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Archives : Physical Therapy Links
Medical practice management 101: Scalability
In this new series on The Healthcare Entrepreneur Blog, we’ll be taking a look at a number of medical practice management concepts that medical practice managers, administrators, and clinic owners should consider as part of their planning and day-to-day management. The principles we’ll be outlining as part of the Medical Practice 101 series are applicable to all types of medical practices including general medicine, the surgical specialties, and rehabilitation services such as physical and occupational therapy.
Here, we’ll discuss the concept of scalability as relevant to medical practice management. Scalability is the ability for a medical practice to expand its current systems, infrastructure, operations, and staff alongside the growth of the practice over a number of months or years. Scalability is an area of medical practice management that is not always fully considered when planning for the implementation of electronic medical records and business systems used to run and administer the medical practice, and can end up costing a medical practice severely in terms of time and money in order to meet the changing demands of a practice over time.
When planning for the use of electronic medical records (EMR) and practice management software (PMS), one of the scalable solutions that we like around here is the the use of web-based software or software-as-a-service (SAAS). The use of web-based or SAAS solutions allows a practice to operate one medical facility just as easily as operating two or more sites because the infrastructure used to link each user with the medical practice database exists via the internet. The need for a robust hardware infrastructure, including servers and virtual private networks (VPN’s) is minimized, and with it – the upfront cost of implementation.
Web-based software is typically provided on a per-user license basis, meaning that as additional providers or staff join the practice, additional licenses (or ’seats’) are purchased which allow the medical practice to easily grow, or ’scale’ their investment alongside the growth of the medical practice. Web-based software is a very scalable solution when it comes to medical practice management, which is why our medical practice consultants often recommend web-based solutions to our clients when determining solutions that will allow them to continue with their medical practice management infrastructure over the long haul.
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Tannus Quatre is a private practice consultant and principal with Vantage Clinical Solutions, Inc., a nationwide healthcare consulting and management firm located in Bend, OR and Denver, CO. Tannus specializes in the areas of healthcare marketing, strategy, and finance, and can be reached through the Vantage Clinical Solutions website.
Customer service and referral opportunities are everywhere
As a service industry, stakeholders within private practice health care (physical therapy, medical practice, dental offices, or anything in between) notice a job well done. Whether it’s a pat on the back after a good physical therapy session, or giving your patient your cell phone number after a medical office visit, it’s sometimes the little things that go a long way toward establishing a lifetime relationship with patients.
I’ve written about it before…you simply MUST differentiate yourself as a private practice, especially in this economy. Patients and referral sources are becoming selective, and if you don’t offer something different, something better, something kinder, you’ll get left behind.
Take a moment to think about the opportunities that exist in your practice every day – the simple things like how you answer the phone, how your front office greets your patients, and what you tell your patients when they leave. These little things make up the whole of who you are, and what your practice means to your patients and your referral sources. It’s wise to put some thought into it.
Here’s a great article from PT Magazine that discusses some specific keys to cultivating new referral sources by paying attention to – and mastering – the simple things.
What that PT should do at the conclusion of any patient visit, Steffes says, is thoroughly recap the session, emphasize any progress made, reiterate home program instructions, and end by saying, “The next time you come, this is what we anticipate doing.” The result, she says, is that the patient’s or client’s “perceived value” of the visit will be enhanced–which, in turn, will foster positive impressions of the PT and of physical therapy on anyone to whom the patient or client subsequently describes the session. “Your patient isn’t, then, going to limit the description to, ‘She rubbed me,’ or ‘He made me do a bunch of exercise,’ Steffes says. “Instead, he or she is going to say, ‘When I first went in there, I could only turn my head this far. Then the physical therapist did this, and now I can do that. And this is what we’re doing next time.”
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Tannus Quatre PT, MBA is a private practice consultant and principal with Vantage Clinical Solutions, Inc., a nationwide healthcare consulting and management firm located in Bend, OR and Denver, CO. Tannus specializes in the areas of healthcare marketing, strategy, and finance, and can be reached through the Vantage Clinical Solutions website.
Branding has a place in private practice
Developing a strong brand has a definite place within private practice healthcare. A lot of practice owners don’t (or don’t want to) acknowledge this, thinking [erroneously] that simply hanging out their shingle and providing good care will keep the practice full.
Guess what? Everyone provides good care…at least we all say we do.
To develop a following requires a brand, and it doesn’t matter if you are a doctor, dentist, physical therapist, or an auto mechanic. Like it or not, your “brand” is what comes to mind when your patients are deciding whether or not to come see you for the first, second, and 100th time.
One thing about a brand is that one will find you whether or not you put in the time, money, and effort to craft it yourself. And depending on who you are and what you create, this can be a good or bad thing. You might be the doctor with bad breath, the dentist with the rude front office staff, or the physical therapist who is always late for appointments – believe it or not, these brands exist even though we would never choose them.
The process of branding can be likened to the development of our own personal attributes. Our looks, clothes, personality, achievements, networks, experiences, and anything else that adds to (or detracts from) our appeal to others is basically what constitutes our own “personal brand.” Now, branding as related to our personal development is only partially in our own control – we can’t control what we look like (well, thanks to the medical field I guess we can), our personalities are inherently difficult to change, and our achievements, networks, and experiences are in part built from the innate attributes that we are born with.
When branding our private practices we have much more freedom to carefully craft a brand position that will appeal to our market, helping to make our practices more successful through broader (or in some cases, very specific) appeal. It takes time, energy, and often entails a reasonable budget, but is there any doubt that development of the right brand is worth it?
This post from the Branding Strategy Insider talks about the seven concepts critical to positioning your brand in your market.
What seven concepts are critical to positioning?
1. Perception (their’s, not your’s)
2. Differentiation
3. Competition
4. Specialization
5. Simplicity
6. Leadership
7. Reality
Getting the word out for your startup healthcare practice
You’ve probably heard the adage, “there’s no such thing as bad press.” I actually disagree with this statement (contact me offline for some really good examples of bad press being bad press), and think the adage should say, “free press is the best press.”
Free press enters the consumer’s mind as information, education and value – contrasted with advertising which enters the consumer brain with an asterisk that states something like, “great ad, but I wonder what the real story is…”
A client of ours, Pelvic Wellness Center, opened in Eugene, OR last week…and talk about free press. The practice owners, Judy Hoar, PT, and Shannon Forrestall, PT have done an absolutely fantastic job of getting their name out there, and as you can see from this news clip from KVAL, even the newscaster is surprised at how quickly they are getting in front of a camera.
Kudos to Judy, Shannon, and Pelvic Wellness Center – readers take note…it’s just that easy (at least it can be).
The Pelvic Wellness Center is located at 295 W. Broadway, Eugene, OR 97401, and can be reached at (541) 515-6215.
Creative healthcare career: Fantasy sports injury specialist
It’s a good thing nobody told Stephania Bell, PT that you can’t make a living playing fantasy football. Bell has done just this, as ESPN’s fantasy injury analyst. That’s right, Bell provides her take on the injuries that plague professional sports’ most notable players, providing fantasy sports participants with much needed information with regard to strategies behind sports trades and team builds.
Stephania is a physical therapist who still practices clinically, but travels to ESPN headquarters to provide much needed analysis of all of the recent sports injuries through television broadcasts, blogs and podcasts. Talk about crafting a dream career – way to go Stephania…now that’s entrepreneurship!
Read this article from Portfolio.com for the full story.
To the data-obsessed fantasy-sports community—a population numbering nearly 20 million and driving a $1.5 billion-dollar industry—Bell is a hero, one of a handful of analysts covering sports injuries for the fantasy crowd that forms a sort of parallel universe of analysts, beat writers, and producers alongside that of traditional sports (and, yes, she does go to spring training and the Super Bowl).
Bell discovered the unlikely profession after she sustained an injury, underwent physical therapy