Archive for A Career in Practice Management

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So You Want to Be a Practice Management Consultant?

I recently was asked how to start consulting in the medical practice management space. I love consulting, but it’s not nearly as glamorous and freewheeling as it might look.

Don’t Quit Your Day Job

Unless you have an amazing referral stream or money to put into marketing, you cannot expect to be able to support yourself initially. I consulted informally on the side for years before starting my actual consulting practice, and after 6 years of pure consulting, I’ve gone back to having a day job managing a practice and consulting on the side.

Write Every Day

Consultants write reports. Every day. It’s our product. If you don’t write well or have trouble with spelling or grammar, get help. If you’re not sure if you can write well, get help.

Consultants Have to Market Themselves

As an independent consultant you have to wear every hat. You have to:

  • Market yourself.
  • Get consulting agreements.
  • Collect deposits.
  • Consult and write a report on your findings and recommendations.
  • Bill and collect your fee.

I started my blog in 2008 with the idea that I might someday leverage it into an income stream. I was told then, and believe it holds true today that producing good-quality content is the best form of advertisement for consultants. I get 90% of my business through my blog which ranks well because I’ve been writing faithfully for 10 years.

Independent Consultant Advice

  • Start or continue consulting if opportunities are available and give more than you get in service and value to help build word-of-mouth. Get testimonials and clients willing to act as referrals.
  • Get a website. Everyone who considers hiring you wants to see that you are “real” and a website is one measure of real. If you teach yourself how to create a website, you will save money and not have to rely on anyone else to correct mistakes or publish a post when you want it published.
  • Develop your voice by producing content for your website – don’t be afraid that by writing content you are giving away your secrets. Your secret sauce is who you are and the skill you bring to the table.
  • Troll listservs for problems practices are talking about. Don’t be afraid to answer questions on listservs (your state MGMA listserv, for instance) and build your reputation as a go-to consultant.
  • Make sure to offer email subscriptions to your website so you are pushing content to your audience.
  • Pay attention to what content does well (Google Analytics is free) and adjust your writing appropriately.
  • Make one article or blog post work three times – where else can you publish it? LinkedIn? Facebook? A practice management newsletter? Expand it into a white paper or eBook? A webinar?
  • Consider offering something for free – a free 30-minute consultation is a great way to introduce potential clients to you.

Be a Consultant With a Firm

Many consultants “pay their dues” by joining an established consulting company for two or more years. This gives you great experience and can be great money, but you don’t get paid if there’s no work and the traveling is tough after awhile. You have to be a real road warrior to travel every Monday and Thursday and only be home on the weekends.

I am at the point in my consulting career that I don’t travel. Clients prefer the face-to-face, but once I point out how much money I save them by not traveling to their location, they are fine with it. Put a recording or a video on your website to introduce yourself so potential clients can see and hear you and get a feel for who you are.

Blog Monetization

I’ve tried every possible way to monetize my blog (ads, products, sponsored content and campaigns, affiliate marketing) and once you have eyeballs on your site they will produce small income streams but not significant ones unless your website is drawing thousands of visitors per day. I even considered a paywall at one time, but after market research decided that practice managers and practices would not be willing to pay even a small amount per month for exclusive content.

Create a Product

Because medical practices – especially small and non-surgical/procedural practices – are really hurting financially you may want to develop products to sell as well as your time and expertise. One of my niches is implementing Credit Card on File. Practices may have the resources to implement the program themselves, so I also sell an Action Pack of templates and worksheets so they can DIY.

Develop Your Specialty

Think about your experience and skills, and research who is filling a niche that you’d like to develop. Do your homework and see if you can either emulate what they’re doing, or provide something different or better. Think about how you can distinguish yourself in that niche and write, write, write about it so you can be found.

Posted in: A Career in Practice Management

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Excel is the Skill You Need or Need to Improve

Learning Pivot Tables in Excel is Timely

It’s Time to Improve Your Excel Skills

Excel (or any spreadsheet program, try OpenOffice if you don’t have Excel) should be the go-to tool for any medical practice manager who is tasked with data analysis.

