In private practice, you need to walk across the bridge between a medical world to the world where your patients spend their time. You need to be a human being—at least part of the time—to win the respect and affection of your patients.

There is a revolution in how doctors relate to their patients. Be sure you understand how to deal with the following relatively new developments in this ageless relationship between patient and doctor:

1. Patients like to be thought of as clients and you as their consultant, helping them find their way to better health.
2. A patient (or client) of yours may know as much about their illness as you do.
3. Patients are not afraid of computer-assisted diagnosis and care.
4. Patients expect more from you than prescriptions and orders.

Some examples of how these new developments can be turned into practice-building traits in your  private practice…

• Offer a handshake and a smile. You’re on equal footing with your patient. Show it.
• When a patient offers information you doubt, say “That’s interesting!” and ask for the source so you can study it yourself.
• Show your concern for each patient by asking (and caring about) how they are doing. Remember each name. Look at your client with a smile in your eyes.
• Give the patient work to do. Keep a log for a couple of weeks. Switch to another type of diet. Walk a certain number of miles or paces. Carry out exercises you feel would help.
• Ask your patients questions about how they feel they are doing. At the end of your time together, ask if there are any questions and then wait for a response.
• Every patient should leave with a diagnosis. Let them know what you don’t know, what you expect, and, most of all, what you do know about the patient’s condition.

Submitted by Griffith Publishing

“I’ve always gone to Dr. So-and-So for my checkups and general care. He’s caring and thorough.”

“When my mom died in the hospital, I was so glad that Dr. So-and-so was her doctor. He was always gentle.”

“I’d recommend Dr. So-and-So hands down for a pediatrician. He knows his stuff but really likes kids.”

A recent survey found that half of primary care patients took the recommendations of close friends or family members when choosing a new primary care doctor. On the other hand, most patients rely on a physician referral for specialists in surgery, urology, or other areas of medical care.

How do you generate word-of-mouth referrals? You can’t pay your patients to give them. Printing them in an advertisement about your clinic or medical center might help, but they aren’t terribly convincing.

Here are some tips for generating word-of-mouth referrals to your clinical practice:

• Good advice by Susan Keane Baker, who not only shares many tips and suggestions but also offers book titles she feels deal well with the topic.
• Have a happy staff. If your receptionist, office manager, nurse, PA, and other team members like you a lot, it will show. A bit of banter, a surprise box of chocolates, friendly smiles for everyone are all ways to endear your office staff to you.
• Get acquainted with prospective referring people in your community. Make friends with leaders such as the clergy, realtors, police officers, and people already serving the public in a healthcare setting.
• Give a hearty welcome to new physicians coming to the community, whether they are primary care providers or specialists. Be friendly with all hospital staff, and the office staff of other physicians.
• When you do receive a referral, keep a stack of “thank you” notes or blank cards handy so you can let the person know how much you appreciate the referral.
• Get involved. Become active in your local church. Attend picnics and outdoor concerts or other events.
• Choose your favorite topics and prepare a list of them plus a statement about your availability to go on local radio or TV. You can’t find a better way to make friends quickly, although a newspaper column or interview is also effective.
• Compliment members of your staff when you take notice of them being especially courteous and patient. There’s lots of work to do, but lots of friends to make as well.

Follow these and other steps that will draw you closer to your patients and the community where you serve. Your patient roster will grow as you are friendly and prove yourself reliable and helpful.

