Building Profitability
10 Steps To Build Practice Profitability
by Keith Borglum

Unfortunately not only do physicians have to cope with reduced reimbursement from Medicare and HMOs in a period of accelerating expenses, but the recession is having a significant impact on some practices.

Many patients are losing jobs and not quickly finding replacement employment. This causes them to curtail elective expenditures, and health care is often viewed as elective, especially when insurance benefits expire.

Even so, there are practices that are not only holding their own but actually thriving and achieving new records of productivity and profitability. Listed here are a few of the techniques they employ that might help you too:

1. Increase Efficiency Inefficient practices on the part of both the physician and staff waste time and money. Seeing just one more new patient per day can increase net profits by $30,000 or more per physician per year. Review your systems and behaviors and eliminate or streamline inefficiencies.

2. Minimize Waste. Audit your practice for wasteful procedures. Review your inventory control system for currency and put one person in charge. Over ordering wastes cash and storage space and under ordering wastes labor..Negotiate for better supply prices. Not retiring charts early enough wastes labor in filing searches.

3. Learn To Manage Your Managed Care. If you are using all the same office operational rules and protocols with your discount contracts (including Medicare) you may actually be losing money every visit. You can still deliver appropriate care in a managed care environment. Learn how.

4. Eliminate Staff Overtime. If regular overtime occurs you are probably understaffed and should hire extra part time staff at reduced rates. If overtime at "time and a half pay" does occur limit it to over 40 hours per week, not over 8 hours day to day. If you always run late, maybe you can keep just one person late, not the whole staff.

5. Train Staff Rarely do I find staff that doesn't appreciate training to increase their abilities, and rarely does training not pay. Have staff report back to the group on what they learned and how it can help the practice. Listen to their suggestions. Hold regular in-service training on your specialty.

6. Buy Equipment That Will Help You Make Or Save Money. Fax machines, computers and pocket phones qualify when used properly. I have no clients that have them that would give them up without a fight. Clinical instrumentation needs to have accurate financial and usage projections calculated. Make sure you or your staff use what you buy by asking them first.

7. Increase Marketing. This is an area that should be built up in a recession, not decreased. Every practice should know how many new patients per month it takes to keep busy and take action to insure that flow. Marketing can be as subtle or bold as you dare, as long as it produces adequate results. If you are not meeting you new patient count goals, get help. There are hundreds of tasteful ways to encourage referrals or attract patients directly.

8. Present Appropriate Care In my observations more physicians undertreat rather than overtreat, in often misguided deference to their patients' wallets. Present appropriate care and let the patient decide whether or not to make the investment. Even in a recession many patients value their health above all else.

9. Audit Your Charts For Oversights. In many specialties I find that patients "slip through the cracks" on follow up or even surgeries due to missed appointments or unscheduled recalls. Review 10 charts a day for compliance and call patients that need to be seen.

10. Look At Your Own Activity We all do things to "sabotage" our own success at times, like not staying late to return calls, maintaining chronic tardiness, etc. Ask your staff what you can do to make their jobs easier or to make patient visits more pleasant. Listen to their input and take action. Call a consultant for a practice survey if you need help.

Reprinted with permission from CALIFORNIA MDs BUSINESS ADVISOR.

Author Keith Borglum is a consultant and medical practice appraiser with Professional Management and Marketing, 3468 Piner Road, Santa Rosa California 95401.

Member National Association of Healthcare Consultants, Society of Medical Dental Management Consultants, American Medical Association's Doctors Advisory Network, American Academy of Family Physician's Network of Consultants, California Academy of Family Physician's Consultants on Call, and the Institute of Business Appraisers. Phone 707-546-4433 for consulting information. Permission is granted to reprint or quote any portion of this article provided that both the author and publication are named and two copies or the quoting journal are immediately mailed to the publisher.

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.