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Avoid the Pitfalls of building a Concierge Medical Practice

Are you considering transforming your medical practice into a concierge medical practice? If so, than there are a few do’s and don’t’s that can make the difference between success and failure.

The average family doctors see about 4,000 patients in their practice which leads very little time for one-on-one interaction with the patient. In order to have a successful concierge practice, you have to change your large insurance-based practice into a more patient-centric practice by reducing the size of your patient load so can provide a higher quality of care.

Starting a new concierge practice is not easy. There are many doctors who do it successfully while others have failed miserably. If you do it properly, you can reap the benefits of receiving higher pay, quality care with patients, and the overall rewarding experience of receiving cash for your time rather than the paper chase and denials of insurance-based practices.

Do: start with a business plan

It is completely astonishing that most small businesses lack a business plan that is relevant to their business services and produces as well as their position in the market place. A business plan is a road map to show you how to price points, service offerings and overall how to reach your goals. The best way to shape the future of your new business is to begin with a business plan that outlines how your concierge medicine practice will be structured. If you are planning to get financing to open your new office, a business plan is required to show the lender your financial viability to qualify for a loan. Your business plan should include information about your patient load, revenue streams, staffing requirements, and recruitment efforts to keep patient load at a sufficient level to support your business.

Don’t: use a ‘boilerplate’ business plan

There are sample business plans available online that you can purchase, and while these can be a great resource as a starting point to let you know the types of things to include in your plan, they should be treated as just an outline. If you copy and paste the information directly from the sample plan without customizing it for your area, the estimates about revenue, patient load, and other information will range from being either slightly wrong to wildly inaccurate, which can affect your success in the future. Spend the necessary time to customize your plan to fit the needs of the market and to position yourself in a more strategic place than your competitors.

Do: educate your patients of your new practice

Most patients today are very familiar with a traditional model for primary care doctor’s offices, and some may have never heard of a concierge doctor before. Change is hard for everyone, but you can ease the transition for your patients by communicating with them about your plans to become a concierge physician, and helping them understand what that means for them. If you surprise your patients one day without any advance notice or education about what a concierge physician is and why it’s beneficial, you may not be able to keep those patients in your new practice.

Don’t: assume your patients know what your new practice will be like, spell it out for them in your marketing materials

As a physician, you are very familiar with different types of practices and different models, and you know the advantages and disadvantages. Patients, on the other hand, are not familiar with all this information, and it is your job to educate them on why you are choosing to become a private physician, and how it will benefit them. If you’re not sure about the best way to reach out to your patients and help educate them, consider hiring a marketing consultant to help.

Do: hire the right team – hire slowly & fire quickly

Your new concierge medicine practice will require the support and help of a great team, including your staff, an accountant who understands concierge medicine practice models, an attorney, and a healthcare consultant with experience setting up and running patient-centric businesses. Every single employee from manager to operator needs to be on board with your patient-centric business model and culture. If one employee is not, then don’t waste your time. Fire them.

Don’t: hire a consultant with the wrong experience

There are a lot of healthcare consultants who can help you convert your practice to concierge medicine, but you want to be sure to hire one that has experience working with patients that fit your demographics, and not one that tries to make your practice fit into a “one-size-fits-all” model. I have noticed the greatest benefit that a consultant can have when being hired for a concierge medical practice is experience in developing a menu of cash services. You do not want the practice management consultant who only has experience in insurance-based medical practice business models. These two models are tremendously different. One model treats patients as if they are a number and the time the doctor spends with the patient is very limited. The other model is based on a patient-centric model whereby each contact with the patient ensures a positive experience.

Do: review your practice regularly

Constant gauging and auditing your progress is a necessary task that will show you if you are meeting your goals. Set a schedule to review your practice at least once a year to ensure that you are meeting your goals, and find areas where you can improve. You can do this on your own, or with the help of a consultant, to make sure that your practice is thriving for years to come.

Sometimes change can be scary, but both patients and physicians often appreciate the improved care that comes with a concierge practice.



