Recruiters / Search Firms / Head Hunters

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There are two models for search firms, retained and contingency.

A retained firm works for the organization and is paid a flat fee upfront (a retainer) to launch the search and an additional fee when the position is filled.  Retained firms usually visit your community to understand your needs and culture, carefully sourcing candidates who will be a good fit for your organization.  Retained firms are often the answer for hard-to-recruit for locations or specialties.

A contingency firm works for the candidate and is paid if/when you hire a candidate they found for you.  There is an agreement that you sign before they present any candidates stating that you will agree to pay them if you hire anyone they have introduced to you, typically within 12 months of the introduction.  You may sign an agreement with as many contingency firms as you like.  There is a great variance in candidates sent by different firms – some are pre-screened and some are not.  Because their goal is to place candidates, they may well be presenting a candidate to you and to your competition simultaneously.  Make sure that a contingency firm presents a name to you before sending a CV in case another firm has also presented the same candidate.  Some firms charge a flat fee and some charge a percentage of the hired employee’s first year gross salary. Contingency firm fees hover around $10K for mid-level providers (nurse practitioners and physician assistants) and around $20K for physicians.

Some recruiters have the reputation of being out for themselves and not serving their clients (candidates and organizations), but instead only serving themselves.  The professional organization for physician recruiting organizations is the National Association of Physician Recruiters (NAPR) which has a Code of Ethics that members must adhere to.  You can research member firms here.

On the NAPR website, it notes a collaboration with MGMA:

MGMA, in collaboration with NAPR, surveys its membership to obtain the most recent physician starting salary placement compensation data. This is the fourth year of data collection and the third year of stand-alone publication for the Physician Placement Starting Salary Survey report. The report provides accurate data on the range of physician placements to assist recruiters and health care organizations in benchmarking salaries and other employment terms. The report also allows users to compare and learn more about the factors affecting first-year placement compensation. All survey participants receive a complimentary copy of the Physician Placement Starting Salary Survey

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How Much Do Medical Practice Managers Make?

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Read the 2011 update to this article here.

You’ve heard that healthcare is one of the few job markets that is still growing in a down economy and you think you might like to be a medical office manager.  The question is: how much do medical practice managers make?

The real answer to this question is  “it depends.”  Two people in different parts of the United States could have the same job description and one could make $50,000 and another could make $100,00.  Most experienced, capable medical practice managers make a good living somewhere in the middle.

What differentiates medical practice managers (and I use this term in a generic sense to cover the variety of titles used in the healthcare field) from other office managers is that they are expected to know something about almost everything.  A typical day in the life of a medical manager might well include tasks in the areas of:

  • human resources
  • risk management
  • coding and billing
  • credentialing
  • accounting
  • information technology
  • facilities management
  • conflict resolution
  • physician compensation plans
  • marketing
  • physician/provider recruiting
  • and more! (see my post on what managers do here.)

The medical practice manager is often in the unique position of both answering to the owners (physicians) and managing them – a phenomenon not seen in other industries.

What a medical practice manager earns relates to:

  • what the decision maker(s) believes the job is worth, or what they’re willing to pay
  • what a consultant or financial adviser has said the job is worth
  • what other local practices are paying their managers
  • what the previous manager made

Factors influencing the posted salary for a position are:

  • the specialty or specialties (single-specialty vs multi-specialty and primary care vs. sub-specialty care)
  • the number of physicians/providers
  • the number of sites or ancillary services (imaging, physical therapy , medical spa, ambulatory surgery center)
  • hospital-owned vs. non-hospital-owned
  • if hospital-owned, how the position is graded, or where it fits in the management structure
  • billing in-house or outsourced
  • financial soundness of the entity
  • the entity’s competition in the community
  • cost of living factor for region

Factors that might influence the salary ultimately offered YOU for a position are:

  • Years of experience in healthcare management
  • Years of experience managing the same or similar specialty
  • Years of experience managing the same or similar # of physicians
  • Stability of jobs over the past 10-15 years
  • Special degrees: Master’s, CPA, CPC, Compliance, RN, Lean, Black Belt (Six Sigma)
  • Having installed an EMR (electronic medical record)
  • References

Where does one look for specific information on what managers make?

