Archive for the ‘General’ Category

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The low hanging fruit

Monday, August 8th, 2011
Apple of Sodom;

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What is the “low hanging fruit” in your practice? By that I mean what is the opportunity to improve your practice that is ripe for the picking? What could raise the revenue in your practice without a lot of time, energy and money expended?

I know some of you think that making money is a crass subject that is completely beneath you. To those select few I have an important message: “Wake up!”

If you do not do everything you can to service your patients‘ health needs you are doing them a complete disservice. And if you think they are only patronizing your services perhaps you are likewise deluding yourself.

As a physician, you have to ask yourself how you can best help your patients to maximum health. But as a business person you have to ask yourself a completely different question – What can I do to raise revenue? As long as the answer to the second question does not conflict with the first, you have every reason to move forward with vigor.

Here are a few ideas to get you thinking:

  • Improve billing processes and personnel
  • Raise more capital and add more providers to your team
  • Improve patient retention and reactivation
  • Run TV and radio ads
  • Revise your website to be a patient capture site
  • Do weekly staff training
  • Bring in ancillary services
  • Start a medical village concept
  • Do public speaking
  • Start a wellness program

David Zahaluk, MD is a Dallas-based 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.

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Trends in the business of medicine

Monday, July 25th, 2011
WAIMEA, HAWAII - DECEMBER 8: Six surfers drop...

Image by Getty Images via @daylife

There are three big trends going on in medical business practice:

1. Online health records and medical community portals

2. Aggregation to be part of a larger group

3. Corporate wellness

All 3 are huge waves to increase revenue and simplify practice workflows. Which wave are you on and what is your practice goal in participating.

David Zahaluk, MD is a Dallas-based 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.

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Retention Marketing

Wednesday, July 13th, 2011
Thanksgiving Turkey

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OK, your turn to educate and impress me. Send me your best retention marketing ideas. We will review all entries and choose a winner and I will gift the winner $5,000 in free coaching (personally with me which is next to impossible to get these days). Send me the concept, the creative and the results. I want the actual materials as a patient would get them. My team and I will select a winner just before the Thanksgiving holiday 2011.

By the way, I have just 7 things on my patient retention marketing plan but they happen to be the most powerful and most scaleable tactics available. And we use multiple media to effect retention. Just review the articles on the site or read my book and you’ll probably have a pretty good idea of my best ideas for patient retention.

David Zahaluk, MD is a Dallas-based 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.

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Halfway through 2011

Thursday, June 30th, 2011
Winston Churchill, Prime Minister of the Unite...

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OK, we’re at the halfway point. Are you ontrack financially, in terms of your personal schedule, in terms of the staff you want and the pateints you want in the practice? If not, time to course correct. Here are some things you can do to create the ultimate practice in place of what you have come accustomed to.

  1. Spend 10 minutes at the beginning of each workday – with phones unplugged, door closed and pager off – thinking about what your practice would be like if it were absolutely perfect in every way, and make notes.
  2. Decide who you need to add to your management team to make you better at management, finance and marketing.  Think ‘new blood’.
  3. Decide whom, if anyone, on your current staff needs to move on to a new place of employment.
  4. Decide what metrics will predict success for your practice over the next 3 months, 6 months, 1 year and 5 years – and collect that data on an ongoing basis and review it with your management team.
  5. Articulate a vision for your practice that would attract the best staff and retain them for life and attract the best patients and retain them for life and ensure they would refer their friends, family and coworkers.
  6. Have someone external to your practice come in to evaluate your vision, your strategy, your financials, your goals and your plans.  Be willing to listen to the feedback, even if it painful.  Reality is your best friend.
  7. Realize that this is your responsibility, even if you work with a consultant or coach.  This is not a problem that can be solved by a cookie-cutter approach; it’s something you have to feel in your gut.  To quote Winston Churchill “The key to a leader’s impact is sincerity. Before he can inspire with emotion he must be swayed by it himself. Before he can move their tears his own must flow. To convince them he must himself believe.”   

David Zahaluk, MD is a Dallas-based 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.

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Drowning in Same Old Same Old?

Thursday, June 23rd, 2011
Stick figure in peril

It’s great to talk about strategy and tactics for growth in a medical practice.  I love the subject – to me it’s  fun, mainly because I’m good at it.  Yet as I talk about strategy and tactics with many prospective clients I sometimes get the feeling it’s all a big waste of time.  Why?  Because they don’t have the right people to work with in the first place and even if they did, they don’t have the right vision and management structure to move those tactics forward.  The sad fact is that many practices right now are hanging in by a thread and they lack the sound fundamentals to survive in this or any economy.

