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.

Extra, Extra – Now Offering Coaching Services

Screen Shot 2015-02-03 at 7.56.46 PMPeople always ask me if I do practice management consulting.There was a time when I did. But for the past two or so years, I’ve responded by saying no. I enjoy consulting and love to do it, but I had to stop because of the time commitment.

Recently, I was talking with a loyal reader of PediatricInc about this very topic and she suggested I do remote coaching.

My friend, who owns her practice, explained that she doesn’t necessarily need a comprehensive on-site consult. “I just want to ask a question about my practice or run things by someone familiar with practice management,” she said.

She went on to say, “…you know doctors don’t get training on business, management, marketing, collections…. having somebody to reach out to that has the business and practice management training would be valuable.”

“Like a practice management coach?” I asked. And she said, “ yeah, that is a good way to put it.”

We talked a little while longer. By the time we finished up, my loyal reader and friend had convinced me.

Today I’m announcing a new service on PediatricInc called PMB Coaching for those pediatricians and/or managers that want my perspective on practice management, discuss in detail a blog post, run something by me or provide another set of eyes.

Interested in learning about the PMB Coaching?

Click on this link.


Do Pediatricians Have A Marketing Problem? [Pediatric Practice Management AwesomeCast]

WorkingTogetherToday, Chip and install about pediatricians’ marketing problem. We dive in and discuss how pediatricians have not done a good job of distinguishing themselves from the competition. And when we say competition, we don’t mean other pediatricians, but rather retail based clinics and large hospital networks.

The result of our poor efforts in differentiating ourselves? Parents don’t really understand the value that comes from visiting the pediatrician’s office rather than a retail based clinic. So in many parents’ mind, going to retail based clinic is the same intern of quality of care as visiting the doctors office, but faster and cheaper.

We also talk about what each of us thinks peds could do to begin fixing this problem.

We hope you enjoy the Awesome cast, and if you do, make sure to tell your friends about it.

For the audio version, click below:

iTunes link

#17 What Every Medical Practice Needs to Know about Web Design [Pediatric Practice Management AwesomeCast]

For today’s Pediatric Awesome-Cast Chip and I sit down with Alan Houser of Squareflair. Alan is a web designer. He and I worked together on Salud Pediatrics’ website.

I really enjoyed working with Alan. I’ve also enjoyed talking with him. We’ve had some interesting conversations ranging from web design (of course), to managing a small business, to how our wive’s use the iPad.

So I thought, why don’t we bring Alan on the AwesomeCast so we could talk about web design, some of the pitfalls people run into when designing their web sites and what are the things we could all do to make better websites that not only look pretty, but are also functional for our parents.

So we did.

We always like to make our AwesomeCast available in multiple formats so you can consume however you’d like:


Don’t forget to visit the PPMMC Google+ page, and PCC.

NCE AAP: Do You Know How To Market Your Medical Practice?

Most of the time, we think of marketing as a direct mail piece or an ad in the paper or a Yellow Pages ad. These things, however, are merely marketing tactics. They are not the essence of marketing.

Marketing is much, much more. It is more than a pretty Facebook page or a website. It is more than an ad in the Yellow Pages or even an newsletter from your practice. All those things are important, mind you. But it isn’t the extent of a marketing strategy.

Companies that do great marketing understand that marketing is not a department, but rather an attitude. It is a way of life for the organization and everyone that works in it. It transcends the organizations. In fact, marketing begins even before you create your product or service.

At NCE, I will also be giving a talk on marketing with my friend Dr. John Moore.  I will be focusing on the essence of marketing. Specifically, I’ll be addressing five components that when woven together, you get marketing gold. Dr. Moore will be bringing it home by describing how social media can affect the inner workings of your practice network and your communication outside of your practice.

The talk is called Information Management: Marketing Your Practice From Handshake to Hashtags.

Dr. Moore and I will be presenting at 10:45 am Saturday, October the 20th. It is part of the Joint Program between the Section on Administration and Practice Management (H1020) and Section on Young Physicians. Check your brochure for details.

