Anatomy of a Physician Consultant Relationship
by Keith Borglum

According to a Medical Economics poll "more than 80% of doctors who have used practice management consultants are tickled pink by the job they did". This high level of successful relationships may be due to the fact that physicians are very used to using clinical consultants on a day to day basis and may transfer those communication skills to their business relationships.

There are those though, as indicated by the Medical Economics poll, that do not experience a successful relationship. In some cases this is due to consultant incompetence or error. Other disappointments may stem from personality conflicts, hiring the wrong type of consultant for the task or not having the consultant agree with the doctor's pre-determined solution or agenda. Proper goal setting and hiring procedures will avoid most of these problems.

There are consultants for every need you can imagine and then some. The Professional and Technical Consultants Association lists over 360 different types of consultant and they barely scratch the surface. Despite the diversity of available expertise, physician demand falls primarily into a few categories:

Increasing productivity and/or profitability
improving internal systems and reducing paperwork
staffing issues (hiring, retention, discipline, firing and compensation)
associating/group formation/associate relations

With these or any other need, there are a few rules that will allow a physician to get the most out of a consulting relationship. They are:

1) Realize when help would be beneficial and get it.

2) Get the best qualified expert available. The most expensive advisers are often the least costly in the long run.

3) Check their references.

4) Keep your consultant fully informed. Communicate frequently to keep them on track.

5) When you have properly hired, involved and informed the consultant and they give their advice, take it.


Case Study #1.
Solo Family Physician With Decreasing Patient Load Problem:

Dr. A knew why his practice was shrinking. Kaiser, an urgent care center, a large multi-specialty clinic and another physician had recently entered his area. He just didn't know what to do about it. Solution: His consultant first got Dr. A to modernize his image. Fresh paint throughout, new furnishings attractive plants and abundant patient education literature for the reception area were installed. The doctor and staff were trained in advanced communication techniques and guest relations to make new patients feel welcome and let existing patients know that their referral of family and friends were encouraged. Scheduling procedures were instituted that prioritized new patient visits. Only then were discreet external marketing programs instituted that attracted lots of new patients to the office. The new patients liked what they found and stayed. To his credit, Dr. A never let up. He no longer takes the busyness of his practice for granted, and continues to strive for improvement, except in one way. With his consultant's assistance, he clarified for himself that with his personal style, he would remain solo rather than add associates or join a group.

Case Study #2:
The Bungled Retirement Problem:

Dr. B, nearing retirement age, determined to get his practice appraised and sold before the anticipated deluge of doctors leaving practice occurred. Solution: Dr. B had his CPA, a good accountant, appraise his practice. His CPA, never having appraised a medical practice before, used the wrong formula and priced the practice too high. Dr. B then tried to sell the practice himself but had no takers because of the price and an inadequate effort. Word got out into the local medical community, then the lay community. Patients steadily changed providers until there were inadequate numbers left to support the practice, at which point it folded.

Case Study #3:
Almost A Group Problem:

A loosely knit group of solo and partnership internists had been discussing forming a group for a number of years, but never could quite get it going. Solution: An aggressive local hospital constructing a new medical office building wanted the physicians in it and retained a consultant on the physicians' behalf. The consultant organized a series of presentations to the physicians to clarify goals and benefits that could be expected and how a group could actually be a reality. He then worked with a handful of practices who were most interested, confirmed their suitability, and got them to individually conform to uniform operational protocols that would allow for an easier merger. Simultaneously group discussions were held on the details of group practice. This allowed the participants to become better acquainted and more comfortable with each other and the feeling for group involvement before making the big commitment. They finally did merge, much to their benefit.

Author Keith Borglum is a consultant and medical practice appraiser with Professional Management and Marketing, 3468 Piner Road, Santa Rosa California 95401. Keith is a member of the National Association of HealthCare Consultants, the AMA's Doctors Advisory Network, the American Academy of Family Physicians Network of Consultants, the American College of Physicians Managed Care Professional Advisory Network, the Business Appraisers Institute and an affiliate of the Medical Group Management Association.


Permission is granted to reprint or quote any portion of this article provided that the author, firm, phone and city are named and two copies of the quoting journal are immediately mailed to the author at 3468 Piner Road, Santa Rosa CA 95401.