Are Practice Management Consultants Worth Hiring?

In the end, the practices who invest in themselves are, almost always, the top performers. You’ll see among best performing practices, that many have engaged – and continues to engage – consultants on matters that are outside their expertise.

This is a guest post from Chip Hart. Chip is a frequent contributor to PediatricInc and former co-host of the highly revered Pediatric Management Awesomecast. When Chip isn’t protecting independent pediatric practices against evil conglomerates, naysayers, and the League of Shadows, you can find him at PCC doing… something (I’ve never figured out what is it that he does at PCC, exactly). 


I will never forget the scene. I was the lonely consultant in the dark and shag-carpeted basement “conference room” of a large pediatric practice and was giving them a stern lecture about their pricing. The practice hadn’t updated its prices in years and was undoubtedly losing money. Lots of it.

Chip Hart and Brandon Betancourt
Working really, really hard.

After my explanation of RVUs and why 105% of Medicare wouldn’t cut it, the senior partner – well, the loudest one, anyway – looked me in the eye and said, “OK, that sounds smart, let’s just raise our prices.” It was the response I was hoping to get.

The youngest and newest partner jumped in quickly, “What?! How can you listen to this guy?”

Uh oh, I thought. His voice cracked, “…I’ve been telling you this same information for almost two years and he just waltzes in here and says ‘Correct your pricing.’ and you do it just like that?”

I honestly thought he was going to cry in frustration and relief. 10-minutes of back-and-forth among them ensued. I just stayed out of it. At the end of the year, the additional $250,000 they collected erased the discomfort and awkward part of the memory for them.

I didn’t forget, however. I remember sitting there thinking, “This poor practice lost hundreds of thousands of dollars simply because they were unwilling or unable to listen to themselves. They had to hear it from someone else.”

HOW DOES THIS HAPPEN?

The answer is both obvious and convoluted. I have often said that the most important and difficult task for any small business is to find and hire good people. Unquestionably, this challenge extends to the hiring of practice management consultants.

Pediatric practices successfully hire consultants all the time without a tremendous amount of consideration – realtors, attorneys, I/T – but when it comes to getting help on the inner workings of the practice, the majority of pediatric offices too reluctant to ask for help.

And when they do ask for help, it’s often ineffective.

Every practice I visit codes imperfectly, yet some practices lose tens or even hundreds of thousands of dollars a year as a result of their inability to address the problem.

Most practices could use help negotiating with insurance companies, yet remarkably few of them do. Many practices need help with a compensation model or managing a challenging partnership, yet most of them just live with the problems and hope it will go away. And so forth.

Physicians, unfortunately, are uniquely susceptible to mis-using consultants, even if it is simply to not use them enough.

You expect most vendors and consultants to try to take advantage of you – all doctors are rich, right? – while having trouble admitting that you cannot solve all of your own problems.

Combine those aversions with the impecunious nature of most pediatricians, and there is no surprise that I meet practices every week who would rather lose another $15,000 this year due to a poorly designed superbill and bad pricing than pay a consultant half that amount to fix the problems.

HOW AND WHEN DO YOU KNOW YOU NEED A CONSULTANT?

There is no magic formula, but try these parameters on for size:

  • When there is an issue that your partnership cannot resolve, or when a neutral third party can facilitate a necessary change in your practice, consider a consultant.
  • When you are not an expert in the matters that affect your practice or if there is simply another party who might be more effective and efficient at addressing the matters, consider a consultant.
  • When your practice is losing more money on an issue than it would cost you to fix, consider a consultant.
  • When the amount of money you would pay a consultant is less than the amount of money you would generate seeing patients, consider a consultant.

Those last two examples are often conjoined in a death spiral of inaction. Many of you don’t want to pay a consultant $20,000 to renegotiate a contract increase of $50,000 annually because “you can do it yourselves.”

Yet, you don’t do it. Or you start the project and sink 10, 20, 40 hours into the task – often worth more to the practice than what you would pay the consultant – and then never complete the job.

Pediatricians, as business owners, are notoriously bad at examining the return on their potential investments and usually focus far too heavily on only the costs.