If you will be attending NCE this year, make sure to stop by our  talk. I think you will not be disappointed.

You may also consider attending all the sessions on this track.  Some of the most savvy doctors from a practice management perspective will be in attendance. This is the Superbowl of practice management, in my opinion. If you want to learn how to manage your practice, you will not want to miss  it.

Click on the link to download the flyer for all the practice management events at NCE this year.

Oh, and remember to come say hi. I’d love to meet you in person.

I Don’t Know How Else To Put This, But My Ebook Is Kind of a Big Deal

If you are a regular reader of this blog, you probably know about my e-book, 101 Ways to Transform Your Practice.

If you haven’t picked it up (it is free by the way) I wanted to give you a little nudge to do so. Not everything in the ebook is going to work in your practice. But at the very least, I think the ebook will spark ideas that you would have not had otherwise.

If you are still not convinced, then let me share this little something that I got from a reader of PediatricInc recently that got the ebook.

Hi Brandon

Thank you soooo very much!

I  shared your book  with my staff, as the template for our practice meeting today, as we are forging ahead to re- engineer our practice, and I must say , afterwards our way forward became crystal clear.

In one day, we have created a Facebook page, developed an email template to thank new patients for visiting our medical home, and created three mini videos using myself and my nurse to welcome patients to Frontier Kids Care!

We have a new excitement about implementing our changes.

We are also looking at recalls, and the financial status of the practice.

We looked at our mission and are working on the charter.

Our improved website is due to be released next week, but we are going to be wasting no time in putting our new status on Facebook etc now.

I invite you to preview our before and after website at frontierkidscare.com

In Trinidad, obviously our needs are much simpler, we definitely do not have practice managers, but my solo practice has a nurse and a receptionist, and we cross train.

I definitely am challenged on  the business side, so I realize I need a business manager in some form or fashion.

So again thanks, and I wonder if your book has been published so I can purchase one.

Your practice is blessed to have you!

Take good care.

Rose Marie

I don’t know how else to put this, but my ebook is kind of a big deal. Pick it up for free by going here.

The Secret to Getting Referrals

Have you seen those signs in doctor’s offices that read, “The best compliment you can give us is a referral?” Some say this is a great way to get referrals. Simply asking for one.

I’ve also heard “healthcare marketing professionals” suggest that doctors ought to spend time in the community networking with other physicians like OB/GYNs, neighboring schools, daycares or any other person that can send a patient our way.

At Salud Pediatrics, we’ve done all kinds of things… for example, we’ve sent out letters to OBs, we’ve stopped by to say hello at daycares and also dropped off a few business cards at the local pharmacy.

But I wonder… are all these suggestions the right approach? Is doing all those things the best way to get referrals?

Let’s think about this… why would someone agree to refer a patient to you or to your practice? What is so special about your office? Is your Prevnar better than the other doctor’s Prevnar? Is your Amoxicillin more powerful than the one that is prescribed at the local retail clinic? Are patients going to refer to your doc because he wears a Mickey Mouse bow tie or because your waiting room is decorated with trains?

Those are all nice things, I suppose; but are they enough to help people decide whether or not to refer patients?

Think about some of the places, restaurants, vacation destinations or other professionals you’d be happy to refer your family, friends and acquaintances. What was special about them?

Let’s take your favorite restaurant as an example. What is it about that place that that makes you want to tell others about it and to encourage them to go?

Is it the way the servers dress? Is it the decoration? If it is food? Is it the peanuts shells on the floor? Is it the friendliness of the staff? Is it the size of their huge beer jug? Is it because it is cheap and good or because it is expensive and fancy?

My guess is that it could be one thing our all of those things. Who knows. But the constant is always the same; which is, the place is remarkable in some way. Otherwise, you wouldn’t bother referring anybody. Right?

Therefore, the real secret to getting the most referrals…. ready?

…you have to be remarkable is some way.

Thus, our focus should not be on getting the word out so much (although getting the word out is important), but rather working on being worth remarking about.

