Today’s Special Guest is SOAPM Troublemaker, Dr. George Rogu [Pediatric Practice Management AwesomeCast]

For today’s AwesomeCast, we get to talk to Dr. George Rogu. If you have spent time on SOAPM, you know who Dr. Rogu is. A troublemaker. That is right. For those of you that don’t know, Dr. Rogu works for RBK Pediatrics in Long Island, NY.

I think this episode is going to be one of my favorite episodes of all time. I learn so much from Dr. Rogu. I even took notes. Dr. Rogu shares with us his experience negotiating with big payers. You will not want to miss the technique he used to pester executives at the insurance company and how one day he got a call from the insurance company executives asking him to tell his patients to stop calling them. He also gives great advice on how to prepare and execute contract negotiations with insurance payers.

We also spent time talking about technology and the approach Dr. Rogu has taken in order to find the best of the best as it relates to technology.

It is a great AwesomeCast. You should definitely listen or watch the YouTube video below. I think you’ll want to take notes on this one.


To listen to the AwesomeCast, click below.

You can also download the audio version of the episode on iTunes

Why We Selected Physician’s Computer Company As Our New Practice Management Vendor

We decided to switch our practice management system. We selected Physician’s Computer Company as our new vendor.

I’ve been a fan of PCC since I learned about them and I’ve always said that had we known about them before buying all of our IT, we would of gone with them. But we had made a huge investment in IT before learning about PCC and it didn’t make sense to move things over back then. We were already too vested in our infrastructure to make a drastic transition like that. But as usual, things change and we felt it was time to make the move.

Here is a little back story.

Why I’ve always liked Physician Computer Company

For starters, they have made our business, their single business. Meaning, they are exclusively a pediatric driven organization. Not only that, they’ve been doing pediatrics for 30 years. I think there is something to be said about that.

Because they’ve made pediatrics their business, they know it better than we know it ourselves. Sure, we know our own practice. But they know the business of pediatrics better than we do. There is huge value in that.

Another cool thing that you get when you sign up with PCC, is benchmarking. I like to think of them as the MGMA of the pediatric world. What they do is look at the data from all their [pediatric] customers and use it to benchmark your practice.

As if the benchmarking isn’t cool enough, they are also in a position to help your business maximize your clinical goals. For example, by looking at one’s immunizations rates and comparing them with their data, they can tell you if this is an area you could improve on. Here, here and here are some example of what I’m describing.

This probably is going to sound cheesy, but what the heck. When you buy into PCC, you get a partner that delights in knowing you are winning as a practice. Their goal is for you to be the best practice (both clinically and financially) you can possibly be.

I haven’t seen the company’s written values, I have no doubt this is a core value of the company. Why do I believe this? Because I’ve seen PCC take a hit on a sale or even lose a customer in order to meet the needs of the customer.

You know it is a core value when they are willing to be punished for it.

The decision wasn’t easy

Despite riding high on this company, it took me a long time to make a decision to move things to PCC. In fact, I was on fence for a very long time (the only thing I regret about the process so far is that some people at PCC saw what a little wuss I was about taking the plunge; but please keep that info between you and me. I have a reputation to uphold :-).

I was hesitant to make a decision for several reasons.

For starters, we liked our PM. It has been working fine for us. Although it didn’t have all the bells and whistles I wanted it to have, the system was flexible enough to let me work around its limitations.

We were also very comfortable with our Practice Management support. Our IT guy, Mike Schwartz is a boss! But moving to PCC would mean we would probably have to part ways with him.

Leaving Mike’s expertise, common sense and no-sense practical decision making — which helped us save money while maximizing our practice’s efficiency so many times — was going to hurt.

Another thing that was going to hurt, was leaving our billing company. David Brown and his team at Bookkeeping and Business Service  (BBS) have been exceptional partners. They’ve always understood that our success is their success.

I also think that the set-up we have with BBS has turned out to be a great strategic move that would have not worked had BBS not been on board with my ideas.

Many companies will tell you that the customer is the most important thing, but it isn’t always true. Let me tell you that for BBS, it is true.

Here is another reason why I hesitated

PCC offers outstanding service, and even though they may be willing to take a hit or two in the best interest of their customers, they aren’t Mother Teresa. What do I mean? These guys are expensive; they are NOT a non-profit.

I understand that this level of service comes at a price. So that wasn’t an issue for me. The issue was, could I achieve the same level of productivity for our practice without spending so much money?

It is like deciding to work-out on your own or join a gym and hire a personal trainer.

Another big part of this is that change is no fun. As much as I advocate it and tell people to embrace it, I’ll be the first to acknowledge that thinking about a transition like this made me apprehensive. Let’s face it, the status quo is very comfortable and there is no doubt that a transition like this will disrupt everything.