Sources: Physician News, All Business

Compliments of Joyce Griffith, Physician Publishing

1. The Medical Group Management Association has produced a book entitled Rx for Business Success: Joining a Medical Practice. The 6×9 inch paperback book has 195 pages and sells for $34.99 at Amazon.com. It was first introduced in 2005.
2. Marketing Your Clinical Practices: Ethically, Effectively, Economically, 4th edition. By Neil Baum and Gretchen Henkel. The paperback version has 608 pages and costs $71.96 from Amazon.com.
3. The Ultimate Practice-Building Book, by David W. Zahaluk, MD. Self-published through Trafford Publishing, but a search at Trafford came back empty. The book has 106 pages and an ISBN of 1-4251-3639-7.  Try a book store or look up the doctor in Plano, Texas. The best address I got for him is Family Medicine Assoc, 6300 W Parker Rd Ste G20, Plano, TX 75093, (972) 981-8181. Or go here to learn about the doctor’s coaching systems.
4. Building Your Ideal Practice. This is not a book but a system you are invited to join. It includes audio seminars, tapes of past seminars and podcasts.  
5. Lean Six Sigma Subtitle, for the Medical Practice. A book published by Greenbranch Publishing and written by Frank Cohen and Owen Dahl. The subtitle is Improving Profitability by Improving Processes. Six Sigma is a method of business management originally developed by Motorola in 1981.
6. 27 Proven Marketing Strategies To Boost Your Practice Profits – Medical Edition (Audio CD), by Lonnie Hirsch and Stewart Gandolf. Available from Amazon.com for $199.

I haven’t found a book on how certain marketing tools can help you develop a bigger or different practice base. Probably the fact is that consultants believe they’ll do better by offering their consulting services than by writing helpful, practical books.

If you come across such a book (helpful, practical), please let me know. If you’ve given up, let me know, too. It could be the next book I produce…

Joyce Griffith, MBA

Brought to you compliments of Griffith Publishing
Producing books for doctors since 1988

The best way to start is by understanding your current patient mix. For example, you may need to know how many of your current patients are over age 65–or under age 30, live in a wealthy–or poor–part of town, have diagnoses that match–or are outside–your primary area of expertise. You might also want to track how often your current patients call your office to request medical care, what percentage of your patients are new to your practice within the past three years, and how many of your newer patients are also new to the community.

After you’ve studied your current client roster, it’s time to start digging for ways to reach your “ideal” patient. You may want to engage the services of a business such as PracticeBuilders, a healthcare practice consulting firm for thirty years. At least part of the solution may be as close as the office telephone. In a recent newsletter, PracticeBuilders calls the office telephone the “biggest black hole of lost revenue” for medical and dental practices and offers useful ways to deal with this problem.

If you can’t afford a “mystery patient” just now to analyze the weaknesses in the way your phone is used, at the very least start spending some of your time listening to how your staff answers the phone and what they say to the caller. Here are some ill-advised actions people hear too often when making calls to medical or dental practices.

* Clicking and clacking of computers can be distracting to both sides of the conversation.

* The sound of swallowing food or chewing gum carries through the telephone.

* Rapid speaking to the other person may not be rude, but it sounds rude.

* Letting the phone move away from the speaker’s mouth creates causes and indistinct speech.

* A hurried, breathless, greeting can make the caller feel unimportant.

* Sneezing and coughing can be irritating to the caller.

These may sound like elementary points, and they are. From basic telephone hygiene you need to move to more appealing speech that will convey a spirit of friendly concern to the caller. But without listening for these common pitfalls and gently working to bring the entire staff up to a higher standard, you risk turning away patients who could be your valuable clients for years to come.

Brought to you by Griffith Publishing and Physician Publishing

The Business Courrier, a national business journal published in Ohio, reports we may face a shortage of general surgeons within two years.

In the specialty journal, Surgery, Dr. Tom Williams says that the shortage could reach 6,000 by 2050. This would be a huge blow to hospitals because 68 percent of hospital revenues come from surgical procedures, not counting laboratory and other services directly related to surgery, according to reports by the actuarial firm, Towers Perrin. The OR is not a cost center, although most hospitals consider it as such, but should be seen as the primary revenue-generating unit of the hospital.

Sometimes the shortage is market driven. Joint replacement surgery, for example, will soon be needed by more people who require the procedures than there are surgeons to provide them. If the number of surgeons qualified to perform total joint replacement surgery grows at the same rate as now, by 2016 there could be as many at 46 percent of hip replacements and 72 percent of knee replacements that will not be offered due to the surgeon shortage.  More than 700,000 primary total hip and knee replacements are done each year, and the number will double by 2016. Information from a news release posted by the American Academy of Orthopedic Surgeons.

