Physicians Practice - February 2008 - (Page 71)

is therefore a priority. But imagine the frustration inherent in a workday like this: “He has his own little systems,” Angie and Val tell me, and although these systems seem to work (mostly), “we just don’t know what they are.” After 14 and seven years with the practice, respectively, Angie and Val surely have much to contribute in terms of operational improvement. And although the practice certainly belongs to the physician, Plotzker particularly in a specialty such as endocrinology, which has been experiencing well-documented provider shortages that are expected to continue until 2020 and beyond. Unless you live in a highly desirable locale or can offer plum perks, the limited pool of new graduates will likely look ﬁrst to larger groups — those with a concrete possibility of partnership, or, in the case of endocrinology, academic or research positions. • Treat hiring a nonphysician provider in the same way you’d treat hiring an associate physician. This means ensuring that your care philosophies align, putting plans in place for productivity-based bonuses and ongoing education, and introducing the new provider to patients and referrers so they understand that this person is there to be a real part of the care team, and not just a second-best substitute for the doctor. Let patients know how often they can expect to see the physician and other providers in the practice, and under what circumstances. • Look for a nonphysician provider specialist just as you might seek a physician subspecialist who’s SPATIAL SKILLS NEEDED The front office is where Angie and Val spend most of their time, and so their ideas for streamlining the physical space should count for a lot. After all, physical clutter begets psychic clutter. might consider bringing them into the planning process in a more formalized way. Here’s a prime example: The ofﬁce is cluttered. An old, disused copier has been sitting in the “storage” area — really a highly visible part of the waiting room — for years. “We tried to put a DNR on things, but he won’t have it!” they say. The front ofﬁce is where Angie and Val spend most of their time, and so their ideas for streamlining the physical space should count for a lot. After all, physical clutter begets psychic clutter. HELPING HAND The obvious big ﬁx when you’ve got too much demand for your services, though, is to hire another physician. In reality, that’s not an option for the vast majority of small practices, WWW.PHYSICIANSPRACTICE.COM Of course, a certain percentage of physicians will always be attracted to the perception of increased patient contact in the small private practice setting, but overstretched practices can’t bank on ﬁnding those individuals. For years, the medical management literature has been encouraging physicians to bring nurse practitioners, physician assistants, and other nonphysician providers into their practices to better distribute the workload and give patients more face time with a provider. But when I bring this up, Plotzker objects: “I imagine I would have a very unhappy referrer if … they’d asked for my expertise and didn’t get it.” Based on his own past experiences with referrals, these fears are perhaps well-founded, but they can actually be addressed: keen on, say, thyroid disorders. Endocrine PAs (www.EndocrinePA.com), for instance, get high marks from top-ranking members of the American Diabetes Association and American Association of Clinical Endocrinologists, as well as from endocrinologists who have incorporated their services into a practice. Specialized nonphysician providers are still rare, although their ranks are swelling. Consider that training someone in your specialty may therefore be a good investment in the practice’s future. • Get contracts and so on in place just as you would with a prospective physician employee. Like so many of the physicians I meet, Plotzker clearly has a lot of things right, as does his staff. The trick is teasing out the trouble spots you can actually address — which unworthy “friends” you can drop without hurting your status as the most popular kid in school. • Laurie Hyland Robertson is a s enior editor with Physicians Practice. Request a makeover of your own, or just let her know what’s bugging you, at lchrobertson@physicianspractice.com. FEBRUARY 2008 | PHYSICIANS PRACTICE | 71 http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - February 2008

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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