Examples of some of the data you should be analyzing in your practice:

  • What are my net collection percentages by payer?
  • Am I receiving reimbursement at cost plus for any vaccines and injectables I am supplying to patients?
  • Do I know the potential value of a contract offered by a payer or an Independent Physician Association?
  • What is the cost of adding a new physician, NP, PA or service line to my practice?

Your practice management system may already crunch numbers for you, but:

  1. Is it exactly the information you need?
  2. Is it in the format in which you need it?
  3. Is all the data I need to analyze found inside the practice management system?

What if you don’t trust the information coming from your practice management system? Many managers don’t. One of the first rules to data analysis is “Know What You Are Looking At”.  Are you confident that the data you received is the data you asked for? You may need a conversation with your practice management system support team to be sure you understand where the system is pulling data from and if it is the date you want.

A clear understanding of how your practice management system filters and reports your data is critical to producing INFORMATION. Data only has the potential to become information when it is accurate and actionable.

How to learn Excel or improve your Excel skills:

If you know only enough Excel to get by, Nate Moore’s series on Excel is a great place to start. Because he is in the healthcare field, his examples make sense. His videos (new ones regularly) are free here.

I first wrote about Massive Open Online Courses (MOOCs) back in 2013 here and the list of offerings just keeps growing. Coursera offers buckets of free courses, including courses on Excel like these:

For those of you that have the basics of Excel under your belt, proceed to learning about Pivot Tables. They will become your new best friend.

Big list of all kinds of free courses here.

Posted in: A Career in Practice Management, Day-to-Day Operations

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10 Books Every New Medical Practice Manager Should Read

 

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Daniel Pink recently published a list of 10 books every new manager should read. I’d like to spin his list into my own 10 books that I recommend for all new healthcare managers.

Dan’s pick #1: ‘Drive’ by Daniel H. Pink

I agree with his description:

In this best-selling business book, Pink explains why, contrary to popular belief, extrinsic incentives like money aren’t the best way to motivate high performance. Instead, employers should focus on cultivating in their workers a sense of autonomy, mastery, and purpose in order to help them succeed.

I have always felt that as a manager, my job is to make sure employees succeed, not look for the ways in which they fail.

Dan’s Pick #2: ‘The One Thing You Need to Know’ by Marcus Buckingham

I’ve not read this book, but I would replace it with my all-time recommendation The One Minute Manager’ by Ken Blanchard. I have given this book to scores of people that I’ve worked with over the years and I recommend it because it introduces you to the seminal concept of

“Praise immediately in public, critique later in private.”

I do agree on capitalizing on individual’s greatest strengths, but especially in small offices, one does not have the ability to craft jobs or tasks that play to one’s individual strengths. You can certainly search for those strengths during the recruiting phase, understanding what qualities often are reflected in those that are good at the front desk, in the exam room, etc.

Dan’s Pick #3: ‘Thinking, Fast and Slow’ by Daniel Kahneman

I had never heard of this book, but now I am anxious to read it. It sounds like it covers things I had to learn along the way, the hard way. Pink says:

Kahneman, a psychologist who won the Nobel Prize in economics, breaks down all of human thought into two systems: the fast and intuitive “System 1” and the slow and deliberate “System 2.” Using this framework, he lays out a number of cognitive biases that affect our everyday behavior, from the halo effect to the planning fallacy.

Dan’s Pick #4: ‘Act Like a Leader, Think Like a Leader’ by Herminia Ibarra

Right away I have to say that I was turned off by the notion that you can be too authentic at work,. Authenticity can be much more of a problem for women than for men. Dan says:

For example, Ibarra, a professor at business school INSEAD, suggests leaders act first and then think, so that they learn from experimentation and direct experience. There’s even an entire chapter devoted to the dangers of being too authentic at work.

Being authentic doesn’t mean wearing your emotions on your sleeve, or making all employees best friends. It does mean being the same person at work that you are at home. See my blog post “Should (Female Leaders Cry at Work?”