Top Five EHR and Practice Management for Medical Practices

 The Mechanics of Keeping Your Patients Part 2

Running a profitable medical office requires keeping on top of key metrics such as accounts receivable ratios and net collection percentages. However, you have to look beyond those numbers to stay in the black, experts say. Successful practices prioritize teamwork and ensure that everyone on staff knows their role in the revenue cycle and that includes implementing an integrated practice management and EHR software system that best-suits your practice.

For a medical practice, EHR may be important — but practice management is essential. According to KLAS ratings, the top five practice management software systems are as follows:

    • 1. – Epic has become the default system of choice for hospitals, particularly larger hospitals. As a system designed for large enterprises, it is not even an option for small medical practices. While customers may choose Epic as much for its reputation and the breadth of its suite as for any single piece of software, the KLAS rating shows they are also happy with the practice management functionality, which actually reflects the performance of multiple products
  •  2. – Aethenahealth: Aethenahealth rates #1 for practices of fewer than 75 physicians. While most practice management software vendors offer some version of their product as a cloud service, Athenahealth is the one most insistent on sticking exclusively to a cloud model. Just as significantly, the AthenaCollector software is inextricably linked to the company’s business services. One major strength of Aethenahealth is that it can see where in the workflow employees are getting hung up, or how long it takes a patient to get checked in or checked out for a visit.
  •  3. – eClinicalWorks: Ranking in the KLAS survey as one of the top practice management systems for practices of all sizes, eClinicalWorks is second only to Epic for practices with more than 75 physicians. eClinicalWorks boats that it’s clients currently experience a 98% first-pass acceptance rate (claims paid on first submission).
  •  4. – NextGen Healthcare is another of the top-ranked practice management systems in the KLAS survey across practices of all sizes. NextGen offers a revenue cycle management service, although so far fewer than 5% of customers take advantage of it. The software’s ability to track the work that needs to be done to process claims and secure payments are among NextGen’s strongest features. While often overshadowed by EHR hype, practice management is really the core of the system.
  •  5. – McKesson shows up in the KLAS rankings for two products, Practice Plus, one of the favorites for practices of 75 or more doctors, and Practice Partner for smaller practices. McKesson prodcuts are distinguished by their ability to adapt to individual locations, so it’s not cookie cutter, and adjust software workflow to the way a practice functions.

warkprofileprofessionalPractice management software is just one component of helping keep medical offices running smoothly. Technology systems are not the only systems that need to be adopted in your practice. Before you decide a system that fits your practice, you need to have a full grasp of every function in your practice. For example:

  • What happens when a new patient contacts you?
  • What actions happen when you sign on a new patient?
  • What steps do you follow to deliver your healthcare services?
  • What tasks need to be completed when you complete a project?
  • How do you run your back office and administrative affairs?
  • What roles and responsibilities do any team members (employees, subcontractors, etc.) have and what steps do they follow to meet those duties?
  • What does your schedule look like? What constitutes “open for business hours” and “closed for business” time?
  • What are your policies and procedures for working with patients? (Think: patient forms and arbitration agreements.)
  • What are your billing and payment policies and procedures?

The above components are all a part of creating standard operating procedures and policies to adhere to at every level of your practice. If you need help with designing your operations in a way to help your practice runs efficiently, please give us a call. It’s time to start running your medical practice like a very successful business.  Call us today at 702-682-8300.


The Importance of an Infrastructure in a Medical Practice

The Mechanics of Keeping Your Patients Part 1

Operating a private healthcare practice in today’s environment presents many challenges. Shrinking insurance reimbursements, changing regulations, rising business costs, can all feel like barriers to success. Over the last few years, there has been a shift towards attracting private pay patients with the advent of Concierge Medicine, MediSpas, and various complementing services that doctors are pushing in their practice to increase revenue.

