Whether health care reform happens as the result of legislation from our friends in Washington or because of financial constraints imposed by the major purchasers of health insurance policies, one thing is sure: Health care reform will effect the amount of money doctors and hospitals are paid for their services.
Experts agree that one solution to the certainty of change in the management of medicine is to make your office more efficient. By lowering the costs of providing health care, your practice will improve its financial strength. Many offices, however, feel that "lower costs" always lead to lower quality medical care. This is simply not true. There are many cost-saving steps your practice can take which will actually increase the quality of your patient care.
How do you achieve this goal? How can you become more efficient? As many offices often forget, it all starts with your staff. While you actually see your patients, your staff should be busy around you, completing hundreds of tasks a day. For example, your staff's time is probably spent answering the phone, scheduling each provider's time, scheduling the staff, scheduling patients, maintaining your computer system, providing phone triage advice, screening each patient, seeing your patients, processing and following up on lab work, maintaining patient charts, auditing patient charts, negotiating with insurance companies and suppliers, managing personnel issues, sending bills to patients and insurance companies, monitoring cash flow, and many other tasks.
How can you minimize these efforts without reducing your effectiveness? Below, we have listed 10 general suggestions which should apply to nearly every medical office. Because there is a tremendous difference between a Pediatric office in rural Oregon and a 15-physician MSO in urban New Jersey, it is silly to suggest that every suggestion offers a complete solution. Our experience, however, has shown these issues to be universal.
As you consider each of the suggestions below, remember that every minute you and your staff save on administrative issues is another minute you can spend caring for your patients. Some portion of every minute you save can go directly to providing better patient service, whether it manifests itself in new lab equipment, new furniture, or that new phone system, things that both you and your patients will appreciate.
Your staff usually knows a lot more about what happens at the front desk and in the billing office than you do! Do not make the same mistake that many offices make: They don't pay attention to their employees. Everyone has heard of using "Total Quality Management" for your patients. Why not your staff?2. Think ahead.
Take some time out of each work day or work week to think about the issues discussed below. Have staff members be responsible for particular aspects of the office rather than having one person oversee it all. Meet regularly, form teams, take office meetings seriously, and, most of all, follow up on your plans.3. Implement only one change at a time.
Presenting your office with a list of changes can be confusing at best, harmful at worst. Take your time and let each change begin to settle in before moving on to another. Some changes may take effect immediately, while some may take weeks or even months.4. Be patient.
Once you and your office decide to make a change, be patient. Depending on the nature of the change, you may want to wait a week or even several months before evaluating its success. Don't throw everything out the first time someone complains!
Be prepared to face difficult decisions and, obviously, do not make decisions based on your emotions. Nearly every office has someone who is incredibly resistant to change. Do not let others' frustration, fear, or anger cloud a vision for you and the staff.5. Once a year, examine your office "from the ground up."
Once a year, hold an office-wide meeting to discuss the entire practice, particularly how you envision the "perfect" office working. This will provide plenty of new ideas for change and will provide direction for future efforts.
A common mistake offices make is to under-emphasize the importance of office-wide planning meetings. Make your meetings mandatory,and do not be afraid to close the office while you meet! Distractions can stop a meeting in its tracks.6. Develop a personnel policy.
Developing a good personnel policy will help you find and keep good employees. In addition, it will protect both the office and employees from the dozens of common miscommunications and disagreements that can lead to larger problems down the road. The first step in any new employee's training should be to read the Personnel Manual.7. Develop a financial policy and stick to it!
Develop and print your financial policy for both your staff and patients to take home. Your staff will appreciate having an official, written source for financial questions and your patients will have a clear understanding of your expectations.
Once you implement a financial policy, stick to it! Too many offices are inconsistent with their policies.8. Use the telephone to your advantage.
Develop triage guidelines so that your nursing staff knows whether or not a patient should come into the office. This is particularly important with managed care.
Some offices have found that automated phone systems work wonders, other offices find them miserable. Talk to your peers in the area and consult your patients.9. Conduct peer reviews.
Review the monthly statistics from your computer system. Does one provider consistently order more lab work than the others? Is it necessary? If not, the provider may cost your practice money, especially with managed care plans.
Each provider should have his or her chart notes reviewed by the other providers. Are the charts complete and easy to read? If not, fix your bad habits now before your charts get audited.10. Add nurse practitioners to your practice.
This issue is no longer in debate: Nurse practitioners can clearly increase the financial and medical efficiency of your practice. With proper organization, they can see many of the routine visits (for well care or common illnesses) and allow the office to see more patients.
In nearly every office PCC has ever visited, the way a pracftice handled these 10 issues was almost always what made the practice efficient...or inefficient. Take a step back from your daily routines and examine your own work habits!