One last thing… most doctors that I know will say that their quality of care is better, thus that is what sets them apart. Perhaps.

But we know that statistically speaking, every single doctor’s quality of care can’t be superior. I mean, if everybody is super, then nobody is.

So if your quality of care sets you apart, then it ought to set you apart. It has to be evident, obvious, and noticeable. Otherwise, unless that person is your friend, why would anybody else refer to someone that is, at best, average?

Godin says, “the only thing that will make you remarkable is being worth remarking about.”

So here is the challenge. Take a look at every aspect of your practice. Everything from the way you provide care (if you’re the doc) to how the practice answers the phone to how letters get sent out in the mail and see what is remarkable and what is not. Separate the average from the worth remarking about.

Then, all you need to do, is get to work.

Why Your Practice Should be On Google Places

According to a Pew Internet study, 87% of adults use search engines (mostly Google) to find information. And an increasingly amount of those searches are for local stores and establishments. Seventy-three percent of all online activity is related to local content, according to data released by Google.
One of the ways to take control of your listings on search engines is to sign up for a free service by Google called Google Places.
This free tool allows you to not only list your medical practice, but also list how it appears online. You can add a map of your location, your services, photos, health insurance plans you currently take or anything else that helps you stand out from other practices in your area.
Here is a great video that explains how this service works.
In addition to the listings, Google Places offers a lot of data that tells you who’s searching for you on Google, how they are finding you and where they are coming from.
Don’t overlook this valuable (did I mention it was free?) resource that Google offers that will help your practice get the visibility it needs online.

Can Costco and Your Medical Practice Have Something in Common?

I always feel guilty when I’m at Costco and I sample a product without any intention of actually buying it. Like those delicious bite size quesadillas or that scrumptious guacamole dip.  More than buying it, I wish those sample size were bigger to tell you the truth. But that is why I have three kids… so each of them can get a bite for dad.

I don’t think I should feel guilty though. Sampling product has been a common practice probably since “retail” was invented. And retailers still do it; so someone is buying the product. Right?

We see sampling all over the place; not just at food retailers. For example, the company Evernote actually uses “sampling” as a business strategy. Evernote offers their product for free. The free version includes about 80% of the complete functionality of the product, which satisfies the majority of the users. Traditionally, around 5% of their user base needs more functionality and storage for example. Evernote then charges a monthly subscription fee for those users that require a little more.

What is brilliant about this model is that instead of trying to covert their main user base into paying customers, they make a bigger effort in trying to attain users that will use the product for free. The strategy? Well, they know that around 5% of the user base will convert to paying accounts. So, if they have 2,000,000 users, 100,000 will eventually become paying customers. If they manage to get 5,000,000 free users, they know they will get 250,000 paying customers; and if they manage to get 10,000,000 they’ll get 500,000 paying customers.

Just like the food vendor does at the grocery store Evernote allows the majority of customers to “sample” their product in an effort to convert just a few customers from free users to paying users.

If allowing customers to “sample” products is so effective, why then don’t we, in the private medical practice field, do it?

I know what you are thinking… we can’t give our services for free. That is ridiculous. Besides, how am I going to accommodate all these non-paying patients into my practice when I can barely keep up with the ones I have now.

Let me give you an example of how to sample your product without actually giving away your services:

Here is doctor Natasha Burgert talking about crib safety.

Dr. Sue Hubbard has a great site where she samples tons of her services. Check out this post about soothing a sick infant:


Here are a few more examples of how we use it to sample our product using Facebook.

All these examples are no different than the Costco sample bite size example. They give your customers and potential customers and opportunity to experience you.  Everything from your bedside manner, communication skills, your knowledge, how well you teach and even your appearance (yes, that matters too). After all, you are the product. And what you are selling is your knowledge, advice, and to some extend, your demeanor.

So get out and start sampling your product.

Prevention Is The Best Form of Medicine

The Commitment

In 2010, our office made a commitment to take a proactive approach in the care of our patients. So, we decided that, instead of waiting for kids’ parents to call us when they were sick or needed a visit so we could fill out their school form, we would take a personalized approach to our patient’s health care needs.


