Six Ways to Turn Your Private Practice Around

A few months ago, BlackBerry CEO John Chen wrote a LinkedIn post titled “The Keys to Executing a Turnaround the Right Way.” He discussed BlackBerry’s challenges as other technology platforms surpassed Blackberry’s once industry-leading ideas. After taking a look at their company’s history and deciding they were going to turn around their placement in the market, they started planning for their future and have been growing steadily ever since.

This was an extremely useful post, and I believe that Chen’s ideas can be adapted for private practice healthcare entrepreneurs who are finding that their practices could use a bit of a turnaround as well.

  1. Create a problem-solving culture. Does your practice celebrate collaboration and togetherness? When problems arise, two heads are truly better than one. Bounce ideas off of each other and be open to new ideas – this will help facilitate new growth.
  2. Maintain the sense of urgency. It’s very easy to become discouraged when things aren’t going well. Do everything you can to maintain a positive attitude and keep moving forward. Don’t lose your determination, or your patients—and staff!—will sense a lack of dedication.
  3.  Take care of your company like it’s your home. As I’ve discussed in previous blog posts, private practice healthcare entrepreneurs have the incredible privilege to be independent and unique. Treat your practice like the fantastic opportunity that it is, and put value on the incredible business you started. You wouldn’t give up on your home and your family, so don’t give up on your practice!
  4. Know thyself. Sometimes a “rut” is the best time for self-reflection. Do you know how best you perform? What aspects of your profession are you best at? What are your weaknesses? The more you recognize these aspects of yourself, the better you will be able to plan for the future and use those strengths to move your practice in the right direction again.
  5. Empower employees to take risks. Allow your team to excel in areas where they perform best, but also encourage them to develop areas that aren’t as familiar to them. Sometimes the best ideas come from those that seem the most risky. After all, we are entrepreneurs!
  6. Everyone has a role. Plain and simple, recognize that your entire staff is important. No one on your team should feel left behind. A strong, seamless team that is comfortable with each other and knows each other’s strengths and weaknesses will be able to work together to turn around a struggling practice.

Remember, if your front porch was on fire, you wouldn’t stand there and calculate how long it would take to burn down; you would get out of the fire immediately! Use that same idea if your practice needs revitalizing – get out of the slump (or “fire”) as fast as possible and emerge stronger than ever!

Beginning in 2015, I’d like to expand on these ideas more and create a “New Year’s Resolution” series where I highlight examples and give more detail regarding how to revitalize your practice. Stay tuned for more valuable information for your private practice!

Have a very Merry Christmas, and I’ll post again after the Holidays!


Being an Entrepreneur Doesn’t Have to be “Scary”

The definition of the word “entrepreneur,” according to Merriam-Webster, is thus: “One who organizes, manages, and assumes the risks of a business or enterprise.”

It is no secret that you are an entrepreneur if you own a private practice, which means that you have continuous responsibilities and wear many hats. But when you realize that one of the descriptors in your title literally says that you “manage and assume risk,” it can be a little unsettling to think about.

In light of Halloween, I’d like to dispel some of the scary ideas that go hand-in-hand with having a career in a private practice setting, specifically healthcare. Healthcare in a private practice setting doesn’t have to be scary. Read on for ways you can thrive in private practice healthcare while remaining calm and confident.

  1. Become involved in associations relevant to your field: these organizations, such as the American Medical Association or American Physical therapy Association, are there to help you as much as possible. Attending conferences and networking with others in your same field can be the most important learning experience you will ever find. The speakers, exhibitors, and attendees that you meet can help you immensely in your career. Networking at these conferences helps you realize that you’re not alone and that other people share the same challenges and goals as you. Take time to cultivate those relationships and see where they can take you—as the old saying goes, two minds are better than one!
  2. Become involved in entrepreneur leadership associations (such as the National Federation of International Business or Small Giants): Just as you work hard to hone your clinical skills, these organizations can help you to hone your business skills as well. Being in healthcare, we need to focus on our patients and practices as much as possible; we don’t have a lot of time to worry about the aspects of private practice such as management, recruiting, and other business ventures—in short, the non-clinical aspects of our careers as entrepreneurs. Take on a role in these organizations and you can feel more at ease regarding the management aspects of your private practice.
  3. Stay organized: this may seem a bit obvious, but unless you make a conscious effort to stay organized in all aspects of your practice, it probably won’t happen. By keeping all of your files and schedules organized, you will have one less thing to worry about. Organizational skills are highly important because they can give you more time to accomplish clinical tasks. Being an entrepreneur also means being disciplined. Set an example for your staff regarding how you’d like your clinic to be organized, and you’ll have more time for your patients. Getting (and staying!) organized will pay off down the road.
  4. Discover the rewards: working in private practice indeed has its challenges, but it also has its rewards. It is so special that we get to interact with our patients frequently on a one-on-one basis. Through this, we learn about patients personally, and I think that this is the most unique and rewarding part of being in private practice. In addition, remember that your private practice is important because you’re working to grow a small business in your community. You are a community leader for both clinical development as well as entrepreneurial development. Embrace this notion, discover what makes private practice healthcare so rewarding for you, and don’t ever forget it.

Being an entrepreneur in private practice healthcare doesn’t have to be scary if you’re connected and prepared. You can become empowered in your practice when you step out of the dark and into the light.

As always, please contact me if you would like to speak more about being an entrepreneur and what you can do to ease your mind. I wish you the best as your pursue your career goals in private practice healthcare!