What does it take to have a successful medical practice today? Most physicians rely on referrals for getting new patients, as their marketing budget is limited to social media channels and patient referrals. But spreading the word about your business without building an infrastructure within the operations is a recipe for mediocrity. What does that mean? It means that without having systems and procedures in place, patients will constantly be falling through the cracks. But the right “point of care tools” can not only save your practice, they can take it to the next level.

Every medical practice or small business for that matter needs a starting place when building out its infrastructure. With the advent of Obamacare, many practice management software systems have been designed to help automate your operating system along with integrating your PM system with Electronic Health Records.

Integrated platforms that are more user friendly, while both comprehensive in their features and functionality, are vital to success in a very competitive medical industry.  But beware, you ultimately will get what you pay for.  Doctors usually are more familiar with their EMR needs and functionality than they are about the needs on the Practice Management side. Keep in mind that while you may be providing high quality care, you may not be able to collect what you’re due if your Practice Management system or Staff doesn’t have the ability to track the right metrics.  You should also consider outsourcing your Billing & Collections as your best bet in getting your receivables paid.

warkprofileprofessionalPractice management software keeps the medical office running smoothly, and the wrong package can wreak havoc with billing, scheduling, and other essential business processes. A closer look at KLAS’ top-ranked systems will help you choose the one that best fits your practice. Next week we will cover the top five Practice Management software systems for medical practices.



Important Role of a Website design company in your Online Presence

In an era where people are relying on the internet for the majority of their work, a business website has an important role to play. It acts as a means through which people connect and access your products and services over the web world as per their needs.

As the internet is flooded with hosts of similar businesses, you will have to make your self as an exception as, this is the only way you can attract customers towards your online services. Therefore, the role of a website design company is beyond one’s imagination in today’s techno-savvy era.

warkprofileprofessionalIt takes a lot more than just effort to come up with a unique website design and a good web designing company will always have highly skilled and passionate IT specialists working with them. Each one of the expert is well aware of the likes and dislikes of the customers therefore, it is highly unlikely that they will produce an inefficient design for your company.

Besides being aesthetically sound, the website should also be easily accessible and completely functional; so the years of experience of a good website design company proves to be quite beneficial. They also understand how important it is to stay updated therefore, whenever they begin the design of a website they make sure that the very latest and optimal strategy is used in the designing process.

Website is the reflection of your business over the giant internet world and you will never want your image to be poor and unprofessional before your valuable customers. So, hiring a good designing company should be your first preference when starting your endeavor over the web world.


It’s Time to Talk

Talk is cheap, but a good talk is priceless. We are social beings. We crave communication but we tend to eschew it at all wrong times…like when it’s most needed.

It’s tough enough to be a poor communicator in private life, but in the long term it’s a recipe for failure to be one in the business world. A typical small business with employees is a multi-layered organism. The only way this organism can thrive is if there is meaningful communication between all of the layers and between the employees that inhabit these layers.

photodune-567166-time-to-talk-sOne of the more puzzling things I find as a business consultant is why good communication is even absent when it’s in a person’s best interest. A colleague spoke to me last week about a project where the managers where having quality control problems with a vendor. The managers knew that the standard operating procedure for this problem was to immediately notify the vendor as well as the COO of their company, but nobody did. They just suffered in silence for a week before saying anything. If they had just spoke up and brought it to the attention of all parties they would have avoided what was daily frustration and a loss of productivity.

warkprofileprofessionalMany of my clients over the years have been in the medical profession. Communication problems can be particularly acute because of the interaction between highly trained medical professionals, a rigid regulatory environment, and the sensitivity of dealing with patients. If people aren’t effectively communicating between themselves and their patients, there is more at stake than the success of the practice. Fixing this problem is a process, because you are dealing with behavioral characteristics. Don’t be afraid to create a structure help this along. Here are a few ideas in how to start the process.

Put it on the Calendar-Schedule a regular time every week for managers and employees to speak with each other, and an opportunity for an interdepartmental meeting with the boss. At least everyone will be together once a week for the expressed purpose of expressing themselves.

