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Turn Your Medical Practice into a Successful Small Business: 3 Steps


More than ever, and while you may not want to accept it, practicing medicine is running a business. And you have to make changes that reflect this thinking.

Recently, I was traveling to a conference and my experience got me thinking about technology and how things adapt and change over time. Ten years ago, I booked my ticket on the phone, I checked in at the counter and got my paper tickets, and when I boarded someone ripped my ticket in half. If I wanted to know if my plane was late, I called the airline.

For this trip, I booked online; I checked in with an app on my iPhone; I scanned a barcode on my phone at security and at boarding. There was no paper and I could do it all on my smartphone. I even received confirmation of my flights and changes to my itinerary as alerts on my phone. It was pretty seamless.

The fact is that over time, the airline industry - and others like banking and big retailers - has adapted to consumer demand for access, convenience, reminders, and easy-to-use discounts and coupons. They know they are competing for consumer business. But healthcare hasn’t adapted the same way. About 10 years ago, Paul Tang, chief medical officer at the Palo Alto Medical Foundation said in an Institutes of Medicine press release:
“When it comes to safety the healthcare industry needs to take a page from the airline industry. Pilots have instantaneous access to the data they need on weather conditions and mechanical functions to make informed decisions and about navigation, delays, and midcourse corrections. When accidents or near misses occur, the industry can analyze these events, and the resulting information can be used to prevent future errors. In healthcare, no such universal system exists.”

A decade later, it still doesn’t exist, and healthcare is not that much further along in terms of technology and meeting consumer demand when compared to other industries. About 30 percent of physicians still don’t have an EHR of any kind and the smaller the practice, the higher that number gets. For solo practitioners, it’s closer to 60 percent who don’t have an EHR, according to the "Physician Office Usage of Electronic Health Records Software" survey conducted by SK&A. Why are we - and I mean physicians - so adverse to change? And more importantly, what can we do about it? Because if we don’t change, we may become obsolete.

I believe that physicians are resistant to thinking about their practice as a business. I often hear other doctors say that they are providing valuable care to patients. It’s not a business; they are practicing medicine. Unfortunately, more than ever, practicing medicine is running a business. This may be hard to accept, but if your practice is to thrive, you have to start thinking this way. And you have to make changes that reflect this thinking. One of the main reasons why this is so important is that you are competing for the business of your patients and their expectations are higher than ever. In its 2011 Survey of Health Care Consumers in the United States, the Deloitte Center for Health Solutions found that two-thirds of patients would switch providers to get access to an electronic record. If you lost 65 percent of your patients, you would have to close your doors.

I recommend the following steps to begin changing your thinking and improving your business:

1. Embrace your inner small business person. Start thinking seriously about your bottom line. If you aren’t a numbers person, make sure you have someone else who is. It can be your practice or billing manager or an outside accountant. Analyze your business from soup to nuts and set realistic but meaningful goals to increase revenue.

2. Become a techie. If you are going to succeed in the changing healthcare marketplace you must become more tech savvy and accept all that technology can help you achieve. Dive in. I strongly suggest seeking out an all-in-one solution that can provide fully-integrated practice management, revenue cycle management, and EHR. A recent Black Book study showed that this is the future for successful practices.

3. Recognize that your patients are paying customers. Patients are paying more than ever for healthcare. According to the AMA, patients paid nearly 24 percent of healthcare costs just in copays, deductibles, and coinsurance in 2013. So it’s no wonder they want quality customer service, engagement in their own wellness and healthcare, and unparalleled access to their own health information. Using an EHR that includes a patient portal, patient education, and an easy-to-use mobile application can enable you to document a visit while looking the patient in the eye, give you tools to manage their care, and provide better access to you and their health data.

If you are still a doubter then I ask you to consider this. As big box stores move into your communities, are other small businesses surviving? Often the answer is no. The ones that do thrive are those that embrace change and find innovative ways to stay relevant in the lives of their customers. So too is this true as hospitals buy up smaller practices and consolidate care into larger practice models. We know that patients prefer to see an independent healthcare provider but if you can’t offer the value-added services they want then they may seek their care elsewhere.

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