Patient Compliance & Profitability

Patient Compliance and Profitability

Every day in our offices, patients present with a variety of ailments and conditions. As Podiatric professionals we are trained to quickly recognize, diagnose and treat these conditions in a way that sets us apart from other fields of medicine. I remember early on in my career, I overheard a patient ask Dr. Aronson, “Why did you ever get into feet?” The answer that he gave, I now understand to hold true every day. “Well, Dr. Aronson explained, I got into feet because normally when patients leave my office they feel better than when they came in. Even if they are still having discomfort, I have given them the tools to understand their condition and have instructed them as to what they can do to feel better.” It is this instant gratification that we are all seeking that makes Podiatry such a unique specialty.

For this reason it is important that Podiatrists make sure they in fact have all the “tools” they need to diagnose and treat every type of patient that walks through the door. This includes everything from digital X-Ray and diagnostic ultrasound to stocking commonly used DME items such as Nightsplints, walkers, braces, healing shoes, and more. Why would you refer a patient out to be fitted an item that is needed today, and keeps cash flow in house? In my travels, I have often found that doctors don’t realize the importance of meeting patients’ needs right there in their office until it is too late. Nothing is worse than coming face to face with a patient, returning for a follow up visit, after being dissatisfied with the treatment or product they have received from the facility that you referred them to. In this case, you are now forced to deal with a lapse in the patient’s recovery as it directly relates to their compliance as well as the fact that they now question your judgement and treatment plan.

Not only does this apply to Nightsplints, ankle stirrups and custom braces, the same holds true when dispensing cash products such as topical antifungals, medical strength moisturizers, pre- fabricated orthotics and more. Having everything right there in your office is all part of the instant gratification your patients are looking for. Convenience is what it’s all about and, when your patients are using the products of your choice, compliance rates increase, outcomes are better and referrals go through the roof! The idea is to take what you have already experienced (whether you realize it or not) and build on that. How often do you treat a new patient, who has been referred by a friend that is now pain free thanks to the orthotics you fit her with last month? The answer is, everyday!

This begins by knowing how to offer all of these products without becoming a warehouse wholesale club! Many Podiatrists never consider carrying more than a few products for their patients because “they just don’t have the space.” Recently, after much discussion, we decided to open our own “dispensing center.” In our case, we were fortunate enough to already have a good size room adjacent to our reception area, which we converted from under utilized office space. However, upon doing some research, we found many creative ways of displaying products which would have been just as effective in a much smaller area (still providing adequate display room and ease of dispensing). Slat walls, for example, are a great way to showcase products, keep them out of the way and allow for frequent additions and changes. They come in a variety of sizes and finishes and can transform any space (whether it be one wall of your reception area or an entire treatment room) into a “dispensing center.”

I would advise any Podiatrist who is truly committed to increasing patient satisfaction as well as cash flow to try this. After all, you are the foot and ankle specialist, and your patients have chosen you to advise them on how to improve their conditions and ailments. You are not a sales person, nor should you ever be. You simply offer the products and services that your patients need. And, it should be made very clear that no matter what they decide, “We always carry these medical grade products for your convenience.” This no pressure approach, along with the money back guarantee offered by most of your quality vendors, makes it easy for the patient to see that you are confident in the products you are offering (not “selling”).

The last part of the compliance to profitability puzzle is solved by having a highly trained staff. When a new employee is hired, make sure time is set aside for that person to shadow each member of your staff (including you, the physician). This gives your staff insight into your methods of treating as well as understanding which types of patients are being seen on a daily basis. This not only helps with proper scheduling, but allows for fewer billing errors and communication mishaps. In a similar manor, your podiatric assistants should be well trained to evaluate patients in a way that allows you to diagnose more efficiently and, in many cases, foresee which treatment protocols will need to be followed. It is also important that your back office assistants (those who are hands on with patients) have a good understanding of which products (self pay and reimbursable DME items) you will be suggesting, as they can briefly discuss these with patients prior to their treatment. This way, the “seed has already been planted” and now, you can reinforce the idea of using appropriate, medical grade products at home, in addition to their office visits. These factors will ensure that your office runs smoothly and gives your patients the confidence to know they have chosen the right facility for their Podiatric care.

The success of your practice will be ensured by increasing compliance and improving patient outcomes. You can easily accomplish this by offering all the tools your patients need to treat their conditions in the convenience of your office. Train your staff to understand all that it is involved in your treatment protocols and get them actively involved in administering them. Continue to educate your staff and keep yourself abreast of all the new and improved products and services that are offered in your scope of practice. By having more compliant patients, your bottom line will increase right along with the number of happy feet walking out your door. After all, happy feet walking out means more aching feet hobbling in!

by Cindy Pezza

Are You Ready For An Associate?

Are You Really Ready For An Associate In Your Practice?

So, your practice is growing in leaps and bounds and you are finding it more and more difficult to keep up without spending 15 hours a day in the office. In addition, the “umpteen” hours of overtime you are dishing out every pay period is beginning to make any additional revenue vanish before your tired eyes. And then you have the increasing expense of additional supplies (ordered to treat all of those new patients), and the mountains of compliance paperwork and disability forms that are piling high on your desk. If any of this sounds familiar, it may be time to consider the options for change and expansion in your practice.

One option includes taking a look at how you are utilizing your time and your staff’s time during patient hours. If you are truly a “hands on” doctor, and feel that you are the only qualified person in the office to perform nearly every task from filling out forms to drawing injections and casting for orthotics, it may be time to reconsider your approach. Taking the time to thoroughly train your team can make all the difference between a chaotic atmosphere and creating a steady, controlled flow of patients moving in and out of treatment rooms all day long. The physicians who choose to provide services that could easily be delegated to properly trained staff find that fitting even a few more patients during clinic hours to be nearly impossible. While others who delegate tasks (after proper training has taken place), find it easy to see a much higher volume of patients, with little more effort. Commonly, both front and back office staff members are eager to learn more only to be told by their doctors that “it’s easier if I do it myself.” Or, an assumption is made that patients would be upset by staff performing simple procedures that they have become accustomed to the doctor performing.

As a general rule (and we all know there are exceptions), patients don’t spend time analyzing who is participating in their care, or performing non-invasive procedures. They focus on more important matters such as if they are seen at the time of their appointment, if they are tended to in a timely and professional manner, and the quality of the care they receive. It’s the overall experience that keeps patients coming back, year after year, and referring their friends and family to do the same. With this concept in mind, I encourage you, as a physician and practice (business) owner, to take a closer look at the team you have employed to represent you and your practice and determine if they are able to help you increase production and efficiency. If the answer is “No,” I strongly urge you to consider if you have the right team in place. Many doctors in similar situations have found that by replacing less motivated staff members and spending the time and effort to promote further education and development of practice protocols, which are followed by all, the need for hiring an associate becomes less of an urgent matter.

If your team is functioning at full speed and it is indeed time to consider bringing on an associate doctor, there are a few points to seriously consider. Hiring as a whole, should never be rushed. You know what they say, “Hire slowly and fire quickly.” After all, the faces that patients encounter within your practice (and before they ever meet you) can make or break the entire experience. When it comes to hiring an associate doctor, this becomes even more of an issue, as conflicting personalities or dramatically contrasting treatment styles can, not only ruin the reputation you have spent years establishing, but leave you in a situation far worse than when you were spending 15 hours a days trying to keep up. In order to avoid this difficult situation, physicians/practice owners should allow between 6 and 12 months minimally to find the associate doctor that melds well with their current practice and can actively participate in building and improving it well into the future.

In summary, if you find yourself contemplating whether you are really ready to hire an associate, take some time and assess the situation fully, exploring the options and weighing the benefits, costs and time involved in both. If you aren’t sure which way to go, ask a colleague who has been in your shoes before, or seek out help from an outside source to guide your decision. In matters such as these, it often takes an uninvolved set of eyes to truly see what is happening. No matter which path you choose to explore—whether it be additional staff training and delegation of responsibilities, or hiring an additional provider to care for your growing patient base—take  your time and be confident in your decision. The future of your success and your practice depends on it.


by Cindy Pezza