Don’t be Vague-When making a specific request, make the “who, when, and where” very clear.

Face-to-Face-Improving interpersonal communication skills requires fewer emails and more personal communication. If you have something important to tell an employee, good or bad, do it in person, and do it in an un-distracting environment.

Customer Care-Lack of communication is the number one complaint of clients. Things get busy and hectic and clients can become a second thought. Use a customer management system that will remind your employees when to reach out to speak and listen. If needed, create a script for your employees to get them used to saying the right things at the right time.

Don’t Reward the Gossip-make it clear that the cheapest talk is gossip. Managers have the ability to assist in shaping the work environment by creating disincentives for troublemakers and employees who cannot conduct their speech in an encouraging and productive way. Don’t let these employees poison the business.

These are places to start. Ultimately much of the needed change is attitudinal, and is going to have to come from within the employee. Creating a framework for this change will get your workforce in the habit of communicating better and that’s a great way to start the process.





Culture Wars

A cynical friend of mine once said that “changing a company’s corporate culture is akin to turning a battleship around… a battleship in the Panama Canal”. If anything the lesson here is to root yourself in reality by surrounding yourself with cynical friends. But it’s true, it is a daunting task to wake up one morning, walk into work and declare to your employees that “starting today things are going to be different around here”. That’s probably why the boss seldom says it, and does it. Corporate culture doesn’t change by decree but by influence.

corporate-culture1Corporate culture is a set of characteristics that define a business. It’s a combination of collective attitudes, values, practices, and history that dictate “how things are done around here”. Now you begin to understand how changing the culture is analogous to turning a battleship around, in the Panama Canal or the middle of the Atlantic Ocean.

The cry that goes out for a change in corporate culture usually comes from the boss who has finally come to recognize that something has to change if the enterprise is going is to get to the next level of success, or even survive. Rarely does a business, especially a small one, have the luxury of cleaning house- sorry, no fantasy of a “night of the long knives”. Instead, most bosses are faced with corporate dysfunctionality that is composed of a workplace of long time colleagues, friends, or corporate_cultureperhaps family members who have developed bad attitudes, bad habits, and a bad product. It’s not easy to tell any of these folks that they suck, especially after you have enabled them in their particular less than stellar performance for a protracted amount of time. So here are a few tips to start turning the ship around.

Decide you are going to move forward and keep moving. Expect a significant amount of pushback when you start, and it will come from people who have been most influential in shaping the current culture or figured out how to best use it to turn the business into their own personal little sand box. You are going to disappoint a few people, but keep going slowly but surely.

corporATE-Quick-Stat-Great-DivideLead by example. Express to your employees what your vision of the company is and inculcate in them your values for success. You can’t delegate that responsibility to someone else or send a runner to OfficeMax to buy a pack of Corporate Culture Change to be placed in everybody’s in-box.

A great Harvard Business Review article talks about how important it is to show how a new change in your corporate culture can directly affect a specific project or area in the business that is lacking. For example, it might be apparent to you that better collaboration between departments will improve customer service but remember you are dealing with employees that most likely have gone years without any instruction, encouragement, or example how to work together to achieve a common goal.

company-cultureDon’t be shy about codifying your corporate culture in your company’s standards and practices. If you want better communications then explain in your employee handbook how that is to be done. Make it clear what is to be expected of an employee and then follow it up with a fair and consistent review process. Put some meat on those new culture bones.

Changing your corporate culture may seem like a war when you are in the middle of it. But it’s a war you can win through patience and determination. If you exercise those traits you will no doubt find your employees exercising them as well. That’s not a bad ship on which to be a captain.


Bridging the Gap

PBS television programming in my household is for the most part dominated by Curious George, Cat in the Hat, and Dinosaur Train. I’m lucky if I get to view a little Downton Abbey, but early one weekend morning I accidentally came across one of those obscure PBS public affairs shows that featured three women talking earnestly about women’s issues. In particular they were beside themselves about the gender gap in pay.

