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Monthly Archives: June 2018

Fix the problem, not the blame [practice management tip: operations and workflow]

“Fix the problem, not the blame” is a well-known Japanese proverb. It sounds like common sense – isn’t fixing problems what we all ultimately want? But when mistakes happen, the search for culprits instinctively begins – and with it often comes demoralization and tension. Worse, the search for a scapegoat usually won’t keep problems from recurring. Bad systems create more problems than bad employees. When workflow is faulty, the mistakes are built into the process. Figuring out who was working the process when it failed does nothing to prevent failure in the future. As organizations grow and silos (i.e., departments) form, so do opportunities for workflow inefficiencies to masquerade as staff incompetence. We’ve worked with medical practices that have grown so fast, they haven’t noticed their processes aren’t keeping up.  But even more than growth, market evolution has put new tasks on everyone’s plate. These tasks may not fit well with jobs as originally configured – and that may mean more errors. Here’s a common example. Insurance has become increasingly complex for patients and staff alike. Higher deductibles have also made front desk collections a priority, but it’s a new priority added on top of everything else. Are front desk employees already trying to answer phones, check patients in, answer questions, collect demographic information, and verify insurance? When patients are seen and it turns out they weren’t covered or aware they owe a deductible, it may seem “obvious” that the front desk staff is to blame – especially to your billers, who must deal with the errors. But more likely, front desk employees are simply juggling too much. As jobs evolve, mistakes may increase. Resentments can fester between departments. But the answer isn’t to find someone to blame – it’s to find out where the process breaks down. In the case of the front desk, a better response would be to reconfigure roles, to let staff focus on the tasks in front of them, without multitasking. As work gets more complex, making people feel embarrassed and afraid won’t help them do their jobs better – retraining staff and refining their

By |2018-06-11T16:36:02-08:00June 27th, 2018|

Reducing the cost of no-shows at your medical practice

(c) Sheri Swailes - fotolia.com No-shows can be a huge drain on medical practice finances. Time that is booked but ultimately generates no revenue is a loss that comes right out of your bottom line. It’s similar to what airlines experience when they have an unsold seat – which is why airlines so often resort to overbooking, and some practices do, too. But if you've seen the negative media coverage about the impact of flight overbooking on passengers, you already know what a stressful gamble the double-booking “solution” is. It's all but impossible to predict which patients will fail to show up -- so you could end up with too many arriving at the same time. Even when overbooking helps reduce lost revenue, it can create other problems -- like long waits, rushed visits, and stressed out physicians -- that lead to unhappy patients and higher marketing costs. Practice managers and physicians often throw up their hands in frustration about how to deal with no-shows, especially if they’re already taking steps to remind patients, or perhaps even charging a no-show or late-cancel fee. There’s no doubt about it, trying to improve your practice no-show rate can be challenging. But there are a few ways to look at the problem that practices sometimes miss. Consider if any of these ideas might help you reduce the cost of no-shows to your bottom line. Reevaluate Your Appointment Slots Practices often have standard appointment slots that they haven’t reviewed in a while. We recently worked with a practice that had used only two slots for over a decade: 30 minutes for established patients and 45 minutes for new patients. When we looked at how long visits were actually taking, we found that more time was usually set aside for the visit than was necessary. Besides reducing the overall number of productive slots the practice had available, these over-long slots amplified the impact of any no-shows. Even a single no-show usually left a 45-minute hole in the middle of the schedule – ouch. By tweaking the timings just a bit (30 minutes for

By |2022-01-01T22:51:46-08:00June 11th, 2018|

Cutting long-term staff to improve profitability? Not so fast [practice management tip: human resources]

A practice we worked with recently was struggling to improve profitability. The practice’s new manager wanted to make an impact fast, so she decided to try replacing longer-term staff with less expensive newbies; since staffing was such a big practice expense, she reasoned that this was the best way to improve profitability. The physician owners were surprised not just that the strategy hadn’t worked, but that we questioned the decision. “Isn’t that the kind of thing you practice management consultants recommend?" they asked. But cutting experienced staff members who perform well just to save a few dollars isn’t something we’d recommend trying. Those exiting employees will take with them all the knowledge they’ve accumulated – knowledge that is easily taken for granted. While cuts might boost profits temporarily, it likely won't take long for patient service to deteriorate. Service will also be undermined by the panic felt by the rest of the staff. When employees see their most loyal colleagues being shown the door, they’ll wonder if – or when – the axe will swing their way. Once those doubts creep in, your most energetic and ambitious employees will begin job-hunting in earnest. Swapping out older workers for younger ones may draw a charge of age discrimination as well. Worst of all: the potential upside is probably small. Differences in pay for experienced versus new staff are typically large enough to cause a big swing in profitability. For example, a $5 per hour difference translates to $10,000 per year. The costs of recruiting and on-boarding a replacement could easily exceed these small savings. It’s natural to look critically at expenses when profitability is flagging. But insufficient revenue is often the main reason profits disappoint – and cutting your best people will severely impact your ability to fix that problem. Instead of cutting valued but ‘expensive’ employees, look for ways to refocus staff and make the practice more productive.

By |2022-01-01T22:51:46-08:00June 1st, 2018|
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