Practice Management for the Millennium How to Improve the Efficiency of Your Practice and Enhance Referrals From PCPs

1. Practice Management for the MillenniumHow to Improve the Efficiency of Your Practice and Enhance Referrals From PCPs Dr. Neil Baum New Orleans, Louisiana

2. Goals and Objectives • Identify the needs and wants of the American urologist • Techniques to market and promote incontinence to potential patients • How to attract physician referrals for urinary incontinence • Use of new technology-Electronic Medical Records

3. Needs and Wants of Physicians • Maintain existing patients • Attract new patients • Improve reimbursements • Decrease overhead • Decrease litigation • Improve morale of the staff • Improve the efficiency of the practice • Put the “manage” into managed care • Add new technology to your office practice

4. The Four Pillars of aSuccessful Practice Attracting new patients Patients already in your practice A highly motivated staff Your relationship with referring physicians

5. The Two Secrets of Success 1. Find out what the patient wants and give him/her more of it 2. Find out what the patient doesn’t want and avoid it

6. Secret #1. Find out what the patient wants and give him/her more of it. “Ask and you shall receive!” Patient surveys

7. Give your practice a check-up How do patients perceive your practice? • Conduct personal interviews • Create a focus group • Use a suggestion box • Commission a mystery shopper • Conduct patient surveys

8. Secret #2. Find out what the patient doesn’t want and avoid it Patients do not want to wait to be seen by the doctor

9. Effective Scheduling “Languishing in the waiting rooms causes more patient dissatisfaction than any other aspect of medical care including fees.” Study by AMA

10. Time and Motion Study ____ Time patient arrive in the office ____Time patient taken to the exam room ____ Time spent with the provider ____ Time patient left the office ____ Total time in office / total time with MD

11. Effective Management of Delays • Anticipate delays • Apologize • See patient at end of day-coffee coupons and beeper

12. Effective Management of Delays • Call patient at home • Apology letter • (Don’t charge the patient)

13. Second Take Home Message... • FEW of us can change health care policy • ALL of us can be more sensitive to the patient’s time

14. Who Are the Key Patients? • Patients receiving out-patient studies or procedures • Other • Recently discharged patients

15. Advantages of Calling Your Key Patients • Fewer calls from your patients • Efficient use of your time • Very appreciated

16. Response From a Key Patient “This is the first time a member of your profession has taken the time to call me at home and check on my condition. Undoubtedly it will foster a better relationship between you and me.”

17. Attracting New Patients Public Speaking • Seminars • Lectures • AARP • Junior League • Church groups • Service organizations

18. Writing to attract new patients • Local magazine • Newspaper • Health publications

19. Using the Internet • 33 million patients are willing to switch to a physician who has practice Web site and offers E-mail access to the practice* *Cyber Dialog, 2004

20. Internet • Must be more than an electronic version of your brochure • Looking for outstanding clinical content • Credentialed by a legitimate medical sources • Academic sites • National organizations and societies

21. Provide value-added services • Secure messaging • Appointment scheduling • Insurance verification • Prescription refills • Access to patient’s medical record • Procedure-specific information

22. Notify Current Patients of Your Web Presence • Stationary • Brochures • Calling cards

23. What will the Internet do for your practice? • Increase revenue • Decrease expenses • Improve office efficiency • Improve the quality of care • Can communicate with most patients in your practice

24. Final Advice On Attracting New Patients • Make certain that they have easy access to your practice • Do not allow a new patient to wait 4-6 weeks for an appointment

25. The 3rd Pillar of aSuccessful Practice Enhance your relationship with referring physicians

26. Some Eye-Opening Opportunities • Each urologist has approximately 10 loyal referring PCPs • Average PCP sees 30 patients\day • Approximately 15 are women, and 10 have risk factors for UI • Bottom Line: 100 women could be screened each day!

27. How to Screen 100 Women\Day? • Need to educate PCPs to ask questions about UI • Need to educate PCPs to treat mild to moderate UI and when to make appropriate referrals to a urologist

28. Potential income from 100 screened women\day • IOVs • FU visits • UA, urine C & S • Urodynamic studies • Cystoscopies, BUS, Flow Rates • Surgery (Needle Suspensions, Slings) • Other urologic conditions (UTI, Stones, Cancer, IC) • Opportunity to treat family and friends (vasectomies, BPH, CaP, ED)

29. Marketing To Referring Physicians and Their Staffs

30. Educating Referring Physicians Lunch and Learn Programs Meet with PCPs and their office staffs to discuss evaluation and treatment of UI “UI-When to Treat and When to Refer” 10-12 minute informal presentation Follow-up letter

31. Suggestions for “Lunch and Learn” • No slides or computer • Informal • Leave a handout with your name and contact information • Ask pharmaceutical companies to sponsor the lunch

32. Enhancing Communication With Referring Physicians

33. Why Do Physicians Refer? • Returns patients 38% • Reports back promptly 33% • Availability 13% • Friendliness 11% • Scientific talks 7% • Give RPs an active role 5% • Teaching in hospitals and schools 7% • Entertaining 1% • Publish professional articles 1% • Gifts 1%

34. Traditional Referral Letter • Long • Arrives in 10-14 days • Expensive

35. Key Ingredients of a Referral Letter • Diagnosis • Medications • Treatment plan

36. Computerized “Boiler Plate” Referral Letter Example Dear <Name of Doctor> <Name of Patient> was seen for a problem of <diagnosis>. I recommended <medications and treatment plan>. I anticipate <number of additional visits> additional visits and appreciate your authorizing the continued care in my office. I will keep in touch with you regarding his progress. Sincerely, Neil Baum

37. Advantages of boiler plate letter: • Reduces the cost ($15-$1) • Increases the efficiency of your practice • Keeps the referring doctor as the captain of the patient’s health care ship

38. The 4th Pillar of aSuccessful Practice Motivating your staff

39. Highly motivated staffs follow a mission statement

40. What is a mission statement? A truth told in advance that tells where you and your practice are going

41. Our Mission Statement • Commitment to providing the best health care for our patients • Commitment to exceeding patients’ expectations regarding their health care • Commitment to the attention to the LITTLE details because they make a BIG difference

42. Where to display the mission statement • Reception area • Exam room • Employee lounge • Brochures • Newsletters • Stationary • Web site

43. “I could conquer the world if I had enough red ribbon.” Napoleon

44. ABCD Awards • Above and • Beyond the • Call of • Duty

45. Second Take Home Message • If you take outstanding care of the staff, they will take outstanding care of your patients!

46. Performance Review • Can’t be done once a year at salary review • Suggest every 3-4 months • Complete worksheet before the review • What do you like the most about this job? • What would you like to improve? • Where do you want to be professionally in the next 3,6, 12 months? • What can I do to help you reach your goals?

47. Surprise the Staff

48. Surprise is the spice of life • Office closes for lunch • Limo picks up staff • Box lunch provided on the way to the mall • Each staff member receives $100 which must be spent during one hour at the mall on gifts for themselves

49. Improve the Efficiency of the Practice • In the past, we enjoyed the luxury of low volumes of patients and high profit margins • Today, we can expect large volumes of patients with narrow profit margins • Therefore, we will need to see more patients in the same amount of time without sacrificing quality and patient satisfaction

50. Improve the Efficiency-Office Videos • Topics-medical discussions that are done one or more times a day or several times\wk • Annual exam • Evaluation of ED • Use of Viagra • Vasectomy • Treatment of localized prostate cancer • Evaluation of incontinence