I had a friend ask me the other day, when I was going to tackle managing physicians. And she held up her fists and told me to “Go Get ‘Em”. I am afraid she is going to be disappointed
Though I have “managed” physicians that act like petulant children and even had the occasional Dictaphone thrown in the vicinity of my head, I think a discussion of managing physicians is better addressed by talking about how your team as a whole sets up physicians for success.
Let’s get some basic foundations established to understand the pieces of the puzzle and how they fit together:
- Healthcare is the business of Treating Patients.
- Physicians are Revenue Generators.
- Managers are Expenses.
Our job as managers is to clear the path so that our Revenue Generators can do just that. My job at its heart is simple:
Make seeing patients as efficient as possible for my provider
This means having the clinical staff (CMAs, LPNs, RNs) take real ownership of each patient and getting the providers everything they need before they enter the room – not taking vitals and letting the patient just wait in the room with no other assistance. This means:
In addition to taking vitals, the team can administer questionnaires, draw standing order labs, and look to see if any preventative care is needed at this visit (like a flu shot or mammogram order). They can also update medications.
I encourage practices to train their clinical staff in motivational interviewing to help focus the patient on the 2-3 items they want discussed in that visit. The staff should be partners in the patient’s care, so the handoff to the physician during the visit is seamless.
GOALS: Save time, save money, increase volume and maintain quality of care.
Schedule visits for the right amount of time, and actively manage the schedule
If you have a handful of patients who always need your longer appointment slot, then keep a list for your schedulers and make sure they are scheduled appropriately.
This also means making sure patients are confirmed for their appointments. I have found e-mail or text messages work best. Very few people take the time to call to cancel or confirm, but they can easily reply to an e-mail or text. Note: Most practices I work with have less than 10% of their patients that require a phone call, but keeping a tight schedule on schedule is worth the effort.
In our practice I have found that new patients and physicals take about 10 minutes to prepare for the provider. I book these patients in the first slots after breaks and I double book with a 10 minute phone or web visit. The staff don’t have to prep a phone or web visit and the provider just saw 2 patients in the same slot (this will help overcome the challenges below).
Ensure patient satisfaction so I maintain return customers.
At the end of the day, healthcare on the front lines is like any other business – and patients are like any other service industry client. Treat them with respect and you will keep their business and gain referrals.
Value your customers time! Patients waiting 30+ minutes to be seen (including time in your back office) is unacceptable. Period. Goal: patients don’t wait more than 5 minutes. If your physician needs 30 minutes for return visits, give them 30 minutes. They can bill to cover the time they are spending and you will have a much better quality review from patients and are more likely to get the word of mouth referrals that are priceless.
Get feedback and give it to EVERYONE (including your docs).
Remember, your doctors are scientists at heart, and they need data to support the feedback you give them. Patient data can be gathered a number of ways., by using a free survey site and e-mail just a few days every few months or in-person post card-sized surveys at checkout are usable raw data to help you offer constructive suggestions.
How do you fix the hard stuff? Real world training.
Example: If you have a bedside manner problem, let them know. Then find them training.
- Toastmasters is a great way help improve their communication skills
- Motivational Interviewing helps them find a new way to engage the patient
Remember – Nobody wakes up and says “I want to do a crummy job at work today”, including doctors, and this is a team sport. It takes ALL of us to make patient care pleasant for patients, doctors and clinical staff.