Physicians Practice - February 2008 - (Page 70)

GREAT PRACTICE MAKEOVER patient for more than 30 minutes, he’s probably missing valid opportunities to code higher. Make sure you’re billing for every hard-earned penny. If you’re not sure — and most small practices aren’t — you would beneﬁt from having a coding specialist perform a chart audit. This is relatively inexpensive, and without making any changes to your work ﬂow, you administrative processes rather than strictly the lowest paying. Is it worth your time — and that of other patients who might be forced to wait for you — to jump through their complicated hoops? Not discounting the clinical value of physician-patient small talk and relationship-building, the physician’s goal for an exam must be to begin the interviewing and • Delegate the work. Enlist the services of a hospitalist if you want to concentrate your time on ofﬁce patients. • Make the schedule ﬁt. If you’re always 10 minutes late for your ﬁrst clinic session, either schedule your clinic session to start 10 minutes later or start hospital rounds 10 minutes earlier. (If you’re still frequently late for clinic after making this adjustment, you have a time-management issue and might consider consulting a personal organization coach.) KEY PLAYERS When you give staff explicit ownership of elements of the patient-management process, you’re not only offering them an increased stake in the business of directly helping people, which many appreciate, you’re also minimizing the amount of time the physician must spend on secondary jobs. STRATEGIC DEPLOYMENT could start capturing many thousands of dollars you’ve missed. Watch out for small drains on your time that add up, too. Starting and ending visits on time is obviously key to making good use of those hours you might set aside for catching up on administrative tasks. An unobtrusive solution for avoiding overlong appointments might be a clipboard with a digital clock. (Search for “clipboard clock” online or simply attach a dollar-store cheapie to your own clipboard or binder with heavy-duty double-stick tape.) Also relevant to the quest for recouping lost minutes is the prospect of dropping your worst payers. In this case, that might mean those with the most labyrinthine 70 | PHYSICIANS PRACTICE | FEBRUARY 2008 decision-making processes as soon as possible after entering an exam room. Similarly, he must also begin seeing patients with appointments as soon as possible after entering the clinic itself. In other words, all ancillary tasks should already be executed and resolved, leaving only the work of the exam to the physician. This means that a patient should already have his shoes and socks removed by the time the physician walks into the room. Granted, helping diabetes patients with this task is a lovely way of showing them you care on a personal level, but frankly, it’s not the best use of the physician’s time. As for macro-level scheduling, consider making these adjustments: To help keep him focused on the care-related activities that only he can perform, another endocrinologist I know gives his staff explicit ownership of elements of the patient-management process. He tells them, “You are the person responsible for ensuring that this task happens.” Within reason, of course, he says, “You ﬁgure out how to accomplish it, and make sure it’s always done — and always done right.” With this tactic, you’re not only offering staff an increased stake in the business of directly helping people, which many appreciate, you’re also minimizing the amount of time the physician must spend on secondary jobs. Angela Freeman, Plotzker’s ofﬁce manager, and Valerie Harrigan, assistant ofﬁce manager, could both be serving in a more traditional medical assistant role: helping Plotzker move more smoothly through that endless stream of appointments. Indeed, if someone else is willing and able to undertake a routine patient-prep task, let her. And make sure the right person is doing the right job: The person rooming the patient should be helping the patient get her shoes and socks off so the physician can perform an expeditious foot check. Plotzker says that “Val and Angie are worth their weight in gold,” and keeping them happy with their work WWW.PHYSICIANSPRACTICE.COM http://WWW.PHYSICIANSPRACTICE.COM

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Physicians Practice - February 2008 Contents The Bigger Picture: Your Future is in Your Hands Letters Physicians Practice Pearls: Creating an A+ Practice Noteworthy Cover Story: Conquering Time: 5 Keys to a More Efficient Practice In Balance: A Family Affair Technology: Making EMRs Work in the Exam Room In Practice: "I've Got Some Bad News" The Tech Doctor - The EMR: Savior or Poseur? Ask the Experts NEW! Healthonomics: How to Handle Health Savings Accounts The Administrator's Desk: Finishing School for New Managers Human Resources: Is Your Partner Impaired The Great Practice Makeover: Too Well-Liked for His Own Good? Coding Idealab: 'Why I Blog' Classifieds Advertiser Index

Physicians Practice - February 2008

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