Practice Management - A Year End Self Exam

Main Category: Primary Care / General Practice
Article Date: 24 Dec 2004 - 11:00 PDT

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For physicians practicing in a group setting, good business health is a strong predictor of the quality of the physician partners' lives and the quality of care they provide. Leading practice management experts suggest some areas to examine to help your practice enjoy a "healthy" new year.

When physicians get together to design a successful clinical service, they have to balance the quality with the business," according to Richard D. Hansen. "Maintaining that balance requires continuous clinical learning, basic business acumen, and the acknowledgment that both clinical and business support staff are essential to the long-term success of the practice. That's something that I deal with whenever I work with a medical group-they want to be great doctors, but they must also recognize that business discipline is essential. I found out in my career that there may be terrific doctors in a group somewhere but they're falling apart because they've got poor business discipline."

Over the last eleven years, and in 46 states, Hansen has worked with more than 200 medical group practices ranging in size from three to 500 physicians. It's been his experience that success is built upon a foundation of certain core principles (Table 1), all of which require the collaborative "give and take" that is typical of all functional business or social relationships.

Hansen points to three areas where key indicators of success, or lack thereof, should be established and regularly monitored:

- Billings-Are patients and third-party payers being billed on a regular basis? What is the billing cycle? Is the billing cycle current?

- Collections - Is the practice being paid on a regular basis? What percentage of receivables is 90 days old or more?

- Information access-Does the information system provide key indicators that physicians can look at quickly? Is there some kind of executive summary for doctors to look at?

Who's on Board?

Echoing Hansen's call for core principles and common purpose, Hobart ("Hobie") Collins describes how physicians trained to be independent clinical decision-makers might create an environment allowing them to function as participants in an organization where few decisions can be made unilaterally. "The perfect situation is one in which there is a clear sense of strategic direction, effective governance and decision-making, and an effective management team to run the day-to-day operations consistent with the overall management goals and objectives for the group. Physicians are the owners, everybody works for them, and they effectively function as members of a Board of Directors with responsibility for the whole business, not just the clinical side. The other approach is that the president of the group would have a close working relationship with the top administrative person. Also common is a model that incorporates a small group that can be called the Executive or Operations Committee���.. CONTINUES����.www.physweekly.com

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