Pretending to be 100% self-sufficient serves no one except, perhaps, the insurance companies. Your patients don’t benefit, your lifestyle suffers, and you leave money on the table.

HOW THEN DO YOU HIRE A PRACTICE MANAGEMENT CONSULTANT?

First, hiring a consultant involves a lot of common sense. You want a written contract that spells out the terms of your obligation.

The terms should clearly outline your expectations, identify the fundamental goal, and determine conclusion of the contract. Ultimately, it involves a relationship of trust and confirmation. Some suggestions that go beyond the generic:

1 – Pediatric practices are different, don’t let a potential consultant tell you otherwise.

Most medical practice consultants live in the Medicare world and look for “alternative income sources” that just don’t exist in pediatrics.

More importantly, the attitude and (often unspoken) philosophies of pediatric practices differ from other medical specialties. Find someone who knows pediatrics.

2 – Work with a consultant on one or more smaller projects and build up to a strong relationship.

Before you leap into that full payer-mix and negotiation mission, see how well you work together on something smaller, like simply reviewing the state of your existing contracts. If you are not getting the kind of performance you expected, better to have not committed so heavily.

3 – Don’t be afraid to use different consultants for different needs.

Just as you may not be an expert on RBRVS or pediatric compensation models, your consultant may not know it all, either.

Although some consulting resources pride themselves on their breadth of experience, depth is usually more important. A good consultant might look at your practice and identify work that needs doing. A great consultant can identify work that needs doing, but suggests another resource.

4 – Even after you have chosen a consultant, keep an eye out for conflicts of interest.

Although they are impossible to avoid and sometimes even lead to efficient work (like one consultant recommending another), conflicts are often poorly revealed in the industry.

5 – Use your network of pediatric peers to help vet your consulting needs.

Surely, if your potential consultant expects to work with you, he or she can provide you with pediatric references whom they have helped with similar issues. SOAPM is an excellent place for a sanity check.

In the end, the practices who invest in themselves are, almost always, the top performers. You’ll see among best performing practices, that many have engaged – and continues to engage – consultants on matters that are outside their expertise.

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Three Simple Questions To Help You Manage Disruptive Employee Behavior

Guest post by Brenda S. Campbell

One of the most challenging aspects of practice management is managing the people within the business. It can feel overwhelming to manage employee attitude, behavior and performance, especially if confrontation doesn’t come naturally.

Screen Shot 2016-06-05 at 9.56.40 AMI have had the privilege of working for an amazing pediatrician for the last fifteen years. He’s been in practice for decades and has taught me so much about practice management, especially the “people” part.

He has helped me understand that it is possible to manage any employee behavior and expectations using a simple strategy.

When confronted with unsatisfactory employee behavior and performance, it is important to focus on three questions:

You send a message to the rest of the staff no matter how you handle the issue.

What’s the message you want to send?

If you choose to overlook the behavior, the message to your staff is that it is okay to continue this behavior and that it is acceptable.

If you address a behavior, it sends a message to everyone that the behavior is NOT okay and will not be tolerated. Often times, even though they may not say it, the staff appreciate that you address negative behavior.

For example, we had a telephone triage nurse who had a lot of experience, worked for us for several years and was solid in the advice she would give.

Her customer service skills, however, were lacking. I had to make a decision about the message I wanted to send to the rest of the staff.

What you allow is what will continue. Are you going to allow it to continue?

Make the decision to address the behavior and do it. Don’t put it off. Ask, “May I give you some feedback?” Let them know the problem with their behavior, set expectations and move on. They’ll either choose to correct their behavior or they won’t.

We’ve found that employees generally receive feedback in one of two ways. Some are completely unaware that their behavior was being perceived in a negative manner and are quick to ask how they can fix it.

The others become defensive and refuse to take ownership of the behavior often blaming external factors.

With our triage nurse, I knew that I needed to address her customer service problem, particularly her tone which could be perceived as condescending and snarky at times.

Her response fell in the defensive category and she said “somehow I get all the nasty parents on the phone.” I explained to her that she was the common denominator in each complaint and that her tone was the problem.

“Ma’am” is not necessarily respectful if delivered in a sarcastic manner. It was her behavior that made the parents become, in her eyes, “nasty”.

