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Six steps for fine-tuning a practice

By Rebecca Anwar, Ph.D.

It’s hard work running a medical practice, especially when physicians are confronted with external influences, constant change and increased competition. Running a successful practice in the managed care nineties means staying on top of the business side of medicine, relying on capable staff and being better than the competition.

Here are six simple steps you can implement that will help you keep your practice fine-tuned.

Set Realistic Performance Standards. Work with staff and management to determine what organizational goals you want to achieve and what performance standards you must set to accomplish these goals. For example, if you want to provide better service than the competition, how will you accomplish this?

You may want to set standards for telephone access, such as: all calls must be answered within two rings, no caller will be put on hold before they have a chance to be heard by the person receiving the call, and no caller will be on hold more than 60 seconds.

These performance standards can only be met if you know the number of calls you receive in the office, the peak hours for incoming calls and the number of calls you are currently losing because callers are on hold and all your lines are tied up. Once you are armed with these data, you can set realistic performance standards, based on adequate staffing. In addition, it will be important to have an effective monitoring system to ensure you meet your performance standards at least 90 percent of the time.

Performance standards can be set throughout your office, establishing defined targets for quantity (volume) and quality (reducing errors and ensuring compliance). But achieving successful results will rely on evaluating relevant data, planning appropriately, involving your staff in setting the standards and determining an appropriate tracking method to monitor effectiveness.

Shorter, But Relevant Meetings. It’s important that meetings be held to plan and accomplish things in the office. But it is equally important that your meetings have a defined purpose and you do not get side-tracked. Know what you want to accomplish before you begin. Set an agenda and a time frame and get it done!

When you are bringing a meeting to a close, it is important to evaluate how constructive the meeting was. Did you accomplish what was intended? Could it have been done in less time? Too many meetings drag on aimlessly and are very costly to the organization.

It is also important to be sure the key players are in on a meeting, otherwise you will spend time updating others and information may not translate accurately.

Bottom Up Communication. Listen to your employees—all of them! The front-line people can provide a world of information to you. They know what’s going on and often have a better pulse on the practical, operational side of your practice than you do. They can be the best source to identify a problem at it’s early stage. But they need management’s help in determining the best solution and getting it implemented promptly. Early detection and implementing solutions promptly can help you avoid major problems, reduce costs and improve service. By listening to your staff, you will make them feel important. They will be loyal, motivated and take ownership of your practice.

Multi-purpose Bulletin Boards. Use a bulletin board as a form of communication. Post events and changes in a timely manner and remove them from the board when they are no longer relevant. The bulletin board can be utilized to keep your staff informed of outside activities affecting the practice and to educate them about what is going on in the medical community. The bulletin board should be used to post internal memos as a back up communication for staff. It is a method to keep them informed about any changes in operations, procedures or policies that have occurred.

Another important function for your bulletin board is to use it as a Job Board. When someone in the office has resigned, post the notice of the opening and a copy of the job description. This can serve as invitation for qualified staff to apply for the position. You will be encouraging vertical growth and job enrichment for your staff. It also provides an opportunity for staff to get the word out and assist you in recruiting a highly qualified replacement that fits in with the rest of the team. This is one of the easiest ways to show your staff you value them and to keep employees working as a team.

Structured Salaries. It’s no secret that staff salaries account for the medical practice’s highest operating expense. At the same time, staff is your most valuable asset. The best way to ensure you are fair and competitive in your wages, while controlling personnel costs, is a salary schedule. This means setting parameters and pay ranges for each position in the office and sticking with it. A well-structured salary schedule should be developed based on the qualifications and skills necessary for each position, the amount of responsibility the position assumes and the years of experience. Each position should have a start and end range, the end range being the cap.

Begin building your salary schedule by establishing the base pay for entry level of each position. This should be determined based on the education and qualifications essential to the position, the minimum years of experience necessary to be effective, the amount of responsibility assumed and the supply and demand in your community. Selecting your start rate will require development of sound job descriptions and market research to determine a competitive and fair rate for the position.

You can gather statistical pay ranges through professional organizations, the Chamber of Commerce, local health care employment agencies and regional medical societies and hospitals. Another important resource is your own experience in hiring for positions. What were the previous wages of applicants applying for work with you? Once you set the start range, you can develop a reasonable spread for years of experience.

When you establish a sound salary schedule, you have a mechanism to avoid hiring new staff or offer pay increases to existing staff based on emotion or need. You will have a rational approach to dealing with these issues. At the same time you, the new salary schedule can be used to educate staff on the entire range for their position. They will have realistic expectations and know you are fair and consistent. If you need help addressing this important area of your practice, consider engaging the services of a practice management consultant to accomplish this arduous task.

Rating Management. The best way to know how management rates is to ask your staff. This can be accomplished by conducting an annual survey. The annual survey should be anonymous and easy to complete, consisting of no more than ten questions. The questions can range from: “Does management respect every employee?” to “Is management fair and consistent?” If your marks are less than favorable, show your staff you care by hiring a consultant specializing in personnel and office operations to refine the practice and improve management’s performance.

If you apply these six principles to your practice, you will strengthen your position and be able to respond to a changing marketplace. Your staff will take ownership of your practice and go the extra mile to serve you and your patients. Information will flow and you will reach a higher level of awareness. You will be ready for unexpected change and stay a step ahead of the competition.

Rebecca Anwar, Ph.D., is senior consultant in The Sage Group, Inc., a national firm specializing in integrated practice development, strategic planning and practice management, quality improvement, managed care and marketing for healthcare providers.


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