Average-Income-by-GenderThe equal-pay-for-equal-work movement has been around for decades, and in spite of the significant increase in professional women in the workforce it hasn’t seemed to satisfy those that are most vexed about it. As a female business owner who has employed many women over the years there are a number of compelling reasons why a pay gap exists in a workforce, even an all-female workforce.

When I owned a medical spa I had 12 female employees. Some were full time and others were part time. The required number of hours for each employee was determined through a combination of staffing needs and the desired number of hours that an employee wished to work. Training for different job positions cost my business time and money, so it was important that the investment that I was making in my prospective employees paid off in an employee working a full shift. The full time employee was also paid more per hour because they provided continuity and availability for customers.

Many of my part-timers were extremely skilled but were only looking for part time employment for any number of reasons, and it was their personal choice to not be fulltime.  They worked side by side with full timers in the same position and were paid a lower hourly wage that reflected their value to the overall business. They didn’t feel that they were being cheated. They knew that they were professional equals, but they also accepted the fact that in order for the business to succeed a greater value was placed on the full time employees. Every so often, a part timer would move to a fulltime shift, and they were paid more per hour.

For the ladies on the panel of the PBS show, their heads would explode trying to wrap their minds around a real life situation where there was a “same-gender gap in pay”. But the same staffing situations that dictated my employee hourly wage decisions occur every day in millions of different businesses. A smart boss will pay top dollar for the best talent, be it male or female as long as they feel certain that the employee is fully invested in time and energy in the business.


It Looks Like Optics

So it “appears” that the word optics has attained ubiquitous status. I hear it all the time now, not only from the chattering class in the press and the cable news shows, but I actually heard it uttered at the gym the other day. Optics in its current non-scientific pedestrian use simply means “how something appears, or is perceived”. You hear it used most often today in political discussions, but interestingly enough it seems to have evolved over the years in the world of business. And as business people, optics have a powerful influence on our success.

It’s easy to dismiss the criticism that something in particular “doesn’t look good”, or that it has “bad optics”. After all, as business types we are preoccupied with the realities of our enterprise, not the perceptions. While other’s perceptions are subjective, we for the most part control our optics.

Good optics for your business start well before others may ever step foot into your establishment. If you are philanthropic and active in your community your are creating a good perception. It is something that you can control. If you show up on a YouTube video cussing a blue streak at the referee at your kids  soccer game then the public will not only draw a conclusion about you but they judge your business and even your employees. Once again, it is a situation that you control.

warkprofileprofessionalOptics have their greatest impact on customer service. What are the impressions that a customer feels when they walk up to your place of business? When they enter the lobby will there be a doughnut in the mouth of the front desk person? Good systems and procedures will ensure that starting even in the lobby you can control the optics of your business.

While it seems silly to have to outlaw powdered doughnuts at the front desk, you are going to have to make it perfectly clear what is acceptable behavior because you can’t take good optics for granted.  Even going so far as setting an office dress code can be essential in training your staff in the importance of optics. I’ve always felt that staff uniforms were as much a defensive measure for people that couldn’t figure out how to dress themselves, as a sharp way to create continuity in branding.

As long as we are stuck with optics as an overused buzzword, let’s take advantage of the heightened sense of how important perception is. After all, it is reality.


Performance Anxiety

There are few things in professional life that rival the angst of a performance review. It’s often painful for all parties involved, but like many unpleasant things in life it can be mitigated with a little thoughtfulness and hard work.

It’s not uncommon for the dread to begin weeks out from the date of the review. For the recipient it’s the uncertainty of not knowing if you are going to be walking into an ambush. For the manager it’s the certainty of knowing deep in your heart that your employee’s performance is a direct reflection on your performance as a manager. Uncertainty meets Inadequacy. It can’t get grimmer than that!

