matures” (over 61 years old) make up 18% of the active physician workforce; “Baby Boomers” (born between 1946 and 1964) comprise another 49%; “GenX” (born between 1965 and 1979) makes up another 33%; and the “Millennium Generation” (born since 1980) is only now emerging from training.

Boomer doctors are predominantly male - some 88%—while Xers are but 58% male. But for the first time in history, the Millennials are mostly female (54%). Each generation brings its own work ethic, values system, and priorities to the medical practice. Boomers, Xers, and Millennials each categorically expect something different out of their practices. And each generation brings plenty of opportunity for friction and misunderstanding. And each generation presents a different challenge for those trying to recruit physicians to their respective practices.

Wednesday, August 28, 2013

Six Tips for Improving Practice Efficiency and Patient Satisfaction

Practice Efficiency Patient Satisfaction
If you find your practice stagnating, your profit margin narrowing, and your physician incomes threatened, you would do well to step back and take a fresh, objective look at your operation. Enlist the help of every physician and every clinical and nonclinical employee. Here are a group of ideas that can serve as a springboard for developing your own ways to improve efficiency and patient satisfaction:

Monday, August 26, 2013

Your Patients and Their Safety: How Your Practice Can Help

patient safety
Little by little, your patients have become increasingly concerned about patient safety. Not long ago, most of the general public simply assumed that medical errors were rare. But more recently they’ve become aware of alarming statistics first published by the Institute of Medicine - that somewhere between 50,000 and 100,000 people die every year due to medical errors.

Friday, August 23, 2013

Delegation for New Medical Practice Managers (or Managers Who Struggle with Delegating Tasks)

Medical Office Delegation
Many medical practice managers have difficulty in giving up or delegating projects because they’ve advanced their careers by doing everything themselves. They learned early on not to ask others to do their work for fear of being called a lazy employee...or someone who tried to push work on others.

Now that you are a manager, you need to delegate tasks. But, how do you learn to delegate if you’ve never had the experience?

Wednesday, August 21, 2013

Searching for a Reputation

Reputation Management
Just in the last few years, two leading dictionaries added the verb “to google” to refer to using a search engine to look up information on the World Wide Web.
Once considered something of an ego-trip, googling your own name may prove a wise business strategy as a way to discover what “they” think of you out there. Since more and more of your patients use the Internet for everything from ordering pizza to researching their medical care providers, don’t dismiss this idea as too far out for you. Consider these few suggestions for positively influencing your online profile.

Monday, August 19, 2013

Medication Errors and Patient Safety in the Medical Practice

Patient Safety

In days gone by, managing a patient’s prescription medications was far less complex than today. An adverse drug reaction or interaction is more likely today because of factors like:

Friday, August 16, 2013

How Can I Increase the Patient Loyalty in My Practice?

Patient LoyaltyToday’s patients may fill out your satisfaction survey with high marks for you and your practice, but they will leave you for another provider for multiple reasons not clearly revealed in their survey responses. This post shows smart practice leaders how to anticipate the factors that bolster patient loyalty and encourages them to develop a “branding” philosophy that cultivates and nourishes that allegiance.

Thursday, August 15, 2013

Disruptive Physicians . . . and How to Deal with Them

How to deal with disruptive physician's
How to Deal with Disruptive Physician Behavior
This post is sponsored by The Journal of Medical Practice Management ®
Everyone has a bad day - even a bad week - now and then. How can you tell when you have a real problem on your hands? Seasoned consultant Randy Bauman, from Delta Healthcare Consulting, brings his years of experience to the thorny issue of physicians who simply “don’t play well with others.”

Wednesday, August 14, 2013

For New Physicians: The Do’s and Don’ts of Working in a Practice (Part 4 of a 4 Part Series)

medical office behavior
Quality of Care
Newly-in-practice physicians have a tendency to think that high “Quality” care is a measurement of how the doctor was trained, or where he or she attended medical school. This is not the case. From a patient’s perspective, quality of care is the full spectrum of care delivered in the practice. This includes how the patient is addressed and treated from the time they are welcomed by the receptionist to when they see the physician and other clinical staff…to their final clinical outcome.

Monday, August 12, 2013

For New Physicians: The Do’s and Don’ts of Working in a Practice (Part 3 of a 4 Part Series)

medical practice behavior
Documentation is the best protection for you and your practice in a malpractice suit. Good documentation also shows justification in your billing procedures should you be audited by either the U.S. Government or an insurance carrier. The “Golden Rule” in documentation is “If you didn’t write it down, you didn’t do it.” The physician’s professional conduct should be consistent with the analysis reflected in the medical record. The obvious ethical (and legal) rule for documentation is that a patient’s record should never be changed in an effort to alter situations after the fact. Altered records lead to allegations of fraud and “cover up” and put the credibility of the entire document in jeopardy. There may be times, however, when a change is needed in the record. If an order needs rewriting or should an entry be placed in the wrong patient’s record, the original entry should be able to still be read, along with the new edit and a note to explain the correction. The doctor’s signature, date and time should also be noted.

Saturday, August 10, 2013

For New Physicians: The Do’s and Don’ts of Working in a Practice (Part 2 of a 4 Part Series)

New Physician Behavior
Focus on Employees
Walk through the front door everyday, greet everyone and pay special attention to new employees. Don’t head in the back door and right to your office.

Don’t “skip” out of staff meetings because you have something more important to do. Staff meetings are an opportunity to connect with staff members and find out what’s on their minds. Staff meetings are important and you are expected to attend and participate in them.

Friday, August 9, 2013

For New Physicians: The Do’s and Don’ts of Working in a Practice (Part 1 of a 4 Part Series)

In many medical practices, newly-hired physicians delve into the specifics of their jobs without getting the lay of the land.  They do not always know what kind of attitude, conduct, perspective or administrative skills they will need in their new jobs.  This 4-part article provides some hints for the new physician joining a practice. 

Above all, observe all that goes on in the practice -- the workflow and the personalities of the practice employees.  Identify the physician-champions and the influential members of the administrative staff. By careful observation you will learn about the culture of the practice and your role and fit within the practice. 

Thursday, August 8, 2013

Collecting Patient Balances: Time to Reevaluate and Adapt

collecting patient balances
When it comes to collecting patient balances, methods that worked well just a few years ago might not be as effective in the current economic downturn. Many patients are struggling to pay their regular bills, and an unexpected doctor bill only adds to the load. Some patients may have lost jobs and health coverage; others may have had to cut back to plans with higher co-pays and deductibles.

Wednesday, August 7, 2013

Hints on Medical Practice Start-Up

medical practice startup
With many medical practices merging or selling to hospitals, it is a pleasant surprise that one of our books The Medical Practice Start-Up Guide, continues to be a best-seller.  The book is by Marc Halley, CEO of The Halley Consulting Group. Following are highlights from an interview between me (NC) with Marc Halley (MH).

Tuesday, August 6, 2013

In Your Medical Practice, is Your “Nice” Quotient Too High?

Take this short quiz.

medical practice behavior
Who doesn’t want to have a friendly relationship with staff? But in any medical practice, there are times when you have to be firm. Otherwise, you can undermine the smooth management of your practice. Your staff looks to you for direction and consistency.  

Ask yourself these questions to find out if your “nice” quotient is too high:

Picking Vendors’ Brains

medical vendor
Veteran practice managers and physicians have found a “secret weapon” in their daily battle to identify and absorb the essential information necessary to run their practices effectively.  Vendors.

Many of the vendors who want to gain or keep your business can become valuable information sources for you. Here’s how you can capitalize on these opportunities.