This lack of what I call infrastructure, for lack of a better term, mostly manifests itself as sameness.  You try something new and things don’t really change.  Try something else and it changes for a little bit then reverts to the same old level of dysfunction.  Promises and dreams do not get realized.  Complacency soon follows after the inertia of sameness is realized.  Why?  No compelling vision.  No ‘reason to believe’ in the practice.   

If this describes your practice and your situation what can you do about it?  First of all, realize that the same thinking that got you to where you are is not likely to solve the problem.  You are probably going to need new insight, new blood to come in and change things.  If you’re not open to change, if you’re resistant to bringing in someone that will change the dynamics of your office, realize that you may be the problem.  You may be too complacent to allow the fresh air of new ideas into your practice.   

By the way, if you want to grow your practice, particularly through marketing efforts, this notion of vision is critically important.  If you feel like you are selling too hard in your marketing, that may be a sign that you lack the vision and the management focus to execute on your promise to patients.  But please, don’t use that as a reason to stop marketing – use it as a reason to improve your operational vision and infrastructure.  Rally your team together to fulfill the promise you made to patients when you opened your doors in the first place.  When you get better operationally, your marketing will, in turn, become more specific and effective.

As a cliffhanger, the next post will give you a list of things you can do to overcome the inertia in your practice. Study that list!

David Zahaluk, MD is a Dallas-based 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.

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Leadership – An Inside Look

Sunday, June 19th, 2011
Dirk Nowitzki cropped, Dallas Mavericks

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I know some of you are getting sick of me talking about Dirk Nowitzki. Too bad, here’s more.

In 2006, Dirk and the Mavs got to the NBA Finals against the Miami Heat, led by Shaq and Dwayne Wade. The Mavs won the first 2 games, and led for a good part of the 3rd game, then after an abrupt turnaround, they lost 4 in a row and the Heat took it in 6.

The Mavs, and Dirk especially, were labelled “soft” and “chokers”. They couldn’t get an ounce of respect from anyone.

In the off-season after the 2006 embarassment, Dirk took it very hard. Unlike LeBron, he didn’t choose to belittle his fans. He didn’t even publicly protest the “choker” label. Instead he went inward.

He spent time in total solitude, in the Australian Outback and at sea, and thought deeply about what happened and what he would ultimately have to do differently to get a championship ring. He didn’t try to distract himself with a reality series or a high-profile relationship. He focused on what he would do differently to get him where he wanted to go.

By the way, Dirk does not have an agent or a manager. Just a shooting coach. He negotiates his own contracts. He declines all endorsement deals. In fact, if there is Gatorade in the shot during a press conference, he removes it so as not to be associated with any products.

Dallas loves Dirk because he is not a punk. He has developed the ability to take a game over with his sheer will and get other players to match his intensity. Talking to you both, LeBron and Kobe. 

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Attracting the Best People

Friday, June 17th, 2011
Rod Stewart

Cover of Rod Stewart

Driving home in the Dallas rush hour, bored and impatient, I heard Rod Stewart on the radio singing ‘Reason to Believe’ for millionth time.  In his distinctive whisky voice Rod sings,

“If I listened long enough to you

I’d find a way to believe that it’s all true

Knowing that you lied, straight-faced while I cried

Still I look to find a reason to believe…”

I realized that those lyrics encapsulate a problem that virtually every one of my clients has.  They lack a vision for their practices that unites staff, providers and patients.  They lack a compelling vision that commands people to go out of their way to discover greatness at the workplace.  They lack a credible reason to believe in either the providers or the practice itself.  They have a job but not a great business.

Think that’s a stretch?  Consider Duncan Syme, CEO of Vermont Castings.  Vermont Castings made wood stoves and Syme’s vision was to make the best wood stoves in the world.  Syme was renowned for his high standards and could regularly be seen standing on the production line and personally inspecting the product as it rolled off the line.  By the 1970’s Vermont Castings became the fastest growing company in the wood stove industry with revenues over $29 million and net margins approaching 60%.  Yet when Syme stepped away from day-to-day management in the early 1980’s and turned things over to a professional management team, things went bust.  Customer service faltered, quality standards dropped and focus went off of wood stoves and onto other product lines.

