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Outsourcing Problem Solving at Your Medical Practice


Medical practices are busy places with limited resources - it often makes sense to outsource functions not directly related to the practice of medicine.

Medical practices are busy places with limited resources, and it often makes sense to outsource functions not directly related to the practice of medicine. Payroll, IT, and billing are three of the most commonly outsourced functions. Problem solving is an often-overlooked opportunity for outsourcing that has the potential for very high returns on the investment.

Why outsource problem solving?

The primary reason is that the practice does not have in-house resources with the time to devote to analyzing the dysfunction and developing a solution. Everyone already has at least a full-time job. That is actually good news. Providers and staff are fully occupied doing what they are there to do. Outsourcing can provide extra resources on an as-needed basis. When the need disappears, so does the cost.

The secondary reason is that no one in the practice has deep experience with the issue. Similar to a patient who knows his stomach hurts but needs professional evaluation to determine the cause and recommend treatment, the practice can know that cash flow is insufficient (or that staff are under-performing, or patients are complaining about the office) but need help from someone with particular experience with those problems and their solutions. While the business of a medical practice is medicine, the practice is still a business that can benefit from the expertise of someone trained in business disciplines.

In operational matters, people in the office are often too close to the situation to see much more than the negative consequences of the status quo. They are seldom able to identify the root causes, especially in combination.

A related issue is that people in the office are too close to one another to address the issue objectively. The unhappy consequence may have led to blaming and the attribution of bad motives to individuals, or individuals may be unwilling to be critical of their friends. An outsider can address the facts, with neither pre-existing animosity nor loyalty. An added advantage, in the case of an outsider who must give voice to inconvenient truths, is that the outsider goes away at the end of the engagement.

What is required to successfully outsource problem solving?

The first requirement is a specific problem that management is committed to solving. General malaise and unspecific complaining are insufficient. Unless there is enough dissatisfaction with the status quo to impel a committed attempt to correct the situation, don't bother.

The second requirement is a definition of the desired outcome of an intervention. It is OK for the definition to be somewhat nebulous in early discussions with the outside resource, but it must be clearly developed before there is a commitment to the engagement. A good definition of the desired outcome includes a statement of the status quo, clear enumeration of the objective, and the means and measures by which success will be judged. Without a good definition, it is impossible to gauge the likelihood of success, to hold anyone accountable, or to eventually declare success or failure.

Mutual accountabilities between the practice and the outside resource are the third necessary element to success. Do not trust anyone who will commit to producing results without the active cooperation of the practice, and do not expect anyone to be successful without the practice's commitment to the endeavor. Be sure to assign accountabilities so that the outside resource is relieving the practice of as much involvement in the project as possible. It makes no sense to hire someone and then do most or all of the work yourself.

The fourth essential is to engage an outside resource that can and wants to do the work. I will talk more about that next week.

Outsourcing is a very good way to allow internal resources to concentrate on the highest and best use of their time, skills, and abilities. One of the most productive uses of outsourcing is to engage outside help with problem solving, but it must be done effectively. Otherwise you only get horror stories to tell your friends.

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