Are you better off with them or without them? Is it time to let them go?

If, after you’ve given the feedback and they have not changed their behavior, it’s time to make the decision about the employee’s future.

As you may have guessed, it didn’t take long for another parent to complain about the triage nurse and, at that point, we decided that even though we’d be down a phone triage nurse in a busy sick season, it wasn’t worth allowing negative behavior to continue thereby sending the wrong message to the staff.

We have found that when it comes to working with someone who behaves poorly or working short-staffed most employees would rather work a little harder until we find someone who is a good fit for our practice.

It’s certainly easier in the short term to ignore problematic employee behavior but it’s always costly in the end.

Allowing negative employee behavior to continue can hurt your employee morale, productivity and retention as well as cause you to lose patients. When we reflect on the occasions where we’ve had to let someone go after asking these three questions, we have yet to regret a single one.


Brenda Campbell is a practice administrator for The Pediatric Center at Frederick. You can check out her practice by clicking, here. She is a member of AAP’s subcommittee Pediatric Practice Management Alliance (PPMA). This article originally appeared in SOAPM’s Quarterly Newsletter.


 

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Learn How To Create A Budget For Your Medical Practice

In medicine, the mention of the word profit is often viewed or interpreted as a dirty word. It is as if the word does not belong in the lexicon when health care is addressed.
 Broke doctor
I argue (in the context of the private medical practice setting) that profitability is a medical practice’s responsibility for one simple reason. If the medical practice (also known as a business) doesn’t deliver profits, health care providers are unable to provide for those in need.

Why Profits?

Profits pay for infrastructure, technology, education and human resources, all of which translate to superior pediatric care when employed correctly.
Another way I like to put it is by saying,

 

…a broke doctor does do anybody any good.

 

Calling vs Profits

Indeed, our medical businesses differ from other companies in that we care for children. And the notion of withholding medical services or restricting access to a sick child merely by the patient’s parents inability to pay for health care services is simply not in a pediatrician’s DNA.
However, it is important to accept the reality that without a way for a doctor or the practice’s income to outpace expenses, health care providers are unable to provide services of any kind. At least not for the long term.

Is there a solution?

How do we reconcile these two competing issues? On one hand, it is necessary for a medical practice to deliver profits if it wants to remain sustainable. On the other, we have an intrinsic motivation to put the patient’s needs first.
I am glad you asked.
These two dichotomies can co-exist – and even flourish – alongside each other. There is indeed numerous tools and principles rooted in business that can help medical practices manage what otherwise appears to be opposing forces.

A Resource You Don’t Want to Miss

Today, I want to tell you about a resource I’ve been working on to help your office obtain financial success, while simultaneously providing unsurpassed pediatric care to your patients.

To help you succeed in your financial success, I’ve written a comprehensive eBook on budgeting that walks you through the process of creating a budget for your medical practice. The materials also cover basic principles necessary to put the exercise into perspective.

Budgeting is a major component of financial success. Moreover, financial success is essential to the continuity of care.

To read more about this offering, click on the image below.

Medical Practice Budgeting
Click on the image

I do hope that you buy the book, but more important, that you find the eBook helpful, useful and valuable.

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11 Straightforward And Practical Tips To Improve Your Practice’s Bottom Line

It is our responsibility as captains of our ships, however, to equip our practices and our staff members with the necessary tools and information if we want to have any chance of overcoming these real threats.

You do not have to be a marine captain to know that there are countless potential dangers navigating waters.

With a little imagination you know there are many risks. Some hidden, like currents, while others are painfully apparent (i.e. howling winds, waves and torrential storms).

 

Compass Direction GuideWe know there isn’t anything the captain can do to eliminate weather conditions or enforce her will on ocean currents.

However, we can all agree the captain has control over the vessel. We can also agree that the captain has the responsibility to equip the ship and its crew member to its maximum potential if they have any intention of overcoming environmental threats.

Running a “profitable” practice is indeed becoming more of a challenge. For many, it is uncharted territory. And while there are many extrinsic reasons – like decreasing insurance payments, high deductible plans, and the increased cost of providing care – that are contributing towards the “remaining profitable” challenge, the truth is, there is little – if anything – we can do to eliminate those threats.

It is our responsibility as captains of our ships, however, to equip our practices and our staff members with the necessary tools and information if we want to have any chance of overcoming these real threats.

Below are 11 STRAIGHTFORWARD and practical tips you can implement immediately to help you navigate these rough waters.

  1. Review fee schedules regularly to ensure your fees reflect market conditions in your region.
  2. Adjust fee schedules for certain procedures to improve providers’ competitiveness.
  3. Review all E&M charges by a certified coder before submitting claims.
  4. Hire coding consultants for annual chart reviews to ensure accurate coding.
  5. Monitor and report payments of your top insurance-payers.
  6. Run reports to understand payments by different networks or other contract types.
  7. Renegotiating (or consider dropping) contracts with payers who have low payments.
  8. Monitor how long it takes for charges to be entered and claims to be submitted to make sure claims are being filed timely.
  9. Consider provider training or implement random audits to ensure billing slips are completed clearly and accurately.
  10. Review your practice’s policies for routing super-bills to ensure claim submissions are sent as soon as possible.
  11. Implement processes so your billing staff works missing super-bills, claims, denials, consistently.

Imagine for a moment navigating open waters without navigation tools. Now, imagine what would happen if conditions were less than excellent?

If your boat ran off course or worse, capsized, would you blame the environmental conditions? Or would you take responsibility because you didn’t have the proper equipment and tools to navigate in challenging conditions?

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Is It Worth Being A Member Of The American Academy Of Pediatrics?

I asked a newly graduated pediatrician if she was going to renew her membership with the American Academy of Pediatrics.

Her response did not surprise me. She said, “…probably not. I see no point in being a member.”

As far as she was concerned, there wasn’t an upside ( or value ) to belong to the Academy. I knew what she meant because I share her feelings.

Screen Shot 2016-06-05 at 10.48.49 AMRecently I came across an email that challenged my stance regarding the value the American Academy Of Pediatrics provides to pediatricians.

I wanted to share the email just as I read it. Below are the unedited comments from Dr. Suzanne Berman and Dr. Christoph Diasio regarding the meeting.

I had the privilege of attending the 3rd Immunization Congress in Washington DC with some of your favorite SOAPM types: Rich Lander, Geoff Simon, Christoph Diasio, Drew Hertz, Joel Bradley and uber-awesome AAP staffers Lou Terranova and Elizabeth Sobcyzk.

We had an opportunity to describe what works and doesn’t work with pediatric vaccinations, and lessons that can be applied in the adult world (where they do not vaccinate like we do).

Rich Lander spoke eloquently about the need for calling it PAYMENT not REIMBURSEMENT and people listened!

He presented the business case for vaccines. For the whole rest of the time, people would start to say “reimbursement” and then caught themselves and said: I should call it payment! I need to update my slides!

Geoff Simon and Drew Hertz spoke about some of the practical aspects of immunization delivery in large health systems and the implications of alternate payment models in vaccine delivery.

Geoff also talked about the challenges of providing vaccines across state lines (PA/DE).

Joel talked about the need for VFC to turn on 90461 and the need for local Medicaid and VFC programs not to do their little unsupervised strange things.

Suzanne Berman, MD

Dr. Diasio chimed in and added this:

There’s so much the AAP in general, and SOAPM, in particular, does quietly in the background- it is important to share this.

I am sure it will surprise none of you that I was continuing to beat the drum for removing the VFC flu vaccine delivery disparity.

Suzanne is humble- her talk on “the stupid things insurance companies/Medicaid agencies do re: vaccine payment” was terrific and included descriptions of dysfunction that I had never heard!

We touched on 2D barcoding uptake, but this was more related to trying to fix registries and increase communications.

We did discuss trying to create incentives/funding for EMR companies to support barcode readers

Christoph Diasio, MD

I have been particularly vocal about the Academy’s presumably disregard towards the numerous challenges pediatrician face in light of the AAP’s recommendations and children’s advocacy initiatives.

