Nick Weeks

As medical practice managers and recruiters, we hear the constant refrain of over-communicate versus under-communicate.  But how much communication is too much?

We find that many practice staff members, managers, and physicians struggle when attempting to communicate effectively via e-mail. As I’m sure my fellow over-communicators can also attest, there is nothing more frustrating than putting together a carefully crafted email with all necessary information, only to have the recipients come back with a litany of questions that are all answered in the e-mail itself.

While these aren’t completely foolproof, here are some effective e-mail tips that I have found to be helpful:

• Be thoughtful with your formatting.  

Bold, italics, and ALL CAPS can be useful, especially if you are crafting a long e-mail.  Use them to draw attention to key points. Ask yourself, “If they only read one section of this, which section do I want it to be?”  And then make that part stand out.

 This will get easier with time and, at first, is downright painful.  But you’ll be surprised how a few simple edits (taking out superfluous words, removing sentences/paragraphs that don’t actually add anything) can cut your document in half and make it twice as readable.

• Set expectations and deadlines - but make sure they’re always relevant.  

If every e-mail you send requests a response immediately, then the term “immediately” begins to lose meaning for your recipients.  Begin your e-mails by giving a realistic timeframe in regard to expected responses, and also let your readers know what you want from them, whether that’s a quick skim and basic feedback or detailed analysis.

What are some methods you find helpful when sending out e-mails to staff, managers, and/or physicians?

Articles

Many medical practice staff members, managers, and physicians struggle when attempting to communicate effectively via e-mail. Here are some suggestions.

Effective E-mails: 3 Tips for Physicians, Managers 

Like many ideas, our consulting company wasn’t founded in a garage, but on a napkin. It was the blueprint of a consultancy that would focus on small practices: house-call practices. At that time, we were all executives with a national house-call group and the thought of leaving to start our own company was both thrilling and daunting.

There was considerable risk involved as private practices, and house-call practices specifically, are a small and highly volatile sector of healthcare. But here we stand, one year later, proving that sometimes the risk is worth the reward.

They say that the first year of any new business is the toughest, and we can second that. But the challenges we faced are not unique to our company. In fact, we believe that many independent practices might benefit from hearing about some of the challenges we faced, and some of the lessons we learned along the way. For our one-year anniversary, we've decided to share three of our biggest lessons. We hope they can benefit your practice in some way:

While we originally set out to only serve the house-call market, we started getting inquiries from urgent-care centers, traditional family practice groups, and health. If we elected to work with them, were we losing our focus on the original mission? If we diversified, would we lose our identity as a unique consultancy? Ultimately, we made the decision to diversify and not only have we kept our unique identity, but our non-house call clients have created opportunities for our house-call clients.

Many practices stick to the traditional way of getting patient referrals such as brochures, events, word of mouth, and being part of a hospital. Those are fine methods but with the growing number of individuals who are getting insured that might not be enough to get ahead. One area to look at is sites that provide online appointment bookings through a third-party site. Many times when patients are looking to be seen by a physician they want an appointment that day or the next day. This is a great way to gain patients with little work of actual marketing. So, remember don't be stuck in your ways. Embrace technology.

 This can be a tough subject, especially for small practices. We understand the pride in building something from nothing, but not every idea works out the way we hope it will. It could be something as small as changing your patient management software or as large as terminating a long-term employee who is no longer productive. We’ve been there ourselves, recently re-designing our website based on feedback we received from clients and potential clients. It doesn’t mean you failed, it just means it could be done better. We’ve also learned a lot from our clients on what they need, what their concerns are, and what we can invest in to better help them.

3. All work and no play makes Jack a dull boy. 

This isn’t a reminder to watch "The Shining." This is a reminder to take the occasional moment and have some fun. Your staff will appreciate it, and your turnover rates will decrease. We do it ourselves. We’ve organized a movie club, trivia nights, and other activities that allow us to unwind and come in the next day refreshed.

They say that the first year of any new business is the toughest, and we can second that. Here are three lessons we learned that can benefit medical practices. 

Three Tips for Struggling Independent Medical Practices 

Still carrying around that BlackBerry you've had for the last five years? Still using Microsoft 2003 on that XP machine of yours? Still think the "cloud" is a fad? You might be doing yourself and your business a disservice if you answered "yes" to one or more of those questions.

Keeping up with the ever-changing world of technology is tough. Change can be hard. It's much easier to keep the status quo and ignore all the technological advances happening around you. The problem is, if you don't adapt and keep up with technology, you'll miss out on all the advancements and benefits it has to offer.

That trusty BlackBerry took too long to embrace touch-screen technology and missed out on creating a robust app store. The result is you can't check into your American Airlines flight on your phone, you can't use Hailo to get a cab, you can't access your Google Drive documents, and you can forget about looking up restaurant reviews on Yelp. Basically, even though switching to an Android or iOS device may be inconvenient in the short-run, the long-term benefits are well worth it. You'll have to learn how to use a new tool but that took has far more uses.

