Sunday, September 9, 2007

Practice Management - Blocking and Tackling and the Aerial Game in

As editor-in-chief of Physician Practice Options ( over the last 11 years, with a theme of “Improving Patient Care Through Increased Practice Efficiency,” I secretly suspect doctors are tired of being lectured about their lack of “efficiency”

Physicians know perfectly well that grinding it out in practice is mostly about blocking and tackling - seeing and pleasing as many patients as possible, applying proper codes, making maximum use of time, and recruiting, training, and retaining the best staff possible.

Occasionally, physicians know practice may be about the “aerial game,” i.e. innovations such as EHRs, patient-emails, Ipods, e-prescribing, concierge practices or cash only practices, open access scheduling. But truly useful innovations that dramatically advance the practice, improve care, and enhance revenues are infrequent.

Nevertheless, there’s always room (and gloom) for improvement.

Accordingly, I bring to your attention two new sources of practice management information you may find useful.

• Judy Capro, Secrets of the Best-Run Practices: What Makes Some Practices Stand Out from the Crowd; 2006, Greenbranch Publishers, $64).

This compact 140 page book has 12 chapters: The Perfect Receptionist, Conquering Workflow Problems, Amazingly Productive Doctors, Mastering the Appointment Schedule, Commonsense Risk Management, Team Spirit – Team Power, Dynamics of the Outpatient Academic Practice, Power of Revenue Management, Great Employees – The Simple Truth, Money Crunch, Reshaping the Practice,, and Practice of the Future.

Capro bases her arguments on 20 years of practice management experience. She concludes with these “secrets” – 1. The nation’s focus on quality is a reality. 2. Quality has clinical and non-clinical components. 3. Commitment to quality must be demonstrated. 4. Maintaining loyal employees requires more effort than in the past. 5. Technology is a major contributor to improving efficiency. 6. Technology is important in mastering clinical skills. 7. The future offers more opportunities; 8. These are revolutionary times.

• – This a blog developed by MacMillillan Medical Communications focusing on articles on efficiency and innovations from current communications.

Here are two samples:

1) September 8, 2007

“Micropractices, From the ACP Observer

A micropractice’s overhead consumes about 35% of revenues while a traditional practice’s overhead can be as much as twice that. They’re often but not always single practice providers. These practices can be run by automated systems, which reduce the need for nurses or medical assistants. In patient-centered practices, these questions may arise. “Why have a waiting room?” “”Why have paper float around?” “”Why not have the review of systems be generated by the patient and simply verified by the clinician?”

3) September 7. 2007 From Slate

Why do we have to wait days, and even months for a doctor’s appointment? If some of the most popular restaurants can take same day reservations, why should doctors make the patients wait and wait?

In fact, they shouldn’t. The challenge of reducing waiting times is a classic queuing problem in operations research. Professionals in all sorts of service industries, from restaurants and hospitals to banks and department stores, have faced it in one way or another. Most of them handle the juggling of their clients far better than the physician despite the low stakes. Mounting evidence shows that doctors can see patients quickly too – even in perennially backlogged practices – and when they do, they benefit themselves and the patients they treat.


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