When I read this, the first thought that came to mind was, I think I am misinformed. Then I thought, so are numerous pediatricians, like the newly grad I mentioned.

I then thought to myself, the word needs to get out. Pediatricians need to know what the AAP and committees such as the Section on Administration and Practice Management (SOAPM) are doing on behalf of pediatricians, not just children.

Reached out

I immediately emailed Dr. Suzanne Berman and asked her permission to publish her email. I then spoke to Dr. Christoph Diasio – SOAPM Chairperson – and also asked him if I could add his commentary.

They responded with a resounding:

NO WAY. NOT IN A MILLION YEARS.

I am kidding, I am kidding. It was the opposite. They replied within minutes saying yes.

Times are indeed tough

I am preaching to the choir when I say that independent pediatricians are facing difficult challenges. However, it is reassuring to know that people are working behind the scenes advocating for children by advocating for those that provide for children.

It is my understanding that highly influential people attended the meeting. There were high ranking AAP representatives as well as influential people from the CDC.

Thanks

So, not only did I want to inform those that are not fully aware of what type of initiatives their AAP membership dollars go to support, but also wanted to give a big thanks to all that attended the meeting and all those that worked behind the scenes.

Thanks for looking out for us. And keep up the good work.

For the rest of you, go and renew your AAP Membership.

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The Value of Having Core Values

The airline passenger was upset with the flight crew. So she wrote a letter to the CEO to inform him she did not approve of how the crew was making jokes while doing the pre-flight safety checks.

In her letter to the CEO, she made clear that security announcements ought to be taken serious because of how important they were.

 

Airline Customer Service Values Core Values Business CultureAs it turns out, the passenger that wrote the letter was a frequent flyer of the airline. Surely a customer the airline wants to keep. Right? So how did the CEO respond?

“We’ll miss you” and added, “Rest assured that this company, like all good airlines, take safety very, very seriously.”

Most CEOs would have probably sent an apology letter saying things like it was not their intention to offend her; he’d look into to the matter; they value her opinion and appreciate her business. But not Southwest airline’s CEO.

What Can We Learn From The CEO’s Response?

There are many lessons in the Southwest story we can glean and apply to our practices. However, among the most valuable lesson for me, is the importance of having a set of defined core values.

Why Are Core Values Important?

Core values are used to establish a company’s guiding principles. They serve the distinct purpose of determining behavior and action.

Without core values, employees do not know what is right from wrong. Therefore, they have no choice but to make decisions based on their values. Which, of course, may or may not align with the company’s values.

However, when a business establishes them, they assist in determining the right path. Moreover, they give employees a reference in fulfilling business goals.

Southwest Airline’s Core Value

Embedded into Southwest’s company culture, is a set of core values. Here is how they define it for their employees:

We believe in Living the Southwest Way, which is to have a Warrior Spirit, a Servant’s Heart, and a Fun-LUVing Attitude.

No Apologies

For Southwest, working hard and playing harder is one of the company’s guiding principle. Fun is part of what the airline is all about. That is why the CEO did not apologize on behalf of the employees. The employees were embracing one of the company’s unwavering value.

Core Value For Salud Pediatrics

One of our practice’s cornerstone principles is profitability. This may seem obvious or inherent knowledge considering our practice is a small business.

But for us, profit is a core value because our financial gains are the driving force behind our ability to fulfill our mission to advocate and care for children in our community.

In other words, profitability is essential to our ability to provide health care services. Without it, we would not be able to stay open. Thus profitability is a responsibility to the community we serve, not merely a requirement for our business.

Prepared To Lose A Patient

Recently, a parent from our practice questioned our policy that requires patients to leave a credit card on file with our practice.

After explaining the reason for the policy and addressing her concerns about identity theft, the mom was still apprehensive.

I told her that her concerns were legitimate and that I understood where she was coming from, but that the policy was non-negotiable. I explained to mom that we felt so strong about the importance of the credit card policy, that we were willing to lose her family as patients.

Policies & Procedures vs. Core Values

We all have rules in place. Even Southwest, with their FUN-Luving attitude, has them. Going through the pre-flight safety announcements is one of many, I’m sure.

