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.

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.

Let’s Talk About What Happened In Vegas

My friends from the Pediatric Management Institute (PMI) put on another great practice management conference in Las Vegas last January.Screen Shot 2016-02-21 at 10.55.37 AM

The content was excellent, thanks to the fabulous faculty PMI brought in.

The topics varied from customer service principles to fundamental changes happening in the health insurance industry and how those changes are – or soon will be – affecting doctors’ financial bottom line.

Below are a few highlights and notable points that resonated with me.

ANCILLARY SERVICES | INCOME DIVERSIFICATION

Dr. Jeanne Marconi presented an account of how her practice diversifies income streams by incorporating ancillary services into her practice.

Admittedly Dr. Marconi’s comprehensive – almost overwhelming – plethora of services (they even offer in-house exercise training programs for children with high BMI) is probably too much for the standard practice to implement.

But for me, her talk wasn’t an invitation to follow her footsteps, but instead, provide insight into what is possible, what can be done and what is available to practices.

Dr. Marconi dished out several challenges to the physicians in the crowd. But the one that resonated with me the most was her call for pediatric practices to challenge the status quo, expand their minds, think creatively (or to use a cliche, think outside the box) and begin to think about ways to diversify practice’s revenue streams.

HOW HEALTH INSURANCE COMPANIES ARE PAYING DOCTORS

Susanne Madden arrived in Vegas with her extensive knowledge and expertise of the health insurance industry.

Screen Shot 2016-02-21 at 11.10.10 AM
Dr. Jeanne Marconi and Susanne Madden

She presented attendees the sobering reality of how health insurance companies are adjusting, changing – even experimenting in some cases – with their models to continue delivering value to “their” shareholders. And by value, she means lower cost and higher profits.

Susanne underscored the importance of implementing quality measures such as P4P, HEIDIS, PCMH into our medical practices. But not for the reasons you might think.

While many of these health insurance programs are currently in place as rewards (e.g., enhanced or incentive payments) for medical practices that achieve quality measures thresholds in patient care, Susanne highlighted that these programs will soon become a requirement for practices.

What does this mean exactly? Insurance companies will soon stop offering enhanced payments programs to practices for achieving PCMH level III certification (or other types of incentives). Instead, they will reduce payments to doctors don’t meet PCMH certification.

As if that wasn’t bad enough, she added that many payers are evaluating providers based on how much the provider costs the company in benefits payouts.

How is that different than what they do now?

The difference is that they are not looking at the practice as a whole, but rather evaluating each provider individually.

The implications are that if you have physicians in your practice that don’t adhere to designated quality standards, payors can potentially pay each doctor in the practice different amounts.

HOW MUCH CAN WE AFFORD TO PAY AN EMPLOYED PROVIDER?

PMI’s very own Paul Vanchiere gave two of his hallmark presentations. The first one focused on customer service using the acronym KIDS (Kindness, Integrity, Dignity & Service).

His second talk was my favorite. Why? Because Paul took a complicated, MBA, executive consulting level exercise (determining how much can your practice afford to pay an employed provider) and distilled it into an easy to follow, step-by-step, process, which only requires one to understand a few financial concepts and enter value sets into a spreadsheet.

BROADEN YOUR CODE REPERTUAR

Dr. Rich Lander went over the fundamentals of proper coding. In addition to reviewing the differences between coding Level 2, 3, 4 & 5 for a sick visit, Dr. Lander stressed the importance of documenting “time” correctly in a patient’s chart.

Screen Shot 2016-02-21 at 10.56.21 AM
Joanne Blanchard and Dr. Richard Lander

Dr. Lander shared multiple clinical scenarios that we often encounter with patients. But some of the codes he suggested I wasn’t all too familiar with. I couldn’t recall if we used them.

So I wrote down a reminder to myself to check how well (or not) providers at Salud Pediatrics were using the full scope of codes available.

NO PRESENCE, NO INFLUENCE

Dr. John Moore – a new PMI faculty member – brought us up to speed with some of the new social media trends (Are you familiar with SnapChat and how kids are using it?)

Screen Shot 2016-02-21 at 11.10.19 AM
Dr. John Moore and Paul Vanchiere

One of the points that Dr. Moore articulated that I appreciated the most was the importance for pediatricians to embrace social media.

He said something that I’ve been saying for a long time; which is, had pediatricians adopted social media at a faster clip, the pro-vaccine vs. anti-vaccine arguments would have been balanced. Moreover, there was the potential to stifle the anti-vax movement.

CHANGE IS THE NEW STATUS QUO

You can always count on Chip Hart to deliver great wisdom and insight. Chip also gave two talks.Screen Shot 2016-02-21 at 10.56.11 AM

I’ve heard Chip speak many times, but this time, I felt his talks were different. Chip’s talks had a subtle, tough-love tone to them.

While addressing the challenges practices are facing today, he stressed that pediatricians have faced similar challenges before. He mentioned that during all previous tectonic shifts (aka industry changes) naysayers shouted out the demise of private practices. Much like many are shouting today.

