Practice management today is tough. Here are some perspectives from the front lines:
- Inefficient EHR Implementations. If EHRs are implemented haphazardly and without a holistic perspective that considers protecting physicians' time, practice workflows, information flows, regulatory requirements, and technology constraints, the result can be highly inefficient. One EHR user said: "The healthcare industries transition to digital record keeping has been predictably disastrous. Companies like Epic Systems are better at securing federal contracts and subsidies than making software, and boutique turn-key systems are stuck in the 90s. Virtually all systems will require a full time employee to keep online, and even then technical gaps will require the use of paper, fax, and phone to keep even routine processes running. If healthcare were a competitive industry, organizations which did not digitize, or who choose inferior systems, would go out of business. Instead, klutzes pat themselves on the back as they figure out regressive ways to digitize records and collect HI TECH Act subsidies. This is the number one impediment to a great healthcare system and it will never go away." (Lassor Feasley at http://bit.ly/2wQsDo4)
- "Recruiting and Retention. In many regions, doctors are increasingly hard to come by. If you do find one, you’re going to have to have a good volume of patients to justify their price tag. Meanwhile, patients no longer see physicians as authority figures, but as service providers. Pharmaceutical marketing ads coach them on how to present which symptoms, and they can become irate if the real world physician does not respond in kind. Be ready to make some tough decisions on whether customer satisfaction or physician retention are more important to you. And never forget the merciless barrage of high pressure salesmen trying to steal your physician away." (Lassor Feasley at http://bit.ly/2wQsDo4)
- "Credentialing. Public insurance is becoming increasingly fragmented between federal, state, and local safety nets, and often a constellation of plan administrators. It now takes an encyclopedic knowledge of various credentialing subtleties to get payment, and its only getting worse. Sometimes you can get reimbursed if the practice is credentialed, but not the doctor. Sometimes the inverse. Sometimes you need both, sometimes none. The only thing that is clear is that all of it is arbitrary and stupid. A lot of credentialing bureaucracy is intentional, just to deter a practice from even trying to collect reimbursement. Just figuring this out will cost some practices 10% of revenue, and thats before the burden of turning down good doctors for lack of insurance credentials, paying for certifications, and so forth." (Lassor Feasley at http://bit.ly/2wQsDo4)
- Branding for Small Practices. "The truth is that most patients believe small practices are inferior to large institutions like hospitals. In fact, for routine service, small practices are usually superior in every way. But hospitals, who usually reap hugely inflated reimbursements for simple procedures and are working to take advantage of that misconception. It is up to small practices to find ways to combat this trend, by establishing strong brands and relationships with their communities and patients." (Lassor Feasley at http://bit.ly/2wQsDo4)
- Poor Patient Flow. We discuss this operations problem and possible solutions here: http://news.zydoc.com/how-can-i-improve-patient-flow-in-an-outpatient-clinic.
What can I do about these problems?
There are no magic bullets. But there is one piece of business advice that is true for all businesses, including medical practices. That is: