Tuesday, November 6, 2007

Hospital doctor relationships - Physicians and Hospitals: Priorities and Bottom Lines

Interview with Mike Martin, Publisher, Practice Support Resources, Inc, Independence, Missouri

Q: Mike, how long have you been a medical publisher?

A: 21 years.

Q: Your father, I know, was president of the Missouri Medical Society You cut your medical teeth there, and you’ve been working both sides of the hospital-physician aisle ever since.

A: I started out as nursing home administrator, then a physician practice administrator, then a physician recruiter, then in hospital administration, and finally I started publishing writings related to my experiences.

Q: What’s going on across the medical landscape?

A: Physicians and medical practices are seeking ways to empower themselves to manage themselves efficiently and to get the best reimbursement. It’s a constant struggle, and they’re seeking to identify the right sources to master the business side of medicine. There’s a perpetual battle between the business side of medicine and all the rules and regulations.

Q: What are the most common ways physicians seek to “empower” themselves?

A: Over the past 10 years, physicians most commonly reached out to hospitals. That outreach failed miserably because hospitals failed to recognize the business side of practices is run completely differently than the business side of hospitals. Doctors are saying, “Hospitals don’t understand and don’t work with me the right way.” Now the doctors are looking at everything from study programs on business to MBAs to how-to manuals to see what they can learn for themselves.

Q: You publish a lot of paper products – manuals, books, and instructional materials. Do physicians find this material more useful than electronic approaches, such an EHRs and Internet applications?

A: In the past electronics haven’t been user-friendly. It seems to take years for electronics – EHRs, the Web, appointment scheduling, e-prescribing – to catch on. Most doctors don’t find electronic products user friendly, efficient or effective. Physicians are waiting until electronic products become useful. During the interim, physicians will continue to use paper resources to get their jobs done.

Q; Doctors are so busy, they seem to prefer pithy manuals to electronic menus. So, during the waiting period, I suppose they’re buying items like coding and other how-to-manuals?

A: That’s right – how-to-manuals sell big. There’s a lot of ponderous academic publications with one chapter after another, but doctors like their information short, swift, and sweet. Doctors want something to the point about how-to bill, collect, manage, and train my staff to get timely payments. They like checklists and guidelines. They want to use material they can apply right now.

Q: You have an alliance with the Practice Management Institute in Texas, which is devoted to training office staffs.-- field growing rapidly under the radar. Do you find that to be true?

A: Yes, it amazes me there are these good training programs out there, and doctors fail to take advantage of what I call “real training” for a medical practice. That’s the biggest problem I’ve seen in 25 years of practice management -- lack of training of the office staff.

Q: You mentioned earlier that hospitals and doctors have a fundamentally different view of the world. How so?

A: The goal of physicians to deliver quality care to patients. That’s what they’re trained in, and that is their focus. The business part is just something they have to put up with. On the hospital side, business comes first and running profitably and efficiently. Patient care and quality are important but are secondary concerns.

Q: What preoccupies hospitals these days in their relationships with doctors?

A: Competition with other hospitals and with doctors. They fear something will take their market share away, another hospital, a joint venture, a medical group going from one hospital to another. I’ve seen a resurgence of buying practices to allay these fears and to buy loyalty.

Q: What are your best selling publications?

A: They always relate to the bottom line – collecting, coding, how-to-manuals – anything that cuts through the management challenges, rules, regulations, Medicare and Medicaid bureaucracies. Learning the so-called “coding game,” its changes and nuances, is a non-stop exercise. Physicians are also looking at cost and efficiency measures, but it always comes back to billing, collecting, and coding.

Q: Speaking of the bottom-line, we’ve reached to the bottom-line of this interview. Thank you.

Publication information on Physician Practice Management and Physician-Hospital Relations can be viewed on the Practice Support Resources, Inc. website www.practicesupport.com. For publications related to this topic, see Sailing the Seven “Cs” of Hospital Physician Relationships, The Voices of Health Reform, Innovation-Driven Health Care, And Who Shall Care for the Sick?

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