Having systems in place ensure efficiency and safety, among other things. But It is impossible to come up with a scheme for every single potential situation. There will always be situations that fall outside of the “policy.”

Core values, however, can be used in situations that fall outside the parameters of policies and procedures.

Does your practice have a core value statement?

If so, what does it say? Are you prepared to lose patients over it?

 


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21 Questions To Put You and Your Medical Practice Back On Track

Things have changed since the beginning. You are now so wrapped up in the day to day that you’ve lost your North, your purpose, your original destination.

It used not to be this way, but it seems like the practice has lost its focus.

Screen Shot 2015-01-09 at 6.02.01 PMLosing focus was not intentional. You started out with a clear vision, worked out the details and began. You remained disciplined and consistent. You were not distracted easily, you kept an eye on the ball and made sure things were addressed effectively and efficiently.

However, along came bumps on the road, mishaps, unforeseen circumstances, misunderstandings, performance issues, competition, reduction in payments and the vision, the original purpose, got buried.

Now, there is so much stuff going on, so many fires to put out, that you only have time to focus on the immediate, the urgent. No time to step back and re-assess. Not even enough time to align priorities or the important.

IS THIS YOU?

I do not know about you, but we’ve been there as a practice. We’ve felt before as if the practice has lost its north. My guess is that if you practice has been around for some time; you can relate. In fact, whether in the medical field or otherwise, many companies go through similar challenges.

Early in 2008, Howard Schultz, founder of Starbucks, is on record saying he felt the company had veered off its original path and as a result, he announced he was returning as CEO.

Steve Jobs’ return to Apple in 1995 was motivated by similar reasons. The company had spent the previous 10-years drifting and was on the brink of bankruptcy. The board brought Jobs back to realign the organization and restore it to its original innovated breakthrough company it once was.

HOW TO GET BACK ON TRACK?

Like Rocky Balboa returning to the old neighborhood after being defeated, we thought it was best to go back to the early days of the practice to get us back on track. We went back with the purpose to recall the essence of our practice.

However, merely remembering the old days was not enough. So we took the time to draft questions that would remind us of our north, but also is identify priorities and determine next best steps.

Below you will find 20 questions we wrote to help us gain the clarity and the insight that would lead us back on the correct path.

  1. In one sentence, what exactly is it that your practice provides (take care of patients is not a valid answer. Dig deeper to find the essence of what your practice offers)?
  2. Why do you/we come to work every day?
  3. In one sentence, why do parents bring their kids to the practice?
  4. If you closed your doors to the practice tomorrow, would anybody notice?
  5. Who would be most likely to miss you?
  6. What is one thing that is is preventing your practice to accommodate more patients?
  7. What is the one thing that is preventing the practice to have a full schedule?
  8. If you could ask a parent just one question about your practice, what would that question be?
  9. If your practice’s revenue stream suddenly stopped today, how many days would you have before you run out of money?
  10. If someone unexpectedly handed you $250,000 what would you do with it?
  11. If you were forced to hire someone today, who would you hire?
  12. What would you need to do, to ensure, the new hire contributes enough revenue to cover their expense?
  13. If you were forced to hire another person tomorrow, who would you hire?
  14. What was different about the person you had to hire immediately versus the person that you had to hire the next day? In other words, why was the first hire first and not the other way around?
  15. If you had no choice, which department in your practice would you outsource and why?
  16. Which employee would make your stomach sink if they gave you a 2-week notice.
  17. Alternatively, which employee would make you say “yes!” if they gave you their notice?
  18. If you have two columns on a piece of paper, one labeled urgent, and the other important, what would you write in each column?
  19. If you could get one solid hour with a guru you respect, what would you discuss?
  20. How would you define a great day in the office?
  21. What is it exactly that is preventing you from having a great day, every day, in the office?

ONWARD

I am sure there are many ways to jolt a company back on course, however in my experience, businesses that have lost their way, veered off their mission or forgot their purpose regain it by asking critical questions.

Asking the right questions lead organizations to put their current circumstances into perspective, prioritize issues and determine what is the next-best-step for the organization.

