Clinicians spend a lot of time thinking about systems: cardiovascular, neuroendocrine, digestive, and the like. Then, of course, there are the administrative systems that underpin the practice of medicine.
But how many think systematically about their own practices?
According to practice development consultants Gail Sophia Edgell and Traci Brosman, intelligent systems are the secret to success in medical practice. But many clinicians feel so scarred by managed care’s version of “systems,” that they’re reluctant to look at their own.
That’s unfortunate because good systems make it easy for you and your employees to do what you all do best, says Brosman. As Holistic Marketing Mentors, Brosman and Edgell help practitioners redesign their practices to support a more preventive, health-focused mode of care.
“Systems don’t have to be cold, or impersonal. But it’s a big help to have clearly defined methods for everything you do,” adds Edgell. “If there’s chaos, disorganization and inconsistency in your office, patients pick up on that, and it really bothers them. If there are problems with billing, then you’re losing money.”
At Heal Thy Practice 2013, Gail & Traci will offer a unique half-day Post-Conference workshop and coaching program entitled Pathways to Practice Freedom. The 4-hour program, which includes coaching sessions extending for 3 months after the meeting, will help attendees operationalize what they learn during the Heal Thy Practice sessions.
“It’s not about systematizing the care itself–that’s individualized and highly personal,” says Gail. It’s about the structures & process that support the care, about empowering yourself to actually be able to care.”
Good systems really improve the patient experience. “That’s important if you’re moving into a direct-pay model.” They also improve the profitability of the practice, which is valuable no matter what sort of practice model you have. “If your operations are haphazard it may be a reason why income has dropped.”
In a healthy medical practice, everyone has a clear understanding of what he or she should be doing and what you expect. They’re also clear about what to expect from each other. Precise descriptions of roles and responsibilities facilitate harmony in your office.
“No one person can be responsible for the entire system. It’s a team—even if it’s a small team,” says Traci. “You need to define the roles–who’s responsible for what. If you have everybody trying to be responsible for everything, when a problem comes up, nobody actually takes responsibility because nobody really knows who should take responsibility.”
Think carefully about the day-to-day functions. How are the responsibilities delegated and shared? By defining the roles clearly, you make it easier for your staff to perform well. You also make it easier to hire and fire, because the criteria are explicit: You know what you need and you can communicate it easily.
A Consistent Patient Experience
The ultimate goal is to optimize the patients’ experience. This means all systems should support you in providing the best, most attentive care. They should also help you create a friendly, professional, reassuring atmosphere.
You may be an excellent diagnostician, or a compassionate healer highly proficient at a particular therapy, but if your office is chaotic, your employees are inattentive, and you yourself are harried, you’re not providing optimal care. That might not matter so much in insurance-based medicine, but in direct-pay it will hurt you. Unhappy patients will go elsewhere.
It’s really in the details. Think about:
• What happens when a prospective patient calls? What, exactly is said? What happens next? If someone is interested, who follows up?
• What’s in your new patient info packet? Who sends it out? Who sees it when it’s returned?
• How are you dealing with your files and patient records? Hard copy or in computer? Who has primary responsibility for organizing them?
• Who sets the tone and atmosphere for your patients?
This does not mean you need dress codes or scripts, but you should strive to create a consistent, positive and unique experience for patients—one that reflects your highest values. A resoundingly good office experience is your single best marketing strategy!
Effective Marketing Systems
Gail and Traci see a lot of practices wasting money and time on poorly conceived marketing efforts.
“They say they want to do a program, say in April, which is “a few months away.” But they don’t really work consistently on it, and then suddenly it’s March and they scramble, and don’t do a very good job, because they haven’t done any premarketing. They throw an ad in the paper and hope for the best.”
Like everything else, marketing requires a systematic approach. Start small.
“Pick something you’re really interested in and start with that. Explore it deeply. If you say you want to do tele-seminars about a particular subject, you need lots of good material to talk about. Who you can partner with to get that? What are the processes for execution of the seminars? What’s your end goal? Put some time and energy into thinking this through.”
Make sure you know what’s going on in your billing department. Here, more than anywhere, you need well-delineated processes and responsibilities.
Simply put, if your billing is disorganized, you are losing money—regardless of what particular practice model you’ve embraced.
In insurance practice, it’s all about submitting the claims within a certain period of time. Insurers can refuse to pay untimely bills—usually defined as those submitted more than 30 days after services rendered. Traci Brosman says she’s often surprised by how much money clinicians lose because of delayed submissions. “Don’t give them reason to deny payment.”
While direct-pay takes the paperwork out of the process, it adds a personal money interaction with patients that some clinicians find uncomfortable. Yet, it is just as important to be conscientious about billing—and about collecting—as in insurance practice. If you’re not on top of it, no one will be.
Ideally, your team-members will know enough about each one’s roles to be able to fill in, should there be a sudden emergency. A compendium of procedural descriptions can be a real life-saver.
“What happens when someone suddenly get sick? If “Ma” has been doing something her own idiosyncratic way for 20 years, and then suddenly she’s really sick, what does “Pa” do?” Though nobody likes to think about these possibilities, Gail says she’s seen it happen.
“I worked in a cardiac rehab center, and the secretary had been working there for 18 years. She had all sorts of her own systems in place. One day, she got sick, and two days later, she died. For six months after that, nothing was getting done! She didn’t write down anything. Nobody else knew what was going on. Nobody knew how to bill, nobody even knew how to purchase supplies!”
Checks & Balances
Regardless of the size of your office team, it’s a big help to have regularly scheduled staff meetings to review how the practice is performing, trouble-shoot any emerging problems, and fine-tune your systems.
Look at where money’s being spent and work together to minimize overhead—one of the keys to economically successful independent practice.
Good systems are clear enough to provide solid structure, but flexible enough to allow for spontaneity and change. “It shouldn’t be robotronic,” says Gail. But leaving things up to chance under the rationale that one is defending against “cook-book” medicine, won’t really serve you well.
In their Heal Thy Practice Post-Conference program—which is limited to 30 participants—Gail & Traci will help you identify facets of your practice that are most in need of re-systematization. They’ll work with you to set clear goals, timelines and benchmarks, and then help you think through good systems design.
The after-conference coaching program includes monthly individual coaching sessions with Traci and Gail, as well as group sessions, Skype messaging sessions, and access to bonus audio guidance from Holistic Marketing Mentors.