Try ‘Lean In: Women, Work and the Will to Lead’ by Sheryl Sandberg. Even if you’re a man. 

Dan’s Pick #5: ‘How to Win Friends and Influence People’ by Dale Carnegie

Couldn’t agree more! This is a classic and there’s a reason it’s a classic – it is a book that not just all healthcare managers should read, it’s a book that all humans should read. In case you can’t find the time or justification to read HTWF&IP, my mother-in-law’s homespun synopsis of the book is “You enter a room and say hello to everybody.” Got it?

Dan’s Pick #6: ‘Mindset’ by Carol Dweck

This is another book that had not crossed my path before, but one that sounds similar to #2, only applied to oneself. I would substitute ‘Blink: The Power of Thinking Without Thinking’ by Malcolm Gladwell for a slightly different take on listening to oneself to bolster confidence and self-learning. Actually, I recommend every one of Malcolm Gladwell’s books for a good read with powerful insights.

Dan’s Pick #7: ‘Meditations’ by Marcus Aurelius and Gregory Hays

To bring things into the 21st century, I suggest ‘Good Boss, Bad Boss: How to Be the Best…and Learn from the Worst’. Author Bob Sutton is a hero of mine, if only because he had the chutzpah to write ‘The No Asshole Rule’, which I live by in my business. One of the foundations of my consulting firm is that I don’t work with mean people. I’ve had to fire a few (clients) along the way, but not many.

Dan’s Pick #8: ‘Things Fall Apart’ by Chinua Achebe

If you didn’t cover this book in graduate school, or didn’t go to graduate school, pick up Crossing the Quality Chasm: A New Health System for the 21st Century’. It’s the book that changed the way we all look at healthcare and it’s good background reading for where we are today.

Dan’s Pick #9: ‘Now, Discover Your Strengths’ by Marcus Buckingham and Donald O. Clifton

Seems similar to Pick #2.

Dan’s Pick #10: ‘Good to Great’ by Jim Collins

Yes, and yes.

READERS: What books would you recommend to a new manager in healthcare?

Posted in: A Career in Practice Management, Human Resources, Leadership, Quality

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Wearables Will Soon Be Part of Major Shift In Medical Practice

For a long time the idea of wearable health tracking devices seemed like an idea out of science fiction, but these days the technology is real and cost effective, and wearables will have a big effect on how your practice operates. Here with more insight on the nascent wearable industry is Guest Author Anne Zieger, CEO of Zieger Healthcare. – Abe

For most doctors in private practice, the astonishing growth of health wearables has all but passed them by.

Wearable Technology Will Soon be a Major Part of Medical PracticeAccording to a leading health IT group, the use of health and fitness apps is growing 87% faster than the entire mobile industry. That’s pretty astonishing for a product category most of us hadn’t even heard of five years ago.

But to date, this hasn’t changed medical practice much. While physicians may review readings gathered by consumer-grade measurement devices such as home glucose meters, blood pressure cuffs and pulse oximeters, few are integrating data from wearables into their consult, much less integrating that data into their EMR.

The reasons for this are many. For one thing, doctors are creatures of habit, and are unlikely to change their assessment routine unless they are pushed into doing so. What’s more, their EMRs are not set up to gather fitness data in a routine and streamlined data. Then when you consider that physicians aren’t quite sure what to do with the data – short of a shocking data outlier, what does a physician do with a few weeks of exercise data? – it seems even less likely that they’ll leverage wearables data into their clinical routine.

Over the next few years, however, this state of affairs should change dramatically.

Data analytics systems will begin to including wearables data into their calculations about individual and population health. And physicians will be expected to become adept at using wearables to better track the health status of chronically-ill patients. In short, wearables should fundamentally change the way physicians care for patients, especially those at greater risk.

Here’s some examples of how this will play out.

Data analytics

In an effort to improve the health of entire patient populations, organizations such Louisiana-based Ochsner Health System are testing Apple’s HealthKit technology. Through HealthKit, which connects with Ochsner’s Epic Systems EMR, the health system will be able to pull in and integrate a wide range of consumer-generated data, notably input from wearables.

