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Creating the Most Lean, Efficient Medical Practice


Here’s the story of how one physician was successfully able to create a practice so lean and efficient that he runs and manages it completely by himself.

We read stories on the Internet and in magazines about how businesses are becoming leaner - decreasing expenses in order to free up cash flow and help generate a more positive revenue stream. We hear about companies decreasing staff to lower payroll, using software to automate work flow, and spending more of their time, energy, and dollars on their clients.

But very rarely do we hear of real, practical stories taking place inside the world of outpatient medicine. Certainly our number one priority as physicians is to provide the most comprehensive and meaningful care to our patients, but working in the outpatient setting, we must do so as efficiently as possible. Let’s face it, the costs of everything - payroll, rent, supplies, etc. - are only rising. And with reimbursements always in a state of limbo, creating a lean practice is something that is beneficial to all of us.

Over the next several blog posts, I am going to share with you my story of how I was successfully able to create a very lean and efficient practice - so lean and efficient that I run and manage it completely by myself. I do so to provide you a real-life and specific example of how you can apply the same principles to your own practice.

Let me provide you quick snapshot (before and after if you will):

But before I get into specifics, I think it would be good for you to know why I wanted to transition my practice this way. In the fall of 2010, I decided I no longer wanted to file health insurance. We had a run of health insurance delays and problems that mounted over the entire 2010 year. With the new healthcare law passing that year, I sensed that health insurance was very hard to read. Were reimbursements going to improve or decline? No one could tell (or still can for that matter). I was struck with the sense that I am betting my entire livelihood and the security of my financial future on an industry that is becoming more confusing and difficult to navigate.

I came to the fork in the road and decided that I could continue with the insurance model, which would require me hiring more staff to keep up with all of the insurance hassles. Or, I could stop taking insurance and try the model of a direct pay practice.

I chose the latter as that felt much better to me. I never liked feeling pressured to see a large volume of patients each day and going with the direct pay model, I could slow down and take my time with my patients.

Over the course of 2011, I discovered something interesting (and completely unexpected): I was no longer seeing the amount of patients in my physical office to justify all of the expenses of the physical office (rent, staff payroll, supplies, etc.) Instead of seeing my patients in the office all the time, I was spending a lot more of my time on the phone with them, e-mailing them, and using Skype to communicate with them.

This was an unexpected finding for me. And so this summer I knew I had to adjust and change my practice once again, but I knew that I did not want to go back to the health insurance model. I could have taken the road more traveled and gone to work for a corporate hospital structure or join a large group or leave outpatient medicine altogether.

But none of those options solved the core problem: How to provide outstanding, comprehensive medical care while at the same time keeping expenses to a minimum. I think we can all agree that overhead expenses are out of control, but instead of just accepting this as a fact, I was determined to change this paradigm.

They say that necessity is the mother of invention and this was certainly true for me. And while I won’t tell you the whole story just yet, I will tell you that I have developed a brand new practice model that is super efficient, lean, and allows me to provide the most comprehensive patient care I desire.

Now that you know the why, come back next week and learn exactly how I was able to transform my practice in this manner. I will provide you with specific examples and show you how, if you can start thinking outside the box, you can create the most lean, efficient, and value-oriented practice for yourself as well.

Find out more about Craig Koniver and our other Practice Notes bloggers.

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