In 1986 Syme had to return from retirement to get things back on track.  This time he took a different approach to installing his vision for the company.  Instead of personally presiding over the operation, Syme began a process of institutionalizing his vision.  He created a written document that expressed his vision and creed for the company and made that the guiding point for operational decisions going forward.  He sold his managers on that creed as the standard by which business was to be carried out.  He transferred his vision in a way that could live in his absence.

What would happen to your practice if you were away for a month?  What key employees in your practice, if they left, would take down the practice?  What is the vision and the mission for your practice?  What is your practice about, stated in a way that makes sense to a fifth grader? What will your practice look like in 5 years?

David Zahaluk, MD is a Dallas-based 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.

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Congrats Dirk, Jet and Los Mavs

Monday, June 13th, 2011
Dirk Nowitzki

Image via Wikipedia

Wow. 2011 NBA champs.

The cool thing about this team is that most of Dallas loves them and roots for them. The fans were strong when they lost in the first round as well as now and for a long time to come. Good for you guys.

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My Practice CEO

Friday, June 10th, 2011
CEO of Lanxess

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In my last post I talked about the problems that all practices face in changing and growing – specifically the constaints that are “invisible” to the owner for some reason but painfully apparent to the outside consultant. So here is what we decided to do to overcome that situation.

We developed a unique practice development tool called My Practice CEO.  It looks at every key process within your practice as it relates to operational efficiency, clinical quality indicators and revenue optimization.  It is a 3 to 5 year process and we work it one system at a time.

We break down each process in your practice.  We begin with five major categories:

We then apply metrics to evaluate each area and determine where we need to go deeper.  After that we build the plan for process improvement, bring it to the physician-owner for their blessing or correction and then set about the process redesign while the doctor continues to actively practice.

We find typically that there is one key constraint in the practice that is the limiting step for growth.  Once overcome, efficiency goes up, revenue goes up and stress goes down.  And then, guess what happens?  We identify the next key constraint.  And then we work on that until it is resolved and then we find another and another.  

Somewhere after about the fourth or fifth process redesign we start to see some pretty amazing changes.  We start to see a culture shift – a change in the way doctors, staff and patients see and appreciate the practice.  It becomes (not to be corny) a labor of love, not just some mundane effort to pay the bills.

It’s a lot of work and oh boy is it worth it.  It is critical to do this in your practice – on your own or with our help.  And as you consider this opportunity, please keep the following question in mind.  Is it worth the effort for you to fall in love with practicing medicine again?  

David Zahaluk, MD is a Dallas-based 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.

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How Do You Help a Practice Like This?

Friday, June 3rd, 2011
Albert Einstein

Image by MusMs via Flickr

I want to share an important breakthrough I had as a consultant.  It was actually born out of the headaches and frustrations I faced in doing one-on-one coaching with one of my most difficult doctor clients.

This client was not difficult to work with because he was undermining or sabotaging our process – quite the opposite, he was extremely hungry for success. He was simply overwhelmed and unable to implement many of the changes designed to enhance his profits.

What do similar such “difficult” clients have in common?  They have:

  • High staff turnover
  • A culture of chaos in their practice
  • Low patient retention rates
  • A reputation with patients for having an unprofessional staff
  • High stress levels at work, leading some to want to avoid coming in to the office
  • Poor customer service
  • Poor cash flow
  • An inefficient billing process
  • Little to no managerial oversight
  • Little to no marketing
  • No practice budget or regular review of practice financials
  • And the #1 commonality to these “difficult” practices… Everything has to go through the physician, nothing works on “autopilot”

Essentially these practices are like codependent relationships – same problems each day with no new progress.  The doctor felt trapped and isolated; the staff feared the emotional overreactions of the doctor and it felt like you stepped in quicksand every time you walked in the door.

How do you help a practice like this?

As I struggled with this problem over many months an insight began to appear:  There can be no growth in the practice without greater infrastructure.  The processes in the practice had to be either systemized or outsourced.  The doctor had to be allowed editorial input as to how the processes would work, but the redesign and the training had to be given to my team or it just would not get done.  

As Einstein said, “We can’t solve problems by using the same kind of thinking we used when we created them.”  You need fresh thinking to build past the existing constraints in your practice.  You need a team to come in – like you see on reality television where they clean up a junky cluttered house – and redesign the systems, one at a time, starting with the ones that are the most “broken”.

David Zahaluk, MD is a Dallas-based 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.

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