The present day performance review is so poorly executed, it resembles more of a medieval torture device than an instrument for evaluation and constructive team building. You can’t blame employees for this – they aren’t exactly in control of the situation. The onus lies with managment. The performance review should be an integral part of a continuum of interaction between managers and employees. Nothing said in a review should come as news to either party. A constructive review should recap and memorialize instruction, conversations, reproof, and praise that should be part of every productive daily interaction between management and employees. This requires active management.

If you view the performance review as nothing more than a legal requirement to document an employee’s performance just in case you want to fire them, then you probably shouldn’t be a manager. You should be the dean of students at a really bad middle school. While HR certainly needs to create controls for personnel, your role as a manager is to improve the performance of the company by improving the performance of its employees. You have to be interested enough in your personnel to know how to get the most out of them.

warkprofileprofessionalPerformance reviews are notorious for surprises, usually bad ones. Many after-review water cooler commiserations include, “How come that was the first time I ever heard that”. You need to communicate regularly. Don’t wait until the performance review to express criticism. Correct employees at the point of the mistake instead of allowing it to go on, and don’t evaluate an employee as if “they are only as good as their last gig”. Look at their work in it’s entirely, just as you would hope the manager of the company would look at you. An employee should know where they stand with you on an ongoing basis. Don’t be afraid to hand out positive strokes when they are deserved and encouragement during rough patches.

Performance reviews are important to establish metrics for improvement, but don’t create a moving target. If there are goals for improvement then clearly articulate what those are, and be objective about them. If the goals are for advancement then be honest and let them know if achieving those goals will truly result in a raise and promotion.

Finally, be thankful that employees don’t conduct performance reviews on managers.






Love Hate Relationships

warkprofileprofessionalAs a business owner at some time, (or many times), you will have an “I can’t stand the human race” kind of a day. It’s all about the love/hate relationship we have with colleagues, customers, employees, vendors, ourselves, etc. Regardless of the business you are in, you are in a people business. Even if you are running an e-commerce site out of your mother’s basement, you at some point are going to have to talk to a live human being.

When we talk about a “people business” it’s almost always within the context of customers and sales. But the success of your organization begins with the people on your side of the counter. We all have a tendency to keep our focus on the till and take everything else for granted. There are a lot of moving parts that make that cash register ring. When it doesn’t ring as often as it should, start at the front and work your way back.

Not only do we want more customers, we want to keep the customers we have. Good customer service is a combination of having the right customer service people, and having the right customer service systems and processes. You can have wonderfully friendly employees dealing with customers, but if they aren’t up to speed on all of your products and services, company policies, and office systems then customer service suffers. All of these components need to be drilled into front line employees on a daily basis. Good employees will embrace the rigors of this blocking and tackling, and the bad ones will chafe at it. Get rid of the chafers. Even your best employees will have a love/hate relationship with customers, but they will always remember that the customer is always right.

team_killers_slideIf this is all foreign to your employees, who in the world is in charge of that department and how come they haven’t been trained properly? Is the person that you hired as a manager or supervisor the right person? Did you make the age old mistake of using tenure as the main criteria for turning an employee into a manager? A competent manager should be the ultimate “people person”. They should ensure that the employee in their care is trained and equipped to be the best that they can be. A manager worth their salt will be organized, even in the most harried situations, because they will have the maturity to adapt systems and processes to practically any situation. After all, why should you be spending your time as an owner constantly putting out fires and reacting to everything?

Your manager should be an excellent communicator. They should be able to express their praise, correct, and admonish employees in a constructive manner. They should have the confidence to express themselves in a constructive way with you too. Will a good manager have a love/hate relationship with employees? Sure, if your manager isn’t a robot. A good manager will always be prepared for irregular ops, and irregular employees.

I think you are starting to see a pattern here. Success in your business is often manager-centric. If you hire the right managers, equip them to do their jobs, and get out of their way you should see it manifested in retained customers, great word of mouth, and increased sales. You will also find that your marketing dollars go farther.

Making changes at the managerial level is like getting a root canal; painful but necessary. I suppose that’s why we have a love/hate relationship with our dentists…and just about everyone else.

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