For us, the questions did not answer all of our problems. The questions did not immediately place us back on track. However, they led us to admit things we had been neglecting, brought awareness to the tough decisions we were avoiding and in several instances, helped us decide to abandon projects because they were not in alignment with our practice’s vision.


 

Can you think of another question that would fit with the list that I have? What would you add? Also, if you experienced something similar, I’d love to hear your story.

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How Well Do Parents Know What You Do As a Pediatrician?

It’s hard to appreciate the value that pediatricians provide when one is not aware of exactly what it is that pediatricians do.

During the summer months, I posted on our practice’s Facebook page, a note encouraging parents, to schedule their children’s wellness visits.

Although the message was for our entire Facebook community, I wanted to catch the eye of parents with teenagers. Don’t know how well you manage teens in your office, but in our office, we have decent wellness visit numbers with younger patients. The teen population?

Not so much. Once the teen years kick in, we mostly see them when they are sick.Screen Shot 2016-02-26 at 11.48.51 AM

I wanted to encourage parents to make their wellness visits but also throw in a subtle nudge to parents with teens.To get their attention, I opened with this line: Did you know pediatricians are trained to treat children from birth to adolescence? Then I went on to talk about the importance of wellness visits etc.

Something interesting happened. The post outperformed other Facebook post. It received more likes that than the ordinary. But that the surprise me. What surprised me the most, were the comments from parents.

One mom said, “it’s good to know the pediatrician can see my teen.”

Another said, ” Timothy is going to be so happy when I tell him Dr. B can still see him.”

WHAT WAS THE LESSON?

It’s an age-old lesson. It’s a lesson on assumptions and what happens when we make them.

That simple, otherwise ordinary status update, got me thinking about how well (or not) we communicate what it is that we do as pediatricians. If so many people weren’t aware that pediatricians can treat teens and beyond (0-21), what else don’t they know? The irony is that our website is tagged with the line “Pediatric & Adolescent Medicine.”

OPPORTUNITY

We clearly have a communication problem. And I would argue that our lack of proper communication about what it is we do as pediatricians (more than runny noses and giving shots) is why many parents don’t see the distinction between a retail clinic and a pediatrician.


 

It’s hard to appreciate the value that pediatricians provide when one is not aware of exactly what it is that pediatricians do.

 


 

The good news is that there is a significant opportunity for pediatricians to cover a lot of ground. How so? By using social media channels to educate our community about all the great services we are trained to provide.

I also believe that leveraging this opportunity could aid your practice in differentiating itself from the competition.

WHAT IS YOUR COMMUNICATION STRATEGY?

Since I realized there was a chasm between our assumptions and the reality, I’ve been intentional about informing our community about the training, knowledge and expertise our pediatricians can address.

Some of it may seem too obvious for those of us that do this every day. Like explaining the importance of wellness visits.

But the truth is, some parents don’t know about yearly wellness visits. They assume that because the child no longer needs shots, they don’t need to go to the doctor.

Beyond promoting wellness visits, I use many of the things included in the Bright Futures guidelines as a way to highlight that a visit to the pediatricians is highly comprehensive.

And by educating our population, I’m also marketing our practice in a unique way. Instead of mentioning in a promotional piece that we accept most insurance plans, I may mention that how we can provide family support, safety and injury prevention, or mental health.

MARKETING STRATEGY

Not only is promoting and sharing this information relevant and valuable to parents, but I also think it is an excellent way to differentiate ourselves from the MinuteClinics or other medical services that overlap with pediatrics (i.e. Urgent Centers, Family Practice, Telemedicine).

YOUR CHALLENGE

Think about your medical practice’s communication strategy, or lack thereof. What is your practices unique selling proposition? What problems do you solve that others don’t? Then think about how best to communicate your message. Also, consider the channels you’ll be delivering your message. By channels I mean, traditional advertising, email campaigns, social media, etc.

Remember, each channel is unique, thus requires you to craft the message differently.

I’ll leave you with this… times are changing. That is certain. And we have two options, two paths to choose from. Disagree with how things are changing, or find ways to agree with the shifts in a way that benefits you and your practice.

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4 Simple Questions That Will Make You A Better Manager To Your Employees

As practice managers and administrators of both large and small practices, we are wired not to see our failures but instead see the shortfall of our employees and attempt to correct them. Nothing wrong with that. It’s part of management.

