Creating the Almost Perfect Medical Practice: Part II

This article is the second of two parts.

1. Ideal practices offer positive reinforcement.

Ideal practices have office managers and physicians who appreciate the staff, offer praise for good performance, and say “thank you” for a job well done. It is true that you can accomplish more with a pat on the back than a kick in the pants.

2. Ideal practices are HIPAA compliant.

In order to avoid any violations that will generate fines and penalties, the ideal practice has to be crystal clear about the guidelines for HIPAA compliance and must adhere to those standards. The best practices have a HIPAA compliance officer who has the authority and the clout to identify and correct deviations and then stick to the rules to keep the practice in line and avoid any risk of penalties or fines.

3. Ideal practices have a front desk that collects 100% of the copays and remaining patient balances.

Copays, cancellation fees, and deductibles are all part of the everyday vernacular of medical practices. Our staff is taught to request copays and explain that we can no longer bill the patient for the copay. Contemporary patients understand that they cannot fill their cars with gasoline or buy an airline ticket without paying in advance for the product or service. Healthcare is no different, and payment is expected at the time of service. There are few exceptions where patients are exempted from paying their copays and deductibles before seeing the physician.

4. Ideal practices are not involved in costly, emotionally draining lawsuits.

For the most part, preventing litigation comes down to good documentation in the medical record. Ideal practices provide educational material to their patients on the procedures and surgery that they plan to perform. There are no shortcuts for this process.

5. Ideal practices have a cross-trained staff.

Cross-training creates the opportunity for staff to perform each other’s duties for the purpose of maintaining productivity when any person is absent or unavailable. For example, when there are more phone calls than can be handled by the receptionist, any cross-trained staff member can help answer the phone calls. Instead of asking patients to leave a message, thereby possibly losing the patient and his or her business, a staff member trained to be a receptionist for short periods of time can be a huge benefit to the practice. 

6. Ideal practices empower employees to make decisions that are in the best interest of the patient.

I have a monetary ceiling of $200; up to that amount, a staff member can make a decision at the time of the encounter with the patient without having to get approval from the office manager or the physicians. For example, if a patient is delayed in the office because of a problem with the practice (e.g., the physician was running late or the computer system was uncooperative), and the patient is concerned about parking costs, the staff is empowered to pay the patient’s parking and to apologize for the delay.

The combination of cross-training and empowerment becomes a powerful set of tools for achieving an ideal medical practice. Cross-training and empowerment can achieve dramatic improvements in productivity without increasing staff size and also can enhance patient satisfaction.

7. Ideal medical practices embrace technology.

The ideal practice makes good use of technology in the clinical setting and indicates to patients that the doctor and the practice are up-to-date with all the current diagnostic and treatment options. 

Technology costs for medical practices have increased in recent years. All of us who have implemented electronic medical records, however, have seen substantial decreases in both the cost and complexity of our hardware and software, as well as the cost of support or maintenance. You can plan to spend 18% of the cost of your software for annual maintenance and the new upgrades. Moving to cloud-based EMR and outsourcing the billing can significantly reduce your technology costs. 

8. Perfect practices embrace continuous growth and improvement.

The need to improve quality in healthcare delivery is increasing. The CMS, hospitals, and insurance providers are all striving to better define and measure the quality of healthcare. Doctors and staff must understand that a major component of the quality of healthcare is patient satisfaction. Furthermore, patient satisfaction is critical to how well patients do; research has identified a clear link between patient outcomes and patient satisfaction scores.

Bottom Line: Physicians aren’t powerless to craft and sculpt their practices. I believe that the methods described in this article are easily implemented and can be easily accomplished in a cost-effective manner.