While Ochsner’s first big win came from its test with wireless scales for heart patients—which led to a 40% decrease in admissions—the bigger picture calls for clinicians to use wearables data too, leveraging it to track the health of it entire patient base.

Tracking the chronically ill

Though most wearable health bands are consumer devices, used largely by the already fit to help them stay that way, medical device companies are building a new class of wearable devices designed to help clinicians track serious chronic illnesses in a serious manner.

Phillips, for example, announced a few months ago that it had released a biosensor patch designed to track symptoms of COPD, send the data to a cloud-based central software platform using the patient’s wireless device, then route the results to that patient’s clinician via a pair of related apps. This gives the physician 24-hour access to key indicators of COPD status, including respiratory rate, heart activity and rhythm and physical activity.

Conclusion: Much more to come

The bottom line in all of this is that wireless monitoring of remote patients has already arrived, and that new uses for data from health bands and other fitness devices are likely to become a standard part of patient care over the next few years.

While no one is suggesting that the data and practical observations a doctor gathers during a fact-to-face medical visit are becoming less value, medical practice is likely rely more heavily on monitoring of wearable smart bands, sensors, smart bands, sensor-laden smart clothing and more as time goes by. Now is a good time to prepare for this shift in medical practice, or risk getting left behind.

Anne Zieger of Zieger Healthcare

Anne Zieger is CEO of Zieger Healthcare

Zieger Healthcare’s team of veteran marketing communications pros will help you reach out to key healthcare stakeholders and grab their attention.  With decades of experience in the industry, we know exactly how to tell healthcare stories that sell.

 

Posted in: A Career in Practice Management, Electronic Medical Records, Innovation

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Your Practice Management Software Is Only As Good As Your Practice Management

The Robot Practice Manager

 

A colleague of mine has been part of a well-known PM/EMR company’s software support team for 10 years. She often tries to steer people to me when she cannot solve a client’s problems with a software solution. Even though she was once a practice administrator herself, she is a software support person now and the problems she sends to me cannot be solved with software. “Mary Pat,” she asks me, “Why do they think I can solve their practice management issues? All I am empowered to do is to help them use the software.”

Earlier in my career (before EMR) I heard someone call “Practice Management” software “Billing” software and I remember being offended for some reason. I thought “Billing” was such a narrow description of what PM software did – but they were right. That software is meant to deal with everything billing. It all comes down to billing – whether it is the actual billing/claims management itself, running reports to diagnose billing problems, or capturing recalls so patients get reminded to come in for a service and…get billed. Before you unload on me in the comments let me be clear that I am not saying that healthcare is all about billing, I am only saying that Practice Management software was developed to handle the financial side of the house.

Practice Management software cannot “do” practice management. It cannot figure out your workflow so you capture data in the most efficient way, and it cannot analyze your reports and tell you what to change to increase efficiency or decrease overhead. It certainly cannot tell you the best way to schedule, or how much to charge your self-pay patients. It is only a billing tool.

I have worked in healthcare long enough to have helped practices go from manual billing (you typed or hand-wrote claim information on a 1500 form and mailed it in) to their first practice management system. I did a lot of practice management consulting even though that’s not what I was there to do. I had to get them in shape on paper so they could handle the software. I had to get their workflow optimized so the software would make things better – not worse.

An implementation of Practice Management software is not intended to do anything but set-up the system and train you to use it. Sometimes that perfectly rosy future the salesperson paints is nothing like the painful first steps (and cash flow jam) of a new system. An implementation will not fix the issues that are existing in your practice that have nothing to do with the functionality of your billing system.

 

Your Practice Management Software can:

    • Automate your registration process so patients can register and check-in online, or at a kiosk in the practice.

But your Practice Management Software cannot:

    • Train staff to greet patients and make them welcome in the practice.

 

Your Practice Management Software can:

    • Check the patient’s eligibility for active insurance coverage.

But your Practice Management Software cannot:

    • Automatically choose the correct insurance company/payer to attach to each patient account (one of the biggest problems I hear about in the field!)