It would fundamentally change our practice in more ways than one. Were we ready for that? More importantly for us was, did we need to make this transition?

Where do we want to be?

A few years ago, Joanna and I had some challenging times in the office. These challenges prompted us to take a look at the practice from a different perspective.

At that point we had been in business for seven years, so we asked ourselves, if we had to start all over again, what would we do different? We also thought about where we wanted to be as a practice in seven more years.

The answer to those questions led us to the conclusion that we needed to align ourselves with different partners that understood are needs, our challenges and our objectives a little better.

Not to say that our previous vendors didn’t understand our needs or didn’t’ help us overcome our challenges. But we were at a different point in our practice life and felt it was time to move on.

So here we are today.  Locked, loaded and ready to make this happen. We are shooting for a go-live date between November or December of this year. But we’ve already begun the preparations. I’m sure I’ll have more stories to tell as we embarque in this new journey.

Stay tuned!

Editorial Note – There might be a possibility that our billing company, BBS might make the move with us. So we might not have to part ways with this after all. 

Why is Measuring Sick to Well Ratio Important for your Pediatric Practice?

Simply put, measuring wellness-to-sick ratio estimates the focus a practice has on preventive care. And how can this info help your practice? Data shows that practices that have fewer sick visits to well visits tend to be practices with better financial outcomes.

But there are other reasons why measuring sick to well ratios are beneficial to your practice. Practice Management extraodinaire Chip Hart from PCC has some really good reasons as to why measuring this number is good for your practice. Chip says that “with the massive fluctuations in sick visit demand (look at the 2010 flu season and look at now), consistent well visit placement is crucial to business stability.” Chip also adds that well visits establish a practice’s value more than runny noses and sore throats. “It’s a chance to really get to talk about what YOU want while also listening to the parents. It’s a doctors chance to look at the whole health of the child, not just fix an acute problem which, most of the time, common sense fixes anyway.”

To calculate your wellness-to-sick ratio, divide total sick visits by total well visits (both new and established patients). Some offices remove the 99211 from the calculations and only use 99212 thru 99215 as well as the new patient codes.

To give you perspective, the national average in 2010 is 2.06. In other words, nationally, practices see 2.06 visits for every 1 well-child visit. Better performing pediatric practices rate between 1.9 and 1.6 sick visits for every 1 well visit.

Of course every practice is not the same and the numbers will most likely be different. But experts say that if your practice is within the 3:1 or 4:1 range, your practice is heavily focused on acute visits; which can lead to difficulty in making ends meet.

Just remember that the benchmark is designed to give you a rough idea. Ideally, you should calculate your ratio as far back as you can, compare it year over year to determine how your practice is doing, and use those numbers as a benchmark.

Fundamentally, measuring your sick to well ratio (and improving them) will not only give  your practice a stronger financial footing, but the practice will enhance the healthcare needs of your community by being more proactive with prevention wellness.

Swine Flu – A Different Approach

“Stop thinking about [the phone calls] as a chore and start thinking about it as your chance to get them back in the fold. Let them know that you are prepared to help them and that you care.”

Chip, from has an OUTSTANDING post that takes a completely different approach to the Swine Flu epidemic and how medical practices ought to approach the enormous attention and coverage this virus is getting. Here are some of the points that hit the hardest for me.



Addressing how many of us are complaining with the amount of unnecessary calls our offices are getting, Chip had this to say:


“If you think this way, you’re missing a giant opportunity. Every time a patient calls your office, you send them a letter, you change your on-hold message, etc., it is your chance to re-establish yourself as the trusted source of medical information for your patients.  It’s also your chance to let your patients know about any changes to your practice.  And remind them that you, more than anyone, are looking out for their needs.”

He also suggest we can take advantage of this opportunity to infom patients/parents about preventive wellness issues, changes in the practice and practice news among other things:

“I’m talking about improving your clinical care.  You just wrote out a protocol for your nurses to follow for everyone who calls in – add a single sentence about the importance of those well visits.  Did you add morning or evening office hours but many patients still don’t know? Now’s a good time to remind them, a few hundred are calling this week.  A new doctor in the practice?  Added or dropped an insurance company?  More details on the WWW site?”

“Stop thinking about [the phone calls] as a chore and start thinking about it as your chance to get them back in the fold.  Let them know that you are prepared to help them and that you care.”

Wow. I’m jealous and ashamed. I’m jealous because I didn’t come up with a post as good as this. And I’m ashamed because here I am talking about connecting with parents and providing remarkable service, yet I’m complaining about the amount of “unnecessary” calls our office is having as a result of the swine flu coverage.

Chip, Thanks! Thank you  for reminding me (and my staff as soon as I print your post and hand it over to them) that fundamentally, this is exactly why we are here; to provide our parents piece of mind.

You can read Chip’s entire post here.