Eyeworld

92 | EYEWORLD | SEPTEMBER 2021 P RACTICE MANAGEMENT by John Pinto and Corinne Wohl, MHSA, COE About the authors John Pinto President J. Pinto & Associates Inc. San Diego, California Corinne Wohl, MHSA, COE President C. Wohl & Associates Inc. San Diego California sync with the scale, financial challenges, and aspirations of your practice. 4. Do we have control over the volume of patient visits and the mix and volume of surgical cases in our practice? Rather than just taking what comes through the door, you should establish specific volume performance goals for the year, describing the number of new and total patients and mix of services you want to provide. You should then compare these figures monthly to actual performance, implementing whatever marketing actions are needed to meet your goals. 5. Are there costs we could reduce without adversely impacting the quality of care we provide? For example, you may be able to secure more cost-effective billing services by out- sourcing this critical function, something that would be neutral in terms of the quali- ty of medical care you provide. 6. Would cost containment efforts backfire and actually harm profitability? For example, by reducing marketing costs $50,000 a year, you might reduce revenue by $100,000. By dismissing two techs, pa- tient capacity may diminish and cash flow drop far more than the cost of two salaries. 7. Are there steps we could take to improve the quality of our patient care without adversely impacting profitability? Remember that "quality" is not just clinical outcomes, but also patient perceptions. For example, handing every patient an inexpen- sive printed fact sheet describing their chief complaint and your treatment approaches would save some of the cost of having staff spend extra time educating each patient and would potentially improve patient com- pliance for better care. Everyone wins. 8. When will we post charges, submit claims, and receive payment for the services we're providing to patients today? Questions to ask as a practice owner continued on page 94 J ust about every concept you need to know to run your practice you learned in medical school. Here's an example. As an ophthal- mologist, you memorized a routine history question set to help you understand your patient's eye health. You don't ask every patient every question at every visit, but by having a memorized routine, you don't miss much either. The clinical question set you use today is probably a lot shorter than the questions you used as a resident. You've learned what can be left out and what answers lead to an off-ramp to the end of the exam. The same concept can be applied to the management side of your practice, which you might consider to be a kind of "patient" needing your ongoing attention and understanding. Here's a starter kit of questions you can refine and apply daily, weekly, and in some cases, monthly or annually in your practice. Some questions are granular and some are big picture. Some questions should be posed direct- ly to management staff, some should be posed to rank-and-file staffers. Some of the answers you get back will be satisfactory at face value, and some should be cross-checked with outside experts. 1. Do we know what we want to do? Too often, surgeons show up for work with goals that are no more defined than "Let's make it through the day." Start understand- ing your personal goals deeply and have these drive a formal, strategic business plan with a time horizon of at least 3–5 years. 2. How cohesive is our practice team? Does your practice have sufficient orga- nizational "connective tissue" so that the lofty goals held by the doctor owners are being translated completely into workaday action? Do you have a written operations manual? 3. Do we know what dimensions of our practice are growing, shrinking, or staying the same? Practice financial data is often too late, too scant, too short term, or not sufficiently segmented by service area to back up your hunches. Bookkeeping controls must be in

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