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Making Your Practice More Efficient Means Fewer Staff, More Tools


In order to become the lean practice you need to help move medicine in a better direction, you have to start thinking as if you are working by yourself.

Last week, I began telling you how I have created an incredibly lean medical practice that I manage 100 percent by myself. This week I want to give you some practical advice about how you can start creating your very own lean medical practice to start you thinking about how you can manage your practice on your own, by yourself.

The reality is this: Medicine is a business as much it is a noble cause. Yes, we are here to help our patients and yes, we strive to provide outstanding clinical care. But, if we are not able to operate our practices in a lean, efficient manner, the current model of health insurance-based medicine, will slowly, but surely cause great distress.

We are already seeing this. Survey after survey reveals an alarming trend - doctors in primary-care medicine are underpaid, dissatisfied, and leaving the profession faster than ever before. Reforming healthcare sounds great on paper, but the reality is we cannot reform a system that is completely broken. If we as primary-care physicians truly want to provide the very best care in the most efficient manner, we need to start over. We need a brand new way of practicing medicine.

Here are some simple steps you can take with the goal of helping you take those first small steps and give you the confidence you need to do so.

In order to become the lean practice you need to help move medicine in a better direction, you have to start thinking as if you are working by yourself. Yes, having staff can be very helpful, but in order to create a new breed of medicine, we as physicians need to think and act differently. Here are a few simple and practical ideas to get you started:

[Note: In these tips, I mention several companies. I am in no way, shape, or form affiliated with these companies. I have found them to be helpful, but this does not mean these mentions are an endorsement.]

1. Organize Your Inbox: By “inbox,” I mean everything coming at you: phone calls, faxes, e-mails, forms, you name it. Every day it seems we get slammed with more and more requests. In the current model of most practices, we use our staff to deflect and delay those messages, but ultimately our days are filled with constant interruptions. As such, we grow accustomed to the reactionary style of practice - answer each question as it comes at us or delay and procrastinate.

My solution: Use a program like Evernote to keep your life organized. Evernote allows you the ability to forward everything coming at you into one large, digital filing cabinet. You can use Evernote on all devices (desktops, smartphones, iPads, etc.) so that all of your information is with you all of the time.

I have set up several notebooks in Evernote for clinical practice: refills, faxes, phone calls, etc. Now I either “act” on the message or I send it to Evernote to be “batched” later. This way, I can stay focused on each task and free myself from the feelings of being overwhelmed.

I also set up a notebook for every bill I pay. I scan in all paper mail, bills, etc., and now I have a simple yet comprehensive trail of everything I spend money on. Evernote has allowed me to maintain a running tally of everything in my life and organizing my practice this way has completely freed me up to be more available and efficient at the same time.

2. Enjoy Your Patient Messaging: We have grown so accustomed to the idea that a “visit” is when the patient comes into the office. Most of us are still using paper charts to document each visit. Some of us have progressed to EHRs. But most of us still see each visit as a separate event. Another way of viewing visits is that they are chapters of a book of your patient’s health. As such, each visit does not stand alone but weaved together, tell the story of your patient. In this context, messages, labs, radiology reports, consultations, etc., are all part of that patient story. Relying on EHRs or paper charts that are provider-only can only tell part of that story.

It is far better, I feel, to include patients in their own story. I am using Avado, a patient relationship management platform that allows all of my communication with my patients to stay as part of their record. This is a hybrid type of EHR. We need to get past the point where we as doctors feel as if we own the medical record. Programs like Avado now allow us to interact with our patients that much more.

3. Streamline your day: Yes, answering the phone with a human voice provides comfort for the patient and allows them to get their questions to a live person. But having to field phone calls all day long is extremely inefficient and promotes the notion that you, the physician are available at your patients’ will.

Instead of answering my phone calls, I use a virtual office using Grasshopper. All of my phone calls are routed to different mailboxes that I assign. Each phone call I get is transcribed by a software program directly to my e-mail inbox. No, the transcription is not perfect, but the voice message is also attached to each e-mail so I can make sure I know who is calling me and for what reason.

I am no longer available to my patients at every aspect of the day. But, I do get back to them all when I make the time in my schedule. Using Grasshopper saves me tons of time to both see patients and respond to others on a daily basis.

Becoming lean is necessary to free yourself to offer the most efficient and comprehensive care that you seek. It also allows your business to thrive and not get stuck by the traditional health insurance forces that slow and temper many medical practices. My goal here was to show you some practical, real-life tools and scenarios that allow you, the doctor, to practice medicine in an efficient manner. The goal is obviously not to cut corners, but rather to be able to build a practice that is strong, flexible, and comprehensive for your patients and you.

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

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