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The Tech Doctor Is In


General advice for technology in your practice

If you're like most physicians, you've probably felt yourself victimized by the endless paper chase of private practice. How do you get billers to pay you, regulators to leave you alone, and your patients to stay happy when you have less and less time to do more and more?

The answer lies, in part, in the use of information technology, properly chosen and scaled to the size and needs of your practice.
I know you've already heard all the hype concerning information technology, and you may be as frustrated by IT as you are with any other aspect of your practice. Perhaps you've been the victim of a hospital tech department with misplaced priorities. Maybe you've even tried your hand at implementing an electronic medical record (EMR) only to be beset by cost overruns, lack of training and support, or, worst of all, a vendor who just disappears in a merger or acquisition.

That's what "The Tech Doctor" is all about. Starting here -- and continuing every month in your e-mail in-box if you request it -- I'll explain in plain English everything you need to know to make IT work for your practice.

Tell me about you

This is just a primer. Sign up for Physicians Practice's new FREE monthly e-mail newsletter, "The Tech Doctor," and I'll cover many other issues in more detail. Just go to, and click on the newsletter button in the bottom-right corner.

I also want to know what you'd like to hear about in this newsletter. What IT issues are you struggling with? What do you wish you understood better? What's driving you crazy? Tell me about it: Write to

Why you need IT

It wasn't really so long ago that doctors were paid a large enough fee for their services to fully cover overhead costs. That allowed them to buy the space and pay the labor to make the office run smoothly. Production was a function of labor and capital (equipment, office space, etc.).

As long as fees covered costs, with some left over for doctors to make a living, they could take the "easy" way out of practice management by hiring more people when the workload started to overwhelm them.

But in an era of DRGs, unfunded government mandates, and payer cutbacks, that strategy no longer works. You need leverage in your practice, and information technology provides that leverage.

Acquiring patients

To thrive and grow, the first thing your practice needs is a patient base, which in any other business would be called customers.
As important as patient acquisition is to every practice's success, it's probably one of the most overlooked processes. To some extent it's natural to shy away from this topic since by definition it touches on that black box called "marketing."

Think you don't need to do any marketing? Think again. As Peter Drucker, the famous management guru who has been analyzing and writing about business for more than 60 years, says, "Business is about marketing and innovation, everything else is just costs."

As a doctor you are already intimately aware of the "innovation" side of healthcare. When it comes to patient care, you have the scientific training, experience, and education to stay on the leading edge of clinical practice.

But like it or not, your practice is a business. And marketing -- well, that's another story. That's why information technology is such a vital tool in this area. Correctly applied, it gives you a tremendous advantage.

How do you acquire patients? If you're in primary care, traditionally you hang out your shingle, take an ad out in the Yellow Pages, and maybe issue a news release with your bio to the local paper. Then you wait.

It takes an agonizing six months to a year -- sometimes longer, depending on the competitiveness of your marketplace, your specialty, and other factors -- to build your patient base and receivables.

Lately, more and more doctors bootstrap their practices by joining an established group and buying in at reduced pay as they build their patient roster. However you do it, information technology can help you build your practice by easing tasks such as managing your contacts. Here are some examples of the many types of software tools that do just that:

  • spreadsheet software to build easily searchable contact lists
  • conventional "flat-file" databases like FileMaker Pro
  • relational databases such as dBase products, mySQL, and Microsoft Access
  • contact management systems like ACT!
  • customer Relationship Management systems like FrontRange Solution's Goldmine 6.0
  • enterprise Resource Management Systems
  • integrated patient information systems (part of an EMR)

And this is just contact management! Additional tools available for direct marketing include:

  • Weblog software.
  • Conventional Web site design and maintenance with FrontPage, DreamWeaver, and other "WYSIWYG" Web authoring software (WYSIWYG means "What You See Is What You Get," and is pronounced "wizz-ee-wig" in the language of technogeeks.)
  • Off-the-shelf e-mail products such as Microsoft Outlook, Outlook Express, and Eudora
  • Encrypted internal network e-mail such as Novell Groupwise
  • Encrypted external network e-mail such as Kryptiq
  • Embedded encryption software such as Cypherus
  • "Walking" electronic records such as USB flash memory keys.
  • Listserv software for broadcast e-mails available from most Internet service providers
  • Autoresponder services either as stand alone software, such as Mailloop, Web-based database intermediaries like Caspio, and full-service online systems, including Aweber

The proper combination of tools like these, tailored to your practice, will help you manage the patients you acquire by conventional methods. Using advanced techniques of Internet direct marketing, you can build a loyal base of your preferred payer mix.

Quick tips

Finally, here are three things you can -- and should -- start doing today to make the most of IT in your practice.

1.  Spend an hour a week thinking of new ways to improve your practice's business processes to improve patient care. In many cases, such process improvements can be made much easier by technology, but to get the right tools in place, you first must know what you're trying to do.

2.  You already focus on helping your patients. Help them more by asking yourself how you can make their total experience of your practice so good that they refer their friends and family to you. If you take the extra step to make a positive difference in their lives, your success will follow naturally.

3.  Get in the habit of skimming the information technology literature, or talk to someone who does this for you. That will give you an idea of what's out there.

Gerard Steve Rebagliati, MD, MBA, is "The Tech Doctor" for Physicians Practice. He is an assistant professor of emergency medicine and clinical risk investigator at Oregon Health & Science University in Portland, a business consultant with Rebel Group Ltd., in Lake Oswego, Ore., and the technology lead for medical care at Software Technology Group, a consultancy. The companies and products mentioned in this column were supplied by Dr. Rebagliati, and are not intended as endorsements. He can be reached at or

This article originally appeared in the April 2005 issue of Physicians Practice.



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