 

Your Practice Management Software can:

    • Calculate the days since the patient’s last physical, the days left in a global period or visits left in annual cap. 

But your Practice Management Software cannot:

    • Help the patient understand their benefit plans and understand their financial responsibility.

 

Good practice management has a lot to do with attracting, training, coaching and retaining the right staff, as well as providing them with the tools to do the job you hired them to do. Getting the software right is a must, but don’t expect your software trainers to be able to solve any of your staffing, communication, workflow or cultural problems. That’s up to you, the Practice Manager!

(Photo Credit: baboon™ via Compfight cc)

Posted in: A Career in Practice Management, Collections, Billing & Coding, Day-to-Day Operations, Finance

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MOOC For Healthcare: What Can You Do (for Free) to Improve Your Management Skills?

Managers can Go Back to School with MOOCsOur clients and readers are constantly asking “What do I need to do to be ready for all of this change in healthcare?” There is so much to digest, plan for and keep track of that our industry is constantly seeking new skills to confront new challenges. Professional development is a critical part of career plans in most industries – but the speed at which healthcare administration is changing is pressing the issue even further. But when can already-swamped managers find the time (let alone the money!) to stay sharp and expand their skill sets?

In the past five years a solution has emerged from the Internet. The MOOC, or “Massive Open Online Course” is a model that has the potential to revolutionize how we educate people on a large scale – not to mention give busy managers a chance to get high-quality education at little or no cost on a flexible schedule. After several universities put free, open-coursework courses online to great success, several sites developed to expand the scale of the model. Now sites like Udacity, Coursera and edX offer free courses with video lectures, materials, and examinations to anyone who can access their site. The New York Times dubbed 2012 “The Year of the MOOC”, but it might be 2013.

If you are a manger looking to stay sharp, check out some of the Coursera offerings for summer and fall of 2013 below!

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Posted in: A Career in Practice Management, Headlines, Leadership

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Master the Vacation Balancing Act

This article was originally published on LinkedIn as a part of their Influencer series.

Vacation Balancing ActSummer is traditionally the slow time of the year for healthcare. Summer in medical settings means vacations and staff coverage, new physicians fresh from residency, and more chances for the local kids to get creatively injured with school out. Even though summer might not have the intense volume of cold and flu season, or the intense number-crunching of the end of/beginning of the year, as a manager there’s always something demanding your attention. So when you need a vacation, you Need A Vacation. How do you achieve the balance of taking time off with being able to step in and manage if the need arises?

Access is the name of the game in achieving balance. I want to be able to go away knowing that I can easily get to things I need without a lot of fuss. That’s why I am such a fan of mobile technology that lets me stay informed or in touch when I’m away – whether at a conference, on vacation, or fitting in family or personal time.

The key to access is using your phone or tablet to enhance and protect your out-of-the-office time, not invade it. Access equals peace of mind and allows the total unwinding that is so critical to rebuilding your energy for the next round. While I’m taking time off this summer, these are the apps I’m using to stay in touch and give me the confidence to let go!

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Posted in: A Career in Practice Management, Day-to-Day Operations, Quality

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Everyone Is Essential: Guest Author Bob Cooper

Obama Fist Bump with JanitorSome organizations will use the terms essential and non-essential workers as a way to distinguish between who needs to be on site in the event of an emergency, and who does not. I do understand the purpose of this distinction, however, it’s very important that businesses not give the impression that some employees are more important or valuable than others. (more…)

Posted in: A Career in Practice Management, Amazing Customer Service, Day-to-Day Operations, Human Resources, Leadership, Quality

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[Slide Deck] How Doctors Are Paid Today: Understanding RVUs

There’s a lot of talk today about how physicians (and other care entities) are paid. This slide deck discusses how the system used predominantly today (RBRVS) to pay physicians came to be and how Medicare and other payers calculate a payment. Download this Slide Deck and learn about Relative Value Units.

Click Here to Download.

Posted in: A Career in Practice Management, Collections, Billing & Coding, Day-to-Day Operations, Medicare & Reimbursement

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