Dear Technology: Aren’t You Supposed to Make My Life Easier?

Technology is supposed to make our lives easier. Its purpose is to help us increase productivity, organization, and timeliness. However, many physicians are still struggling with technology and refuse to embrace it in regards to their practices. Yes, I am referring to Electronic Health Records (EHR). According to a 2013 survey by Medical Economics, 20% of physicians have not implemented an EHR system into their practice. Of that percentage, 34% don’t ever plan to. However, it is crucial to note that this lack of acceptance can be a hindrance to our practices.

Still, I realize that with the implementation of an EHR comes a few headaches such as sizeable upfront and yearly costs, the need for IT assistance, and time spent on training. I have personally heard from those who grew up before “the age of computers” that EHR programs are hard to navigate and even after two years of using said programs, they still do not understand them. That is why it is so important to keep the following things in mind: 1) we need to be open to change, and 2) we need to find a solution that fits our specific needs.

Times are changing; our society is shifting almost entirely to the internet and communicating through the use of devices. Most aspects of daily life—banking, shopping, and more—can all be managed through technology. Similarly, patients’ medical records can now be managed electronically as well. In a nutshell, the goal of EHR programs is to help providers easily document payments and other records at the time of service. Whether or not we like the shift towards EHRs, we must embrace it with open arms. To refuse technology is to move our practices backwards. We then become outdated, which will, in turn, cause patients to become turned off to our practice.

There are a multitude of EHR systems to choose from, and many can be customized to fit specific guidelines. If you are looking to make the leap to an EHR, then it is important that you find the one that best meets your needs. In fact, it is beneficial to interview several companies and request demos while you find the right match.

Here are some important things to consider when looking for an EHR:

  • Does the program help you become more compliant in your documentation? Some EMR programs offer templates that encompass all elements of a compliant note. However, is there any flexibility in this? Do you only have the option to pull canned statements, or can you free text and make it your own?
  • Is the program cloud-based or server-based? Cloud-based programs will be available through the internet and providers can document from anywhere, as long as they have internet access. Server-based programs are typically only available within the physical confines of your practice.
  • Does the program offer reporting and tracking tools? Can you easily monitor authorization statuses, visit and dollar maximums, and Medicare certification statuses? Create a list of reports that you need for your practice to run successfully and see where the program can automate this for you. This will help you save time on laborious processes.
  • Is the program user-friendly? Is it easy to navigate?
  • What is the program’s termination policy? If you or the company decides not to continue a contract, what happens to the patient records? If you have not made the leap into EHR yet, I highly encourage you to do so. Yes, training may take time and costs can seem overwhelming at first, but the positives greatly outweigh the negatives. Do some researching of your own and find a program that helps you run your practice better.
  • Good luck!
  • The wonderful thing about EHR programs is that they were designed to help us become more efficient and productive. In addition, the programs allow us to easily access patient records with the click of a button. No more time-consuming filing and shredding; it’s all stored in one convenient location.

Authorization – Is It Really Worth It?

For those of us who offer specialty services, we are often faced with the laborious task of completing prior authorization for patient visits. Authorization is very straight-forward – it either leads to visits approved and payment, or denials. In a 2013 study published by the Journal of the American Board of Family Medicine, it was determined that prior authorization tasks can cost up to $3,430 per full-time physician. With all of the time and money we pour into authorization, many of us are asking ourselves – is it really worth it?

As a manager overseeing the practice management operations for a network of outpatient private physical and occupational therapy practices, I am one of the first ones to say that although prior authorizations cost us a lot, this service is necessary. Authorization not only determines whether or not we will be paid for services, but it also greatly impacts the patient’s experience and perception of our practice(s).

Patients come to us in the most venerable times of their lives – when they are sick and/or in pain. The last thing they want to worry about is whether or not their insurances will approve their treatment. They need someone else to work for them on their behalf; someone they can trust. When you dedicate yourself to ensuring patient visits are authorized, you are giving your patients further confidence in your practice and create raving fans, excited to share their experience with others.

Taking a look on the flip side, if you don’t successfully complete prior authorizations, visits are not approved and your patients are forced with the choice of self-discharging or paying for services out-of-pocket. This not only hurts your reimbursement (collections from patients are harder to obtain and most often, you will need to provide a payment plan or discount services), but can greatly harm your credibility. Unfortunately, patients are more likely to share negative experiences with others than positive ones. In fact, it takes 13 positive comments to make up for one negative one. And in today’s world, these negative comments are available online and easily found by other patients seeking a provider. I guarantee you don’t want to be labeled as “the expensive practice who couldn’t work with my insurance company even though they were in-network” to these potential patients.

So, how can we make such a labor-some process easier for us and still be successful? Luckily, we live in the age of technology. Several EMR solutions offer tracking or color-coding to remind you and providers of upcoming authorizations. Check into your solution to see if this is an option for you. In addition, the individual manning the front desk can be a back-up and assist in teeing up you and/or providers of a patient’s authorization need or status. This second pair of eyes will help you stay on schedule and not overlook any patients. Lastly, educate all providers on the importance of documenting the necessity for skilled medical care, as this will greatly impact the authorization decision. Providers must realize that it is their responsibility to the patient to complete their documentation fully. In essence, they are accountable for the authorization decision.

Patients are dependent upon our commitment to their care. Yes, it may cost a lot in labor to complete prior authorizations, but it is worth the confidence boost we give our patients. When they feel like we are their advocate, working for them, they will become raving fans and lifelong customers. Prior authorization impacts not only our financial stability, but also our credibility.