Presented by Physician Publishing

Orthopedic surgeons rank at the very top of the pay scale with an average income of $323,000 a year.

At the other end, family practice physicians and psychiatrists vie for the lowest average income with the family practice physicians earning an average of $132,000 a year and psychiatrists $124,000.

How hard do doctors work?

No way to know that, but if we measure doctor input by the number of hours per week, we learn that physicians specializing in obstetrics/gynecology, anesthesiology, general surgery, or urology all work more than 60 hours every week.

Dermatologists and pathologists work the fewest hours on the list, just 45.5 a week, but specialists in emergency medicine (46.0 hours/week) and ophthalmology (47.0) hours put in only slightly more hours a week.

Now put them together. Which physician specialists yield the highest dollar amount per hour worked?

No surprise. Orthopedic surgery earns an average of $107.10 per hour, while family practice physicians earn only $48.35 per hour.

Most interesting, perhaps, is the average:

Average $$ per year: $208,000

Average $$ per hour: $74.21

Average hours worked per week: 53.9

These numbers come to us from the American Medical Association.

Remember that these hours and dollar amounts are for fees allocated to individual physicians. The cost of running a medical clinic includes not only physician revenues, but also clinic costs and other expenses of practicing medicine in calculating the profit margin.

Brought to you compliments of Griffith Publishing

]]> http://practicebuilding.wordpress.com/2008/11/30/which-doctors-work-hardest-get-paid-the-most/feed/ 2 JG http://practicebuilding.wordpress.com/2008/11/27/who-needs-more-patients/ http://practicebuilding.wordpress.com/2008/11/27/who-needs-more-patients/#comments Thu, 27 Nov 2008 21:49:50 +0000 JG http://practicebuilding.wordpress.com/?p=94 ]]> “We don’t need to announce our new internal medicine docs,” a hospital manager told me. “They’re filled up within two days of opening their doors.”

We have a doctor shortage in the U.S., and it’s getting worse. We’re relying more and more on nurse practitioners and physician assistants, and trimming time with patients for more efficiency.

A recent report by the Association of American Medical Colleges reveals the following state-by-state facts about physician supply and demand:

Alaska: The state needs 59 new physicians (MD’s or DOs) every year to replace those who are retiring or leaving. Alaska has only 205 physicians per 100,000 population compared with 238 nationwide.

Arizona: Rapid population growth puts a higher demand on doctors with specialties in allergies, cardiovascular surgery, endocrinology, gastroenterology, hematology, and infectious disease.

California. Most doctors (60%) practice medicine in only five counties. A rapidly growing population could cause a growth in demand of 4.7% to 15.9% by 20015.

Florida. Population is expected to grow 60% by 2030; during that time the aged population will grow by 124%.

Georgia. Predictions are that without changes in medical education facilities, Georgia will be dead last in physicians per 100,000 by 2020.

Idaho. This state ranks 49th out of 50 states in physician supply, with only 198 physicians per 100,000 population. It is 48th in the number of first-year medical students per 100,000 residents.

Iowa. Aging population points to need for physicians in five specialties: psychiatry, neurosurgery, general internal medicine, orthopedic surgery, and cardiology.

Kentucky. Almost half of Kentucky’s counties are designated as Health Professional Shortage areas (HPSA) for primary care.

Maryland. Now at 16% below the national average for the number of physicians available for clinical practice,

Maryland has the greatest shortage of physicians in Southern Maryland, Western Maryland, and the Eastern Shore.

Massachusetts. The Massachusetts Medical Society produces a physician workforce study every year, and this year is another that shows a “strained” medical system.

Michigan. Growth in demand will outpace growth in available physicians in the state, with a projected shortage of 4,400 physicians by 2020.

Minnesota. Only 5% of Minnesota’s physician practice in rural areas although 13% of Minnesotans live that. Too few specialists are available especially in northern and southern rural areas.