Chip eloquently argued that not only are the doomsayers wrong, but that pediatricians are actually in a better situation than most think.

Chip wasn’t disregarding the challenges or downplaying the potential threats. We are indeed going through tough times. But these tough times were an opportunity to transform and reinvent our practices, he argued.

My takeaway was: If the plan is to defend the status quo and hedge the long-term success of your business on account that you have the initials MD after your name, thus somehow inoculated from change, the end is certainly near for you.

MEETING, CONNECTING, NETWORKING, SOCIAL LEARNING

Attending a seminar like this to learn from the speakers is certainly worth the price and the time. But more often than not, the icing on the cake, at least for me, is the immeasurable, intangible value I glean from networking.

The people who attend these events are the smartest and brightest in my opinion (and I’m not talking about the faculty, although they are good too).

Whether attendees are veterans in managing practices or opened their first private practices last week and believe they have no clue what they are doing, the truth is, there is opportunity to learn from everybody.

The faculty makes the trip worthwhile. But I would say the attendees make the event special.

Next year I hope to see you there. Especially if you didn’t get a chance to attend this year.

Place: New Orleans
Dates: Jan 27-28th 2017

 

10 Questions You Need To Ask Before Starting A Project To Ensure Success

The best strategy one can embrace before beginning a project is to gain clarity on the task at hand. And with these 10-questions, you’ll gain the perspective required to ensure your project gets off to the right start.

Imagine all of the sudden you decide to go on a camping trip. So you round up your spouse and the kids, jump in the car and head out. No supplies, no route, camping equipment, site, food or proper clothes. When asked about all these things, you respond by saying, “We’ll figure it out as we go along.”

I’m no camping expert, but I know that this is a silly way to go about camping. Talk about a recipe for disaster.

Screen Shot 2015-08-30 at 4.17.50 PMBut here is the thing… even though most people would never go on a camping trip without determining a site beforehand, planning out the best route, deciding how much food they’ll we need to take and how many days they will stay, I’ve seen first-hand many practices that have embarked on more than one project with the same carelessness.

“What is the plan for the transition?” 

“Too busy right now. We’ll figure it out as we go.” 

I’m no project management expert, but that is a silly way to about conducting a project at one’s practice. No wonder many projects end up taking longer, are more expensive and cause more headaches than expected.

To get a better understanding of the project, we should ask ourselves these questions:

1 – What is the project?

It is important to write down the project because writing it down actually means something. If you have it in your head, you don’t really have a project. You just have an idea.

2 – When is it due?

The more specific, the better.

3 – Who is responsible for this project to succeed?

You can add all the team members, but ultimately, there has to be somebody that is THE responsible person.
Who is your customer?

4 – List the names of people that you are trying to please.

It could be your boss, your patients, your parents, voters, the board of directors or anybody else. It is important to list them because there is a good chance that you might lose sight of why you are doing this project. And when you do, it is helpful to know who you are doing this project for.

5 – Who are the authorities, influencers and gatekeepers?

List all those names under this question. These are the people that actually matter. Everybody else, you can ignore.

6 – Who is essential to the success of your project?

In every project, there are always key people that must embrace the project for it to succeed. List the individuals or committees or groups of people.

7 – What does perfect look like?

Often times, we start out a project without really thinking about what the end results is supposed to look like. Consequently, we lose direction. For this question, it is important to be as specific as possible.

8 – What does failure look like?

Failure is an important aspect of project that one must consider. For starters, failure is almost a sure thing. Thus, understanding what it looks like helps one steer away from it.

9 – How would you plus it?

Here is the stuff you put down when one says, “you know what would be cool?” List 5 or 10 things that would make your project that much better.

10 – How would you minus it?

Just like adding little things to make your project a little better, there are other things that you ought to consider that don’t add anything to the project. These are the things that if you take away from your project, you will actually improve it.

The best strategy one can embrace before beginning a project is to gain clarity on the task at hand. And with these 10-questions, you’ll gain the perspective required to ensure your project gets off to the right start.

Seven Reasons Why You Don’t Want To Miss This Pediatrics Practice Management Seminar

My friends at the Pediatric Practice Management Institute (PMI) have an awesome seminar that you don’t want to miss.

Why should you not miss it?

Glad you asked.

I have lucky number 7 reasons why you should not miss this seminar.

OAK.0021 – YOU’LL BE AWESOMER

I know awesomer is not a word. But it gets’s the point across. Here is the deal, no matter how experienced you are at managing a practice, there is always something new you can learn.

2 – YOU’LL LEARN NEW IDEAS

Managing a private practice can be a lonely world. There aren’t that many of us. And most of the time we are locked up in a back room (used for both your office and storage) trying to figure out how to keep the ship afloat.

Without exposure to a variety of points of view, you will miss new ideas and trends that can impact future results.

