Practice Management
April 2022
by John Pinto and Corinne Wohl, MHSA, COE
Alot of the calls we get from surgeons dissatisfied with their current practice start with this question: “What’s it take these days to have a strong, thriving, smooth-running practice?”
Here’s a way to save yourself a phone call. Based on our experience in the field, in practices around the world, the following is a list of the basics for maintaining a better practice.
1. Write a board-approved, long-term (5+ years) strategic business plan. This plan should show your current and intended future practice volumes by service segment and by location. This plan should be updated annually and be a “living” document, reread often, well-understood by all practice stakeholders, doctors, and staff. The plan should address six basic questions: What’s our service area? Intended service mix? Provider mix? Growth rate? Relations with the local health system and colleagues? Succession plan?
2. Driven by the contents of the strategic plan, your practice needs a tactical plan showing priority, near-term actions that will help you accomplish your strategic goals. Your tactical plan should cover things like technology adoption, marketing, staffing levels, offices to open or close, leadership development, staff training, and the like, all posited within a 1-year time horizon.
3. You will need a competent managing partner, administrator, and department managers who all understand the twin strategic and tactical plans (and were part of their development). The best practices are built from the top downward. Department heads can’t do their best work unless they are led by a strong, admired administrator. And even the most competent administrator is weakened without an engaged, supporting lead doctor-owner.
4. Next, the best practices use more written communication than verbal. There are written operations documents showing one, agreed best way to do everything. Great practices don’t have customized by-doctor protocols (not even genius techs can do their best work if they have to do things differently for each provider). Protocol changes are only made when all stakeholders have been consulted.
5. Develop agreed, widely received, frequently updated and understood benchmarks to track progress. Each provider, their managing partner, and their administrator should have a memorized command of KPIs (key performance indicators), such as visits per doctor per month, average collections per visit, surgical density, PIOL implant rate, etc. By having a command over these data, everyone on the team is in a better position to collaborate on performance as objectively as two doctors talking about their shared patient’s ocular health (from the perspective of the same agreed metrics and benchmarks).
6. You can’t get very far without an aligned doctor team. Some physicians, by their nature, are lone eagles. Being personally ambitious and striving is fine, but each provider should have goals that are in line with the company, and they should help the leadership team bear the weight of practice management. This means, for example, that a physician who complains about the electronic health records works to become a master of the new system. The doctors in great practices are givers; they behave as one should when part of a team, being sensitive to the needs of others.
7. Understanding that whenever there is an issue (like under staffing) or an opportunity (like adding a new patient service), the universal cure comes in six simple steps:
- Gather the data.
- Pull together a meeting of all those involved with the issue or opportunity.
- Discuss and agree on a plan and critically, a deadline for results.
- Put one leader (and one only, not two co-leaders) in charge of delivering results by the agreed deadline.
- Monitor and report back to the original group on progress.
- Reward the team for results.
8. When launching or relaunching a complex service line like LASIK, elective plastics, or dry eye treatment, it’s critical that you only proceed when there are adequate resources, like board support, an MD champion, equipment, staff, training, time, administrative focus, and marketing dollars.
9. Make sure incentives are aligned. In a setting where physician owners want higher volumes but associate providers and staff won’t enjoy appropriate, proportionate rewards for harder work, the owner’s goals will never be achieved.
10. The patient’s global experience is key. Treat every patient as though they were your only customer. Ophthalmology by its nature is a higher-volume enterprise, especially in the current environment with fast-rising practice costs. That said, doctors and staff alike need to slow down long enough mid-exam to listen to and resolve each patient’s needs.
11. Ask every patient to refer a friend. No matter how much you advertise to the public or reach out for optometric referral support, more than half of all new patients in a comprehensive practice are referred by friends and family. The trouble with this is two-fold. Most patients assume their doctor is too busy and already has a full practice. And many doctors are too shy to ask their patients for referrals. You can overcome these problems with one simple request, delivered at the end of every exam: “Please tell your friends about the importance of regular eyecare.” It’s a simple public service message, but it gets the point across, especially if you simultaneously hand over a couple of business cards. In the average client practice, this simple request boosts new patient volumes by 20%.
12. Realize that business success is measured in profit per doctor hour, not cases per month. Manage your costs, especially at a time like this past year when staffing costs have soared. But at the same time realize that most costs are fixed; profit enhancement is more a matter of revenue enhancement than cost containment.
13. Never stop learning. Find a surgeon more competent than you, and copy what they do. Be an attentive, eager student throughout your career. If you have the honor to be called on by a peer to aid their understanding and skills, be a generous, patient teacher.
About the authors
John Pinto
President
J. Pinto & Associates
San Diego, California
Corinne Wohl, MHSA, COE
President
C. Wohl & Associates
San Diego, California
Contact
Pinto: 619-223-2233; pintoinc@aol.com
Wohl: 609-410-2932; czwohl@gmail.com