Mississippi. Two out of three counties in Mississippi are labeled as Health Professional Shortage Areas. Over half (56%) of all of Mississippi’s physicians practice in four counties.

Nebraska.  Only 9 of Nebraska’s 93 counties have more than 214.09 physicians per 100,000 population, the average for all states in 2004.

Nevada. This state has one of the lowest physician-to-population ratios in the nation and one of the highest population growth rates.

New Mexico.  More than half of New Mexico’s physicians are located in Bernalillo County. Only Los Alamos County, with a rate of 2.41 physicians per 1,000 population, came close to the national average of 2.42, and all other counties were far below.

North Carolina. A Task Force convened by the North Carolina Institute of Medicine concluded that without major changes in the health care delivery system or significant increases in the number of physicians, the state is likely to face a severe shortage of physicians.

Texas. While the number of Texas medical school graduates has remained relatively flat over the past twenty years, the state’s population has grown by 50% in the same time.

Oregon. 2004 data suggests a “looming shortage of physicians.” The state is already experiencing shortages in rural areas and in several specialties, including rheumatology, nephrology, gastroenterology, cardiology, allergy-immunology and pediatrics.

Utah. There are currently shortages in Utah for physicians in pediatric neurology, child psychiatry, adult psychiatry, obstetrics & gynecology, general surgery, dermatology, urology, and cardiology. The state will need to recruit up to 270 physicians a year in order to keep up with growth.

Virginia. By 2020 there will be a shortage of approximately 1,500 physicians in Virginia. By 2030, 25% of the state’s population will be over the age of 60 meaning more people will be making more frequent doctor’s visits.

Wisconsin. A 2004 report from the Task Force on Wisconsin’s Future Physician Workforce, concluded that Wisconsin has current unmet needs for physician services that are likely to worsen in the foreseeable future. Shortages in primary care physicians, general surgeons, and radiologists already exist in rural areas of the state.

For the complete story, read the full account from the Plain Dealer. Here’s a summary of the doctors’ choices for the best of the latest innovations in the treatment of patients:

1. Circulating tumor cell technology
2. Warm organ perfusion device
3. Diaphragm pacing system
4. Multi-spectral imaging systems
5. Percutaneous mitral valve regurgitation repair
6. New strategies for creating vaccines for avian flu
7. LESS (laparoendoscopic single-site surgery) and NOTES (Natural orifice transluminal endoscopic surgery)
8. Integration of diffusion tensor imaging
9. Doppler-guided uterine artery occlusion
10. National health information exchange

Brought to you by Physician Publishing

]]> http://practicebuilding.wordpress.com/2008/11/14/10-top-innovations-in-medicine/feed/ 0 JG http://practicebuilding.wordpress.com/2008/11/14/changes-in-medical-practice/ http://practicebuilding.wordpress.com/2008/11/14/changes-in-medical-practice/#comments Fri, 14 Nov 2008 16:31:05 +0000 JG http://practicebuilding.wordpress.com/?p=63 ]]> Medical practice is on the edge of fundamental changes in the way patients are selected, evaluated, treated, and billed. Physicians who put management and financial issues to one side may find themselves wondering how they got left behind.

A major change that most physicians have felt has been the shift from small, independent clusters of physicians to integrated networks of care providers. Doctors are more likely than ever to be employees of hospitals or networks of health care provider rather than members of a solo or group practice. They are also more likely to be working shoulder to shoulder with “physician extenders” and seeing more of their traditional hands-on methods taken over by other members of the health care team.

Technology is penetrating the practice of medicine even as costs have soared beyond the ability of individuals, insurance providers, or the US government to pay for fully. From computerized patient records, to distance conferences with super specialists, from the sharing by computer of images and data to complex pre-birth surgery, doctors are challenged as never before to tune their skills to the latest changes.

There are plenty of bumps on the high-tech road, but ignoring innovations in the way information is collected, stored, and utlilized can lead to deep ruts as competing organizations learn how to use technology for greater efficiency and higher bottom line performance.

—brought to you by Griffith Publishing