3 – YOU’LL GAIN EXPOSURE

Paul and his team at PMI have put together a superb curriculum. The educational materials will certainly expose you to new ways of managing your business (e.g., private medical practice) and help you discover how to be more productive.

4 – YOU’LL MEET COOL & INTERESTING PEOPLE

Here is the way I see it. The practices that tend to go to practice management seminars are precisely the practices I want to learn from. And PMI’s seminar provides a great opportunity to network with the best practice in the country.

5 – TALK TO CONSULTANTS AND VENDORS

Not only will you have access to a community of like-minded people that have similar struggles, have similar challenges and practical, hands-on advice, suggestions, and solutions, you will also have access to the industries top consultants.

Don’t tell them I said this, but if you ask the right questions, to say… Chip Hart, I bet you, you’ll get thousands of dollars worth of practice management advice for <ahem> free.

Keep in mind that experts in the field are some of the best people for you to get to know if you want to learn more about the current health care business climate as it relates to small, private, independent, pediatric practices.

6 – YOU’LL DISCOVER

You will undoubtedly discover innovative ways to help your practice remain competitive in today’s fast-paced, hectic private-practice.

7 – IT’S VEGAS BABAY (NOT A TYPO)

Did I mention it was in Vegas?

All work and no play can get old fast. PMI’s conference can add a layer of enjoyment to managing your career growth by mixing a social aspect into your learning and industry branding efforts.

Never underestimate the power of a little fun mixed with some interesting people!

BUT THAT IS NOT ALL

Use the promo code “PediInc” and save $75 off your conference fee.

Conference Details:

  • WhenFriday, January 29, 2016 at 2:00 PM –  Saturday, January 30, 2016 at 5:00 PM (PST)
  • WhereTropicana- Las Vegas
  • Sign Up: Click on the Eventbrite logo below to sign up

https://www.eventbrite.com/e/pediatric-practice-management-conference-las-vegas-tickets-18689205918?ref=ecount

Don’t forget to use the promo code PediInc to get $75 off

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.

 

Deceptively Easy Way to Improve Your Practice, Guaranteed

On a piece of paper, write down this question:

Image-1

It doesn’t have to be written exactly like I wrote it. Any variation will do. Then, make copies. Several of them. For the next few days or even weeks, hand each parent that comes to visit your office the sheet of paper with the question on it. While they wait, they will have plenty to think about out. You can ask them to use the remaining space – as well as the other side – if they require more than just a few lines.

I just saved you $5000 in consulting fees. Not to mention provided a way for you to have specific and practical ways  to make your pediatric office 10x more awesome than it already is.

You’re welcome…

How to Deliver Exceptional Service In a Medical Office

I wrote a piece for FiercePracticeManagement last week that I wanted to share with you all.

The piece talks about an experience I had while I was on vacation. I was trying to reschedule an appointment I had the next day with my doctor. The experience turned into a little ordeal that frustrated the heck out of me.

frustration

One part I didn’t mention in the piece due to word limit constraints is that during all this rescheduling fiasco, I was out of the country. Thus, I was using very expensive international pre-paid minutes while I was trying to connect with the doctors’ offices ( I had to deal with two offices). Even the otherwise non-big deal of being put on hold for several minutes felt as if money was falling out of my pockets never to be seen again.

I also had a terrible internet connection that was at best very, very slow, and at worst, non-functioning. All that added to my frustration.

If you are interested in reading about my ordeal as well as learning my thoughts on how I think is the best way to avoid these type of fiascos in our medical practice, click on the link below

Empower employees to bend the rules to wow patients.

Oh, and if you liked the piece, show some love in the comment section. Or share it with your friends and colleagues by using the social media sharing tools on the site.

A Great Resource For Your Medical Practice

My friend Mary Pat Whaley, from Manage My Practice blog, wrote up a great piece called 12 Ways to Super Charge Your Practice.  The list is great. Why? Because each of these tips that Mary Pat gives are practical. In other words, you can start doing each one of them today.

Many times, when one reads tips like these online, the tips are very high-level. They’ll say, “you’ll need to make sure you are billing correctly.” Thanks, I know that. But how do I ensure I’m billing correctly?

Mary Pat, with her 12 tips, walks us through how to implement each tips. She starts out by unpacking how to set up a practice dashboard, to how to create a patient advisory board, to how to overcome the “phone” challenges in one’s office.

I would tell ya to visit Mary Pat’s blog to check these 12 Ways to Super Charge Your Practice, but that is not practical. Instead, I’m going to point you to how to get the FREE Ebook where Mary Pat has compiled all these great ideas in one place.

To get this great FREE resource, click on the link below. Mary Pat has set up a link specially for PediatricInc readers.

[eBook] Positive Improvements to Implement Immediately in Your Practice

Mary Pat Whaley is a consultant, speaker and blogger.  She provides healthcare managers, executives and providers the advice, resources and information they need to drive excellence in their organizations. Check out her blog at: ManageMyPractice.com

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.