“Good enough’ is no longer good enough. For today's medical practices, it's improve it or lose it” (Roy Aymond). These are wise words indeed.
In 1999, Roy Aymond, a former hospital CEO and managing director of the Gainsborough Group (a California based consulting firm that works with healthcare organizations) made 22 tips for how to improve your practice. In 2018, some of Mr. Aymond’s points are more relevant than ever. It turns out, Mr. Aymond saw the future before many others did. Today we look back at the most relevant of his 22 points in 2018…with a few tweaks.
- Focus physician time on patient care. To maximize their value to the practice, physicians and other providers should spend at least 37 hours per week on direct patient care. In a group practice, there are better opportunities to realize this goal, with distribution of efforts, but don't give up on it as a solo physician either.
2018: More relevant than ever. If your patients don’t feel like you care about them, they will leave your practice. Patient loyalty is not what it used to be, and proper communication is key to patient retention as healthcare continues to transform into a patient-centric model.
- Improve patient flow. Regardless of the patient mix, the goal is to have an efficient schedule. Focus on providing appropriate care to as large a community of patients as possible. If you feel overloaded seeing a patient every 20 minutes, the process needs reform. Most family physicians can average four visits per hour, when those visits are appropriately scheduled. Avoid schedule gaps, and stay on schedule.
2018: Patient flow starts from before the patient arrives at the practice. Having advanced digital check ins, and health information including insurance on file beforehand, speeds up the process. With proper communication, patients can have the option to check in in advance, therefore limiting congestion and wait times in the lobby of your practice.
- Enhance communication with handouts. You can reduce the number of unnecessary phone calls for simple questions by using brochures and handouts. These can focus on both clinical topics and information about your practice. Using handouts about patients' conditions or treatments can also help focus the visit so that important information is appropriately communicated.
2018: Handouts are still effective today. Handouts eliminate the need for unnecessary phone calls and follow ups for simple questions. Having a proper communication system optimized for the digital world is a good idea, where handouts and other FYI are available on a mobile device for patients to access.
- Use a good scheduling system. Many practices assign a relatively low-paid employee to schedule appointments manually. Yet the schedule has an enormous impact on productivity and efficiency. Dedicate resources to developing a good scheduling system, hire a top-notch person to run it and ensure that the entire staff understands it. This is especially important for solo practices that are growing into groups. Good scheduling can increase patient flow by two or more patients per day, which is net income to the practice. If you use a manual system, consider computerizing it. Your billing system may have a scheduling module that is adequate for solo and small-group practices. You can buy a more sophisticated system, but don't upgrade until you have established scheduling guidelines and policies.
2018: Efficient scheduling can be the difference between revenue and lost revenue, as well as patient longevity and patient leakage. 60% of calls to Practice’s with call centers are appointment related. If you master the art of scheduling through proper communication, you will have more time on your hands to eliminate secondary tasks and focus on patient scheduling, cancellations, and rescheduling. It would be even better if you can have a direct one-on-one messaging system with your patient.
- Eliminate overtime. There is no reason to have routine overtime. In fact, it often results from the staff's poor organization or performance — or from a disorganized physician. Examine the reasons for overtime. You might find that it is really for convenience, not necessity, and can be eliminated by reassigning duties. Don't get to the point where employees expect overtime as part of their regular compensation.
2018: Disorganization, stress, and poor performances from staff are just as relevant of a problem in 2018 as they were in 1999. Having a communication system for the 21st century in place that allows for triaging and eliminating workflows can make the entire process seamless, reduce annoyances and stress for your staff, and prevent unnecessary overtime for your staff and additional money you will have to cough up for overtime hours.
The bottom line…
The best way to look at how practices can grow is either you increase your top line revenue or your bottom line revenue. Cutting costs and overheads and increasing efficiencies (bottom line) top line—increasing new patients, retaining current patients, etc. These two go hand in hand. Most practices do not have sustainable growth because they choose between one or the other. The best way forward for growth is to keep the focus on top and bottom line and achieve both.