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Take a Measured Approach in Practice Management Decisions


In clinical work, physicians are used to making quick decisions. When it comes to practice management, you must take your time and evaluate options.

As physicians, we are very adept at quick decision making. We are constantly engaging in this mental exercise with our patients. Should we order that lab test? What is the best medication for this patient? Even though it costs more, should an MRI be done because of the increased information it gives?

When it comes to practice management decisions, sometimes a more measured approach is best.  I've seen many articles recently concerning decision making and would like to share a few tips I thought were cogent.

The best business decisions are based on specific and relevant information. Just because one of your junior physicians saw a new and expensive device at a conference they attended doesn't mean that you should order it.  You need to ask questions first: Will this purchase increase either your efficiency or billable income? Can you find similar equipment that costs less? Must you purchase it or is renting an option? If you can bill for this service, what is a reasonable charge and what can you expect to recoup? Get all the facts that you can before making a decision on expensive additions to your practice. 

How much information is too much? Requiring more analyses and information can sometimes lead to confusing yourself and thus no decision is made. Asking yourself specific questions concerning the decision and reviewing the pros and cons can be helpful to clearing your thinking process. Writing it out on paper or large whiteboard can also be useful.

Another pitfall to avoid is lack of communication with key personnel. Discuss the decision to be made with other members of your team, stressing the importance and timeliness required. Encourage input from all parties that would be affected by this decision, but don't just passively wait for them to come to you. You must actively seek their opinions and ideas. Ineffective communication can be just as detrimental to poor decision making as having too much information.

Channel your inner three-year-old and ask "why?"  and "why not?".  And keep asking that question of yourself (and others) until you get to the real basis of the question at hand. Don't let your old assumptions get in the way either. Just because you have always had a certain opinion about something doesn't mean that you should keep those assumptions.  Technology and medicine are moving fast in all directions, making it practically impossible to keep up with all of it.  Keeping an open mind doesn't mean your brain will fall out!

When a decision must be made with a group of people, there are several important ways to keep the meetings efficient and organized. Number one, the reason for the decision must be clarified, with both positive and negative outcomes delineated. Second: it should be stated how the decision will be made and by whom. Third: allow for brainstorming and discussion of all the options available. Make sure all members of the decision team are well briefed and well prepared (if they are assigned to gather information) before they come to a meeting in which the decision will be made.

Finally, it is helpful to examine your decision making afterwards for both good and poor results.  This will help you learn for the inevitable challenges coming your way. There are many great books and articles to help your learn new tricks and apply new techniques as a practice leader and decision maker.

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