To jump start this initiative, we focused on well-visits. The objective was to indentify as many children as we could that had not been seen for a well-visit in more than 12-months.

The Contest

To demonstrate we were serious about this initiative as a practice, and to get the staff behind the cause, I decided to do a contest. Here is how it went. We defined the contest period to be June – July. The goal… 35% more well-Childs than in 2009.

The Goal

A quick report showed that we did 517 well-child between June and July of 2009. Therefore, the goal was 700 well-visits for the same period (I rounded up).

I choose those two months because traditionally, these two months are our least busy months of the year. I excluded August for several reasons. 1) I didn’t want the contest to appear it was taking forever and 3-months seemed like a long time. 2) In August, demand for well-child is already high, so we didn’t feel the need to fill the schedule in August because it is going to fill itself.

Furthermore, these goals were in addition to our regularly scheduled sick visits (ie, follow-ups and same day appointments). Therefore, we still had to accommodate sick patients as we normally do in spite of the goal.

The Execution

We first identified the patients (for example those turning 5 years old) that needed to come in by running several reports.

For a small group of patients, we called personally to let them know they needed to make the appointment. It was a bit time consuming, but when 3 or 4 employees jumped on the list, we got through it quickly. People appreciated the call from a human being too.

For the rest, we sent out a postcards. We also posted signs all over the practice to drive the message home.


The staff did an awesome job of reminding people that came in for sick visits, that the patient was due for a physical and they would urge parents to schedule their appointments sooner, rather than later. Same for people that called in. We’d take a quick peak at their chart to see when was their last well-child. If it had been more than a year, we’d remind them it was time.

The doctors also played a crucial role. During sick visits and follow ups, they’d also check the chart and remind parents of the importance of yearly physicals often reminding them to schedule their well-visits on their way out.

So how did we do?

When it was all said and done, I told the staff there was good news and then there was bad news. The bad news is that we didn’t hit our 700 well-visit goal. But the good news is that our team got behind the cause (to take a proactive approach in the care of our patients) and really worked together in an effort to achieve our goal. It was a collaborative effort; which I absolutely appreciated.

The Results

2010 – 655 Well-child

2009 – 517 Well-child

Diff      138+ Well-child

Although we were only 45 well-child short of our 700 well-child goal, we still managed to bring in 138 more well-visits than the year before; about a 26.5% increase in well-visits. Remember, not only did we have to ensure another 517 well-child made appointments, but that another 183 scheduled their appointment to meet the 700 patient goal. And all this while seeing our normal load of sick, follow-ups and same day appointments.


Now, let’s say for giggles that the  average $120 bucks a well-visit (I know some practices do well above that, but I’m trying to make a point), how much more money did the contest generate?

$120 x 138 = $16,560

Let’s say with vaccines and other services a practice averages $250 for every well-child, what would the numbers look like then?

$250 x 138 = $34,500

Here is the deal…

Whether it is 16K, 27K, 34K or 5K, it doesn’t really matter. That is not really the primary point. What I found interesting is that we were able to take a more proactive approach in the health of our community by putting a simple contest together. Thanks to our efforts, more kids came to see the doc. As the saying goes,

prevention is the best form of medicine.

From a business perspective, we increased our revenue by doing things we, for the most part, are already doing. Except this time, we were a little more proactive and a little more focused.

Even when you subtract the cost of the post cards, one is still coming out ahead. Moreover, the post cards has a longer shelf life than the 2-month contest. Weeks after the contest was over, we had people call us wanting to schedule their well-child an referenced the post card.

Think about this

This contest was a 3-month effort (1-month coordination and 2-month execution). Imagine if we put something like this in place for the entire year? Imagine, if we coordinated an effort like this among all SOAPM members? Imagine if we coordinated an effort like this, all year around with the 60,000 members of the AAP?

By the way, although we didn’t hit the goal, each hourly employee got an extra paid day off for the effort.  Thus, in essence, everybody won the contest.

Photo courtesy: Brit