Technology in the workplace can mean the difference between a successful business and a failing business. Capable hardware and efficient software will keep your office running in tip-top condition and will allow your employees to focus on their jobs instead of troubleshooting their computers.

Look into Web-based programs that can be accessed remotely and that have export features that allow you to easily extract the data you need. Productivity suites like Google Documents are free and offer a comparable experience to the costly Microsoft Office standard (Google documents are compatible with MS Word). If you have to use Microsoft Office, don't skip on more than one major update. The difference between Word 2007 and Word 2010 is probably greater than you think.

The anxiety in introducing new technology to your office staff lies in the assumption that each employee has a different adoption threshold; some will "get it" and others will struggle. That's not as big of a hurdle as it's been in the past, as technology has become more uniform. Most people have a smartphone of some design, and many have households with smart TVs, multiple computers, and other universal technologies. Like all things, it may take a day or two for your staff to become comfortable with the new work flow, but your bottom line...and talent pool...will appreciate it.

In summary, don't be afraid to try new technology. If there's a hot new device or productivity program, there's probably a reason for it being so popular. Don't turn your practice into a technological ghost-town. Think about what your competition is doing.

In regards to technology, it’s good to be a leader and it’s also good to be a follower ... just make sure you’re one of them versus neither of them.

Don't be afraid to try new technology at your medical practice. If there's a hot new device or productivity program, there's probably a reason for it being so popular. 

Keeping Up With Technology: A Must for Medical Practices

As administrators, providers, insurers, and a number of other healthcare actors attempt to generate healthier profit margins while maintaining care standards, much of the conversation is focused on the need for reimbursement increases (and there’s a case to be made for that). But many practices are ignoring real savings opportunities by not adopting tools that can reduce employee time, equipment costs, and paper expense. In fact, many of these opportunities are low-cost or free, and can modernize your office in a way that helps both patient care and business needs.

The healthcare industry has historically been a slave to the paper trail. But that’s all starting to change with the implementation of EHR systems, and the adoption of tablets by medical providers.

While these are major changes with obvious paper-saving advantages, there are also more subtle ways to make your practice almost paperless. Here are four of our favorites:


Probably the most widely known method of reducing paper usage is switching to paperless statements and automatic bill-pay for recurring charges your practice incurs. This not only saves paper, but also considerable time because the bills never reach the accounting department and therefore never need to be reviewed, stuck in an envelope, stamped, and sent out in the mail. Many banks also offer incentives to sign up for automatic bill-pay … bonus!


The amount of faxed information coming into a healthcare practice can be daunting and the cost of leasing and maintaining a fax machine to churn out copies of all those documents can get quite expensive. Consider getting an e-fax account instead. Incoming faxes can be received as attachments (PDF files) to a designated e-mail address instead of automatically being printed. This saves time when the documents need to be archived and integrated into the practice EHR system, not to mention reduces the likelihood of a fax being lost or misfiled, and also saves money on paper and ink.


Now that you have those documents in PDF form, you may need to print them and add a signature, which would defeat the purpose of the e-fax, right? Well, luckily, there are several programs, such as Docusign, that allow the addition of an e-signature to documents, which means you never need to print them. E-signatures are legally binding and save both time and money, because they can be used to sign a digital document without ever printing it.


Google Drive is a great example of a collaborative document creation tool that allows users to simultaneously work on a document with no need to print anything. Oftentimes people are worried about versions of documents being altered and saved, so they’ll print a copy of a document for a colleague to review and mark-up. With Google Drive and Google Docs, colleagues can simultaneously edit the same document, with the ability to restore previous versions in case something goes wrong. Google Drive also allows for mass document storage, so there’s no need to keep hard copies of those documents locked away in a banker’s box somewhere.

These are just a few of the ways you can implement easy changes to make your office less dependent on paper and, as a byproduct, more efficient and more profitable.
 

EHRs are not the only way your practice can cut down on paper usage. Here are four other ways practices can save paper, time, and money.  

The More Efficient Medical Office: Less (Paper) is More 

Throughout my recruiting career, I’ve worked with practice managers who have asked me to put a “hold” on the physician recruiting process as soon as they feel they've attracted a great physician candidate to their practice. They feel that the search is over because this great provider has signed an offer letter and has agreed to start in two weeks. 

Then that unexpected call comes in and the physician says, “Thank you so much for your interest in me.  I was so excited about this job, but I just got another offer that’s too good to turn down.” 

This type of phone call can seriously harm a practice. The practice manager doesn't have any back-ups and is back at square one of the recruiting process. 

That's why it's critical for practices to keep back-up physicians interested in their practice while the practice waits to see if it's first-choice provider pans out. Here are a few smart strategies to use:

When you know you’re interviewing back-up physicians in case your first choice doesn’t stick around, separate their interviews by at least a few days, or even a week or two.  You can always cancel interviews that you set for after your new provider’s start date, once you’re comfortable that he is going to “stick.”  Additionally, you can have a multi-step interview process and space the meetings out by a week or so each.  This makes the process longer and buys you time, but also shows an impressive level of attention to detail and won’t make the candidate think you’re stalling (even when you are).

