A lot of big, impressive-sounding words are thrown around when it comes to strategically analyzing a practice.  Rather than getting stuck in your own or someone else’s ideas, here’s a simpler way.  Give your practice  a score from 1-10 (10 being perfect) at how you rate in terms of the broad categories of finance, marketing and operations.  Then improve whatever you are weakest at until that is no longer your weakest area.  Then move on to the  next weakest area and the next until you are at least an 8 or a 9 in each of the 3 aspects.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

Have you noticed that even in a down economy it is a huge struggle to find good staff?  Even so, your practice is only as good as the calibre of staff you have working in it.  If you find it impossible to get things done in your office, either you’re not training your staff the right way or you haven’ thought through the proper workflow for your processes or you have the wrong people. 

We got much better when we started to use personality testing as part of our pre-hire process.  Everyone can’t do everything.   We use the DISC profile in concert with some other specially designed profiles to learn things like: likelihood of leaving for another job, honesty, empathy, organization, tendency to follow orders or not, and so on.

Not only are these profiles a great way to select the right people, they are an excellent way to train and grow our people through their inherent challenges.  None of us are perfect, but these tools help to grow the employee using a logical and objective process.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

When we were kids growing up, my dad did what every dad was supposed to do – take us on vacation to Disney World.  Oh the excitement.  We couldn’t sleep the night before the trip.  We would all be wide awake at 2am and decide to leave at 4am just because us kids couldn’t stand the excitement any more. 

Similarly, if you are designing your practice the right way, you should look forward to going in to work.  You may be physicially tired after a long day, but mentally energized because you know you are part of something great.  If that’s not happening for you, make it happen.  You were probably the smartest kid in your class – you can figure out anything and do anything.   

Hint: If you’re not feeling the excitement and wonder of being a doctor, ask yourself this question:  What am I doing that conflicts with my values?  All human problems basically come down to that.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

Check out the first of a two part article in Podiatry Management titled: Internet Marketing For Podiatrists – Tips and Tactics.  I am revealing some information for the first time that I think will be highly interesting to any medical provider with a website.  It may be coming out in September, 2010 – that is still being determined.

Like top ten lists?  Well I’m not half the man Dave Letterman is so I’m offering up the top 5 dirty secrets of medical billing.  Drumroll please Anton…

5. 90% of practices are really really bad at it – but can’t admit to themselves they must change, so they stay stuck.

4. 80% of doctors undercode.  The reason they do it is because they are afraid they will be audited and found to be committing fraud.  Here’s the secret: undercoding is against the law too.

3. Most doctors do not document appropriate to the E/M coding requirements.  Performing a level 4 service, coding it as a level 3 and documenting it as a level 2 is still overcoding.

2. In US medical practices, it takes an average of 21 days from date of service to the time when your charges reach the insurance companies.  The reason for this is front office inefficency.  (The best practices do it in 2 days.)

1.  Up to 5%  of services performed in a medical practice are never billed for, because the chart and the claim information never get to the biller and there is no back-check in place.

I wish this were a joke but it’s not.  Most practices lose $100,000 per provider per year this way.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

Have a safe and Happy Independence Day from everyone at Ultimate Practice Builder!  Celebrate this weekend and then call us Monday so we can deliver you emotional and financial Independence from the tyranny of hard work and inefficiency.  Long live the revolution!

Canada celebrates its independence from the British Commonwealth on the 1st of July. 

It’s been 14 years since I lived in Canada and I’m so proud that I no longer say ‘eh” at the end of a sentence and that I can finally pronouce the word ‘about’.  All jokes aside, Canada is really a wonderful place.  (I love Montreal in August.)

A while back a client asked me for a rule of thumb for how much to spend marketing his practice.  A lot of marketers throw out numbers like 5-10%.  I suppose that’s an OK rule of thumb but it really isn’t that useful.

First of all, what are you trying to achieve?  If you have a lot of patients but a disorganized staff, rude receptionist or poor billing process, more patients won’t help you.   Fix those problems first.  It’s like they say, repair your bucket before you use it to draw water from the well.

If you need more patients, I still think it’s only an OK approximation.  I’m a big fan of keeping metrics for your marketing.  I track the return on investment (ROI) of each marketing system in my practice.  Whatever has the highest ROI, I invest the most money into.  If I spend $2,500 and earn $20,000 worth of new patient business (which can be done, by the way), I keep spending more and more on that until my ROI drops significantly. 

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

I hope you enjoy reading this blog.  I hope even moreso that it gives you some ideas and insights into getting more from your practice… including more joy.   I even Twitter my blogs so every evanescent thought that comes out of this brain of mine gets captured and published in some media.  But am I just an untreated narcissist? 

Well, maybe… but don’t you feel you know me a little better as a result of reading this?  And maybe trust me a little better than if you had never heard of me or “met me” in this way?  If so than find a way to do the same thing for your patients.  These days they need to understand your thinking process to trust you.

David Zahaluk, MD is a practice optimization expert and the author of The Ultimate Practice Building Book.  His firm, Ultimate Practice Builder, takes physicians to the top 10% of their specialty – in income, time off and quality indicators - within 3 years… guaranteed.  Learn more at www.UltimatePracticeBuilder.com.

Self Assessment
Rank yourself from 1-10 in each of the following practice areas:

1. Customer service
2. Charting
3. Managing data
4. Managing refills, referrals and patient questions
5. Patient education
6. New patient acquisition
7. Patient retention
8. Bookkeeping, accounting and cash managment.
9. Coding, Billing and Collection
10. Adhering to evidence based care standards
11. Staff management

Next ask your office manager, your accountant and your practice building consultant to rank you in the eleven areas.

Then ask 5 patients that have been with you the longest what could be done to improve your practice.

Put that together and… voila, you have a practice plan.  Just focus 80% of your efforts on the one thing that you do the least well.  Stay with that area until everyone agrees you function at a 9/10 or a 10/10 level.  Don’t stop improving even if you get bored along the way.

Human nature dictates that we tend to do more of what we are good at and avoid the things we aren’t good at.  Constraints theory says that it doesn’t matter how good you are at the things you do well, it’s your weakest areas that limit you the most.