But let me challenge you on this one. The next time you have difficulties with an employee, take a moment and reflect how you are interpreting the issue using the questions above. Consider where you are placing the blame. On people’s character or the circumstances?

As humans, we have an uncanny ability to justify and explain situations in ways that benefit us.  For example…

When we observe a father shouting, tugging or being overpowering towards their child, we raise an eyebrow and pass judgement on that parent’s poor parenting skills.

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If we lose our temper with our kids, we justify it by blaming the circumstances. We’ll say, “if you knew how challenging my children are, you would understand.”

In a medical practice environment, it may go something like this.

Julie: Nancy is late again.
Michelle: That’s the way she is. She’s so disorganized.
Julie: I know. And she doesn’t take her job seriously.
Michelle: Bill has given her so many opportunities, but she seems not to get the message in that thick head of hers.

Let’s look at it from another viewpoint.

Julie: I’m sorry I’m late. It’s just that my car has been acting up. And with my husband being out of town, I have to get the 3-kids ready, drop them off at my mother-in-law’s house – you know she is still upset about that thing – and just as my luck will have it, there was a fender bender on Route 95 and traffic was backed up all the way to the freeway.

CHARACTER VS CIRCUMSTANCES

Medical practice managers and administrators tend to make similar judgements.

When we have an under-performing staff member, we question their work ethic, make claims about their lack of motivation, engagement or lack of interest. Simply put, we tend to judge their character.

When we fall short, we don’t dare blame our work ethic, lack of motivation or lack of interest. Instead we blame the circumstances.

For example, we’ll blame our underperforming employees, unreasonable parents, the healthcare system, insurance companies, the printer, the network, being overworked and our boss. She’s too demanding and has unrealistic expectations.

REVERSE

What if we reverse the tendency to blame circumstances when we fall short and blame people’s character faults when they make a mistake or underperform? What would it look like if you looked at your character when employees in your practice fall short?

To help you put all of this into perspective, think about a time in the practice when an employee was underperforming. Using that situation in mind, read and think about the four questions I’ve listed below.

1.- Am I measuring a fish by its ability to walk?

Everybody has their strengths, but if you place someone in an environment that is counter to their strengths, they will undoubtedly fail.

Before rushing to judgement, ask this question first. Have I done a disservice to the employee by placing them in a position that they are not naturally good at doing?

2.- Am I telling them instead of leading them?

The best leaders are not the best because of their title. The best leaders are remarkable because they have distinctive character traits. Thus, asking employees to think and see the way you think and see things is often unfair.

Instead of saying, why can’t they just… (they being employees) ask, have I led them?

Consider putting more efforts towards helping them understand – leading them – rather than expecting them to know.

3. – Am I assuming employees remember?

Just because you said it once, doesn’t mean it was heard or retained.

If an employee keeps overlooking necessary task for example, take pause and consider if the reason is that you have not made clear the importance of the tasks.

One important distinction to have present when reminding employees. It is more important to tell employees why their jobs matter than remind them how to do their jobs.

4. – What am I doing about it?

Some hires simply are not a good fit. Others don’t work out. You know that. The entire staff also knows that.

Keeping an employee around that doesn’t fit well into the culture, is disruptive, consistently underperforms, and makes mistakes despite coaching, is a failure of leadership.

In other words, an employee that is out of line is not necessarily your fault, but it is on you if they remain an employee of the practice.

As practice managers and administrators of both large and small practices, we are wired not to see our failures but instead see the shortfall of our employees and attempt to correct them. Nothing wrong with that. It’s part of management.

But let me challenge you on this one. The next time you have difficulties with an employee, take a moment and reflect how you are interpreting the issue using the questions above. Consider where you are placing the blame. On people’s character or the circumstances?

 

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Many State Medicaid Meaningful Use Attestations Delayed

My friend at the Verden Group publish thie information below on their blog.

I’m reposting because I think it is important to bring awareness and maintain practices informed as best we can.

The Verden Group is recommending practices interested in this issue to visit your State EHR incentive web page for details.

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