Value: A Critical Element for a Healthy Practice

June 30, 2011

Unfortunately with declining insurance reimbursements, increasing government bureaucracy, and patient demands, we are forced to see more and more patients every day. Combine this with pressure to stick to ever-changing guidelines and protocols, and we as physicians are now in the middle of some stressful pressures.

Have you ever taken a few moments to ask yourself: “What about medicine do I value?”

This is an important exercise; because your answer directly affects your encounters with your patients. And one of the aspects of medicine which gets little attention is how to increase the value of your physician/patient relationship. We hear great talk about insurance reform, government oversight, and optimal billing practices, but the crux of the problems with healthcare start with what happens in the exam room. This is where the art of medicine truly shines: one doctor/ one patient working together to help the patient reach better health.

Unfortunately with declining insurance reimbursements, increasing government bureaucracy, and patient demands, we are forced to see more and more patients every day. Combine this with pressure to stick to ever-changing guidelines and protocols, and we as physicians are now in the middle of some stressful pressures.

One of the key tools you can use to start to grab your stake back from this chaos is to start slowing down and concentrating on value.

Medicine is a unique sector of our economy - it is more personal, more sacred, and I would argue more valued than other sectors. It is also a sector of our economy where the cost has been confused within the services we provide (no other service or retail industry runs on the credit system that the medical system does with its reliance on insurance reimbursements at a later date for services provided). For most doctors, there is a dichotomy - either focus on patient care (and sacrifice revenue) or focus on revenue (and sacrifice on patient outcomes). But there is a way to achieve both: focus on value.

In terms of an economic concept, value is often confused with price. When purchasing services or retail items, we tend to neglect value and focus on price. The interesting aspect to this is that when a remarkable service or product is able to convey value to us, we tend to forget about price and focus on value. Those companies that place a high level of attention on value are able to achieve higher levels of reimbursement than those companies that focus on price. Stop for a moment and think about your personal experience with this. We all have had interactions with companies where they have provided extraordinary services or products and we become fans and want to interact more and more.

In medicine we can use these same principles to help guide us in the exam room. But we have to first ask and understand what we value. As providers we are all unique and bring our very own individual characteristics, personas, and flare into each patient encounter. As an example to illustrate this point, one of the things I value is options. And so I take pride in offering my patients tons of options in terms of how they can better achieve their health goals. As a result of placing this value of options in all of my patient encounters, I have developed a strong reputation in my community for “outside the box” thinking and now have patients come to see me for this exact reason. And so the value I bring into the exam room directly translates to the value the patient takes from the exam room.

But there are so many areas that one can value. Here is a short list of core “values”:• Feeling validated
• Feeling listened to
• Feeling respected
• Building an alliance
• Having an ally
• Intellectual thinking
• Kindness
• Precision


The amazing aspect to value is that when you focus on value, you not only help your patients feel better (patients will always feel better when these core values are being met), but you also increase your bottom line. By bringing value into the exam room, you will be able to develop stronger patient relationships and this will directly bring you more income. You will be able to attract new patients easier and your patients will be more inclined to fight with you to get what you are owed by the insurance companies. And if you engage in any additional revenue stream (selling nutritional supplements, on-site lab/ radiology services, others), your patients will want to spend their money on what you recommend. Put simply, they will want to spend their dollars where they experience true value.

You can start today: spend some time asking what you value and then start bringing that value into the exam room!

Craig Koniver, MD runs a busy integrative medical practice Primary Plus Organic Medicine, LLC in Charleston, SC as well as consults with physicians around the country about how to increase revenue, boost patient trust, and improve job satisfaction.

This is his first post for Practice Notes as a new weekly contributor.