The Bureau of Labor Statistics’ (BLS) most recent information reports:

Median annual wages of wage and salary medical and health services managers were $80,240 in May 2008. The middle 50 percent earned between $62,170 and $104,120. The lowest 10 percent earned less than $48,300, and the highest 10 percent earned more than $137,800. Median annual wages in the industries employing the largest numbers of medical and health services managers in May 2008 were:

General medical and surgical hospitals$87,040
Outpatient care centers74,130
Offices of physicians74,060
Home health care services71,450
Nursing care facilities71,190

According to a 2009 survey by the Professional Association of Health Care Office Management (PAHCOM), the median salary for health administrators in small group practices is $56,000; for those in larger group practices with 7 or more physicians the median is $77,000.

The silver-back of healthcare salary surveys comes from the Medical Group Management Association (MGMA). The Management Compensation Survey is one of the “golden trio” of surveys that I’ve used throughout most of my professional life.  You can view a sample page here: Sample Table (pdf).  The survey information is free if you are a MGMA member and participate in the survey yourself.  You can purchase the Compensation Survey here.

Many state MGMA groups also sponsor state salary surveys and sell them to non-members.  In addition, some local manager groups do limited surveys and make the information available for a fee.

Job descriptions for medical managers can be found under the Library tab at the top of the page.

More articles on medical management can be found under the category of “A Career in Medical Management” on the right-hand side of the page, including A Day in the Life of a Practice Administrator” and The 5 IT Skillsets Every Physician Practice Manager Needs to Succeed in 2009 and Beyond.”

Posted in: A Career in Practice Management

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50 Ways to Attract New Patients to Your Practice

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Some practices are overwhelmed with patients and can’t find enough hours in the day to see all the patients that want to be seen.  Others are in a highly competitive environment and are looking for ways to attract new patients.  Here is a list of 50 ways to attract new patients to your practice.  Some will be better for primary care, others will be better for sub-specialists. Number One will attract patients to all types of practices.

  1. BE NICE TO EVERYONE: patients and their families, staff, hospital staff, vendors, janitors, everyone.  What do people say when they recommend someone?  “You’ll like him, he’s nice.”
  2. Have an open house and offer BP checks, cane/walker checks, free H1N1 shots, etc.
  3. Offer free meet and greet visits to let patients meet you before establishing.
  4. Take extra unassigned ER call or fill-in for other docs (the ER staff will recommend you to patients.)
  5. Visit nursing homes and meet administrators and staff, leave brochures.
  6. Do home visits.
  7. Have a Saturday morning clinic.
  8. Do a radio interview or talk show taking callers’ questions about a medical topic.
  9. Visit the pharmacies and introduce yourself to pharmacists, leave brochures.
  10. Visit high school guidance counselors in the spring and leave information about college physicals.
  11. Place brochures with the Welcome Wagon or Newcomers Club.
  12. Join the Chamber of Commerce and attend meetings.
  13. Join the Lions, Kiwanis, or Rotary Club.
  14. Join the worship center of your choice and become involved.
  15. Join a journal club.
  16. Join a business leads organization.
  17. Take credit cards, offer payment plans and offer a financial hardship program.  My book has advice about collecting from patients.
  18. Call schools and volunteer to do sports physicals in the spring.
  19. Contact the local Parish Nurses and meet them.
  20. Volunteer to be available at local school sports events.
  21. Start a medical issue support group that meets at your practice.
  22. Call local employers and offer to come on site to do physicals, flu shots, wellness talks.
  23. Do DOT physicals and take worker’s comp patients.
  24. Go visit the home health equipment stores and leave brochures.
  25. Specialize in difficult conditions and disease states and advertise that you do.
  26. Volunteer at the local free clinic.  The volunteers will refer patients to you.
  27. Offer to be “on tap” for the local TV station to provide sound bites on the latest topic: vaccines/autism, radiation exposure
  28. Send out info to the newspaper every time you attend a meeting, speak, write, or do anything notable.
  29. Take Medicaid and insurances offered by local large employers.
  30. Tap into social media and have a great website, blog, online registration, online scheduling, online drug refills, etc.
  31. Speak about any medical topic, anytime, anywhere.
  32. Give travel vaccines.
  33. Place a sign outside your practice saying “Now Accepting New Patients.”
  34. Meet the local hospitalists group.
  35. Offer virtual visits to your established patients.
  36. Talk to the local managers group.
  37. Make friends with potential referring practices, take lunch, leave brochures.  Don’t forget practices in surrounding areas.
  38. Have a private line into your practice just for other physicians and practices.
  39. Make it incredibly easy for staff from other practices to refer patients to you. Many referral decisions are made based on ease of entry to the practice.
  40. Ask satisfied patients to log on to a physician review site and leave a review of your services.
  41. Visit daycares and leave information for parents on kindergarten physicals in the summer.
  42. Develop “loss leaders” and advertise them: free/discounted flu shots, inexpensive physicals for <19 year olds, etc.
  43. Take students in your practice: medical assistants, nurses, phlebotomists, healthcare career students.  When they get jobs they will recommend you.
  44. Place small ads in the local professional, amateur or high school theater playbill.
  45. Round twice a day on your inpatients. Satisfied patients refer other patients.
  46. Give a talk at your practice for anyone who thinks they might like to be in healthcare.
  47. Moonlight at a local Urgent Care.
  48. Give a talk for local nurses.  Everyone asks nurses which doctor they would go to.
  49. Let local (nice) hotels know you will make house calls over lunch or after clinic hours.
  50. SMILE.  Never underestimate the value of a smile.

Posted in: Practice Marketing

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Social Networking

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Social media researchers Danah Boyd of Microsoft Research New England in Cambridge, Mass., and Nicole B. Ellison of Michigan State University define social networking as having three distinct features

  • they must provide a forum where users can construct a public or semipublic profile;
  • create a list of other users with whom they share a connection;
  • and view and move around their list of connections and those made by others.

Examples of social networking sites are FaceBook, LinkedIn, and Twitter.

Posted in: Definitions

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CMS to Hold Open Door Forum on Medicare Provider and Supplier Enrollment via PECOS

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On February 17, 2010 from 2:00PM ”“ 3:30PM ET the Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss Medicare provider enrollment issues. During this call, CMS staff will discuss:

  • Internet-based Provider Enrollment, Chain and Ownership System (PECOS) for physicians, non-physician practitioners and provider and supplier organizations
  • Provider and supplier reporting responsibilities
  • Medicare ordering and referring issues
  • Revalidation efforts

Afterwards, there will be an opportunity for the public to ask questions.

Open Door Forum Instructions:

**Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.**

Dial: 1-800-837-1935
Reference Conference ID 52537484
An audio recording of this Special Forum will be posted to the Special ODF website here and will be accessible for
downloading on or around Monday March 1, 2010 and available for 30 days.

For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to
view Frequently Asked Questions click here.

Posted in: Medicare & Reimbursement, PECOS

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Steampunk

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The term Steampunk denotes a time when steam power was still widely used””usually the 19th century, and often Victorian era England””but with prominent elements of …either science fiction or fantasy, such as fictional technological inventions like those found in the works of H. G. Wells and Jules Verne! Steampunk fashion relys heavily on “brass bits, buckles and buttons”! Not healthcare, but interesting nonetheless!

Posted in: Definitions

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KLAS (technology evaluation company)

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Pronounced like “class”, KLAS is an independently owned and operated healthcare technology company headquartered in Orem, Utah whose mission is “To improve healthcare technology delivery by honestly, accurately, and impartially measuring vendor performance for our provider partners.”

The name KLAS comes from the first initials of the founders’ names: Kent Gale, Leonard Black, Adam Gale, and Scott Holbrook.

KLAS evaluates technology products in the categories of:

  • healthcare software vendors (since 1997)
  • professional services to healthcare providers including implementation, planning and assessment, vendor selection, technical consulting, IT outsourcing, and business process outsourcing (since 2004)
  • research on medical equipment, including CR/DR and MRI scanners (since 2005)

According to the KLAS website:

KLAS data and reports represent the combined opinions of actual people from provider organizations comparing how vendors, products, and/or services performed when measured against the participant’s objectives and expectations. KLAS findings are a unique compilation of candid opinions and are real measurements representing those individuals interviewed. Findings are not meant to be conclusive data for an entire client base. KLAS provides the findings as valuable data points to be used with other data points in the reader’s overall analysis. We encourage our clients, friends, and partners using KLAS research to take into account the following statements as they include KLAS data in their other due diligence.

Reports can be purchased by healthcare providers  for +/- $1000. Considering the amount of time and money invested in technology, $1000 sounds like a reasonable price to me.

Posted in: Definitions

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HSA (Health Savings Account)

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Individuals or families covered under a high-deductible health insurance plan during the year are eligible to contribute to an HSA.   Here is some information on HSAs from Reed Tinsley, a Houston CPA and consultant:

  • Money contributed into an HSA is tax-deductible.  Either you contribute into an HSA on your own, or your employer contributes on your behalf.
  • Money invested within the HSA is your money and grows tax-deferred.  Unlike Flexible Spending Accounts (FSA) offered to you as part of your employee benefit package where you set aside a set amount of money to pay for your family’s healthcare costs with pre-tax dollars, there is no “use it or lose it” pitfall with HSAs.
  • Money can be withdrawn tax-free from your HSA at any time to pay for your family’s healthcare expenses.
  • Any money remaining in your HSA upon your reaching the age of 65 is available to subsidize your retirement.

For more information about HSAs, check out IRS Publication 969 (pdf).

Reed’s website is here.

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How to Apologize to a Patient

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I like to get complaints from patients. The best situation is when I have the opportunity to meet face-to-face with the patient when they are in the office.  No, I’m not a glutton for punishment. What I like about complaints is that I get to hear directly from the patient what is bothering them, and I have an opportunity to let a patient know what we’re trying to do in the practice.  Here’s my guide to patient apologies.

Step One: I introduce myself and shake the patient’s hand and the hand of anyone else in the exam room.

Step Two: I sit down. There are two reasons for that. One is to send the message that they do not need to hurry –  this conversation can take as long as they need it to. The second is to place myself physically below the patient.  If they are sitting on the exam table, I will sit in the chair. If they are sitting in the chair, I will sit on the step to the exam table. The message I am sending is “I do not consider myself to be above you.”  It sends a very strong message.

Step Three: I say “I understand we have not done a very good job with __________ (returning your calls, giving you an appointment, getting your test results back to you, etc.)  Can you tell me about it?”  I do not take notes as I want to focus on the patient, but I take good mental notes.  The patient and/or anyone with them needs to be able to talk as long as they want. They might need to tell their story twice or many times to get to the point where they’ve gotten relief.  The patient has to get the problem off their chest before the next part can happen.

Step Four: I apologize, saying “I’d like to apologize on behalf of the practice and the staff that this happened.  I want you to know this is not the way we intend for _______ to work in the practice.”  If anything unusual has been happening, a policy has changed, or new staff have been hired, I let them know by saying “So-and-so has just happened, but that’s not your problem. We know our service has slipped, but we’re hoping we are on the way to getting it fixed.”

Step Five: Answer any questions the patient has. How will you fix this for me?  Why did the policy change? What’s the best way to get an appointment? Are you trying to drive patients away? Are you going to hire more doctors?

Step Six: I offer my name again and a way for them to contact me if they have further problems.

Step Seven: I follow-up on the information the patient has given me to find out where the system broke down or where a new system might need to be developed.

I had the opportunity to apologize twice last week.  It helped me to keep a pulse on the practice, know what patients are struggling with, and of course, practice humility.  All good stuff for a practice manager.

For an excellent article on how doctors can apologize to patients for medical mistakes (AmedNews, February 2010) click here.

Posted in: Day-to-Day Operations

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