This is an excellent way to add a lengthy step to your hiring process with the added bonus of being the most thorough way to screen a potential new provider. While it requires a big commitment on the part of the candidate (as well as your staff), this is the best way to show a provider what she can expect with your organization, while allowing you to see how truly interested she is. Few people will commit to spending an entire day interviewing for a role about which they’re not serious.  This can also provide a much-needed delay in the hiring process when you’re trying to juggle back-up physicians. Typically, it’s difficult to schedule shadow days, as you’re balancing the candidate’s calendar against your own. Afterward, you can also stall as you take the time to collect feedback from everyone the provider shadowed. 

  Let the physicians know you’ll be sitting down with your team to thoroughly and carefully review all providers who interviewed and that you will be following up once all discussions are completed.  Give candidates an extended timeline and make sure to follow up when you say you will, even if that’s to inform the physicians you are off schedule because someone was out sick, you’re waiting for license verification results, etc. 

While these ideas can help buy you time while you wait to see if your first choice sticks around, these ideas also create a pipeline for your future needs.  If that new provider starts on time and works out so well you exceed your growth expectations, it’ll save you time, effort, and money to have a list of pre-screened physicians that you also liked, who might still be in the job market.

Don't stop your physician search too early. It's critical to keep back-up physicians interested while you wait to see if your first choice pans out. 

Three Ways to Keep Physician Candidates Interested

"What’s the turnover like at this practice?" That's a question that I hear over and over again as a physician recruiter. And the candidates don’t want to hear about the excuses or extenuating circumstances; they just want the turnover numbers and make their own impressions from there. 

When physician candidates hear of high turnover numbers, it immediately sends up a red flag. And if the physician network is a small one; the candidates will ask questions of their peers and colleagues who are familiar with the practice. If the candidates hear of negative experiences (regardless of whether or not they're relevant to the candidate specifically), they will walk away.

Join us Sept. 19 & 20 in Philadelphia at 

, our new conference for physicians and office administrators to help improve your medical practice and your bottom line.

Whenever a practice loses a provider, no matter the reason, I strongly recommend conducting an exit interview with the departing physician. Whenever possible, you should have this interview conducted by the individual most likely to elicit an honest response. All too often a provider will focus on leaving on "good terms" and won't be truthful about his reasons for resigning. If you have the option to have a member of human resources or a manager that didn't work so directly with the provider conduct the interview, you should strive for that pairing.

Then, make sure to use the information collected in the interview. Don't become defensive or offended by negative feedback; this provider is leaving and there's nothing you can do about it. But if you can have an unemotional response to the feedback and strain out any exaggerated information, you will be left with data that can help you prevent other providers from walking out the door.

To illustrate this, I'd like to share a story that is outside of the healthcare field, but nonetheless relevant. A friend of mine was an attorney at a large firm and left his position to take another.  He left because of inappropriate internal conduct and conversation, unfair decisions, and a horrible gossip problem that led to tumultuous "office politics."

His supervisor asked the important questions during the exit interview and covered everything as expected.  He asked, "What could have changed to make you stay?" My friend was honest and gave his candid feedback, knowing it would likely be difficult for his supervisor to hear. Instead of taking the feedback in the spirit in which it was given, or saving it to reflect on and discuss later, his supervisor immediately said, "I don’t see that or agree with you, so it must just be a bad culture fit for you." 

Because this supervisor, and others in the firm, refused to accept the problems with their culture, four more attorneys have followed in my friend's footsteps. And all five of them, and who knows how many others, have shared their stories with colleagues, clients, etc.

The firm continues to lose staff members and clients steadily, while finding increasing difficulty in securing quality candidates for even initial interviews.

With the physician recruitment market becoming more and more difficult every day, hiring managers can’t afford to just look the other way when a physician points out issues with the practice.  As practice leaders, you have to check your ego at the door and want to make changes. 

Most people say they can handle constructive criticism, but then are in denial about what constructive criticism is; instead of taking negative feedback to heart, they make excuses such as, "That doctor is just a Negative Nancy" or, "They're just making a fuss because they don't want to follow the rules."

As practice leaders, we need to stop thinking that way and look at it as a positive: Your providers are telling you what you can do to make your environment better, increase retention, and grow your business. Sure, you sometimes have to take things with a grain of salt, but you make a huge mistake when you throw all the feedback out the window and refuse to believe that it might actually be you with the problem, not them. 

Try to pull on the attitude you have toward your patients. When you get calls from patients complaining about your service, do you tell them, "It’s not us, it’s you"?  I would hardly think so. Instead, I imagine that you see how you can make things better.  So do the same within your practice!

Turnover is an important topic that medical practices discuss, but often changes to curb attrition don’t happen until it’s too late. 