Practice Management Improvement Strategies

Practice Management Improvement Strategies

August 09, 2019
4 min read

Practice acquisition: How to be easy to do business with

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Zaren Zupko

by Karen Zupko

When was the last time you ran your referral report? If you are contemplating a merger or acquisition, your referral report is a valuable asset. If you’d prefer to stay independent, it may be one of the most valuable tools you have for practice growth and profitability.

While many orthopedic groups complain their referrals dried up after the health system acquired the primary care physicians, others show more resiliency.

How? One group set out to specifically enhance patient services. After reviewing their report, they were delighted to find more than 50% of new patients came from patient referrals.

Patients know these surgeons are easy to do business with (ETDBW). That’s why those patients refer their friends and family members. These surgeons have polished up their act. The phones are answered promptly and politely. There are always slots for new patients or patients calling with a fracture. They worked to make the appointment schedule patient and physician friendly. For instance, knowing that millennials like doing everything on their phones, they made it possible for some visits to be scheduled via Internet and mobile device — no phone call required and to improve access, physician assistants (PAs) are always available, even when physicians’ schedules are full.

Here’s something else this group did that was unusual: The entire staff sharpened their communication and service skills. Doctors included. They arranged for clinician-patient communication training that gave them evidence-based tools and techniques for effectively communicating with patients. So now, the physicians convey empathy. They listen to patients and families. They understand that to patients, this is just as important as surgical skill and they recognize after receiving training that their so-called bedside manner can incite or dissuade a lawsuit.

Surgeons themselves also now actively ask patients for ratings and reviews and they take the feedback seriously. In addition, they are focused on improving the practice website. They added nicely done videos. Past patients agreed to be interviewed about their experiences and most importantly, their outcomes. Surgeons began posting training tips from their athletic trainers and physical therapists on Instagram three times a week.

They improved the billing process too, making it more consumer friendly. For example, the practice now sends statements via email and patients can pay online. The practice is more accessible, more profitable and the doctors are rethinking their need to become hospital employees.

So if you want to be ETDBW, if you want to either boost your brand image for a higher acquisition value or to stay independent and be strategic about how you can become patient-centric. You’ll harness more risk agreements and bundled payment contracts than your competitors.


Assess your practice using the questions below and make improvements to up your service game:

1. How easy is it to reach you?

You'd think calling an orthopedic surgeon would be easy. Yet, we call your practices all the time and get a phone tree that is confusing. Imagine being an elderly patient or a patient who is in pain and not thinking clearly. Ask five people you know to call the practice and report the experience. Review your protocols for patient triage and callbacks and start investigating digital options to the phone, such as online appointment scheduling, secure texting and secure messaging.

2. How long does it take to get a new patient appointment?

If it's more than 5 to 7 days, something needs to change. Patients will go eventually elsewhere if they have to wait longer than that. Like this practice did, you need to create schedule templates that keep slots open for work-ins. You may need to look at adding non-physician providers. Perhaps you need to look at offering telehealth triage services provided by the PA.

3. Is your website up to date and mobile device responsive?

It's shocking how many bad practice websites still exist out there. In 2018, 58% of Americans accessed the Internet from their mobile device, not their desktop. So if your site isn't mobile device responsive, you're going to lose a lot of potential patients. Outdated websites also make your practice or organization appear outdated, which leads many patients (myself included) to wonder if the physician’s skills and techniques might be outdated too.

These days, you must have video on your website of each physician, about the special procedures you do and perhaps some patient stories. Patients expect this. Remember that the oldest millennials turn 40 years old next year — they are no longer the “younger generation.” They are raising kids, managing careers and running businesses. When they need orthopedic services, they will head to their mobile device to find one and read reviews. Make sure you have put your best digital foot forward to engage them.

4. Are you actively cultivating online reviews? Is someone monitoring these?

Speaking of reviews, does your practice have a strategy for cultivating and reviewing yours to make improvements? Do partners review a sampling of positive and negative reviews at monthly meetings? Your administrator should prepare a one-page overview of reviews and social media metrics.


5. Do you offer modern payment options?

Patients are shouldering a higher portion of the bill than ever. Are you making it easy for them to pay? Do you offer recurring, automated payments by credit card, patient financing options, online bill pay and pay by text? Modern practices offer all of these.

If you are still sending monthly paper statements, your practice is in the dark ages. Not only is this reactive process less effective for patient collections, it’s not looked upon favorably by private equity groups or smart investors.

6. How well is staff trained to capture referral data?

Most practices have a “referred by” line on the registration form, but we often find that staff doesn't use or enter the data. Typically, it’s because the computer system is not set up with categories that can track the detail. Ask the administrator to generate a list of referral categories so you can review these and add detail that adequately reflects where your patients come from. Conduct a training session with appointment schedulers and check-in staff so that they know how to capture and post this critical information accurately.


Karen Zupko is president of KarenZupko & Associates Inc. (KZA), which has been advising and educating physicians about the business of medicine for more than 30 years. KZA develops and delivers annual coding and reimbursement workshops for the American Academy of Orthopaedic Surgeons.


Disclosure: Zupko reports she is president of KarenZupko & Associates Inc.