Who’s in Control of your Practice?

One of the most interesting things I see when I visit doctor’s offices is that providers are just sick of it.  Sick of the paperwork.  Sick of the back office work.  Sick of prior authorizations.  Sick of employees not pulling their weight.  “Sometimes, I just want to close my office, and go work for someone else”.  I have heard this statement, or a variation of this statement in many of Doctor’s offices I have walked in to.  Nobody sits with a new medical billing company when things are going great, so I’m used to walking into disasters.

The single biggest challenge of having your own practice, is that you are actually running a business now.  You have overhead.  You have to hire and fire employees.  You have to choose vendors.  Pay taxes.  Figure out why patients are cancelling their appointments.  Make sure everyone gets paid first, and then figure out what’s left over for you to take home.  This is not what you signed up for.

You branched out to call your own shots; to actually benefit from the hard work you are putting in.  So why are you more miserable working for yourself, than you were working for someone else (who may or may not have valued you)?

If only I had a good office manager; if only my front desk person didn’t quit; if only got paid on the patients that I saw.  When it comes down to it, not matter how idealistic you are about medicine, you still have a bottom line that needs to be met.  So why is it that the most important function after seeing patients is usually overlooked.  I am always surprised to see how little doctors know about their own billing.  One of the first questions I ask after learning about a providers practice is, “What is your collection rate?”

Most of the time, the response will be “It’s good”.  Or “I have a 30-60-90 report here”.  So, I simplify it.  How many claims last year were paid, divided by how many you submitted?  Rarely does a Doctor have this answer readily available.  They don’t even know where to find that information in their expensive PM software.

This is your income.  It is imperative you know where it is coming from, and where it is at all times.  The level of care you provide your patients matters; to an extent.  It will matter very little if you cannot keep your doors open to see your patients.  Or worse, if you are stuck in the middle of some conglomerate of medicine that are taking over the industry.  The entrepreneurial physician matters, and makes a difference.  But in order to continue mattering, you have to be profitable.  If providers were profitable, and were comfortable with their income, they would not be selling to these big hospital groups that are scooping up offices at an accelerated rate.  These big groups are run by business people.  They know how to be profitable.  The thing to understand is you can be profitable as well; while providing the kind of care you want to provide.

The entrepreneurial physician is an ideal to strive for.  Someone who provides great care, and someone who runs a great business.  Read any publications about being an entrepreneur and you will learn that building a great team is necessary; be it the right employees, or the right vendors.  And the entrepreneurial physician knows the value of data.  Data about their business, and other providers around them.  Having pertinent data grounds your decisions with facts.  And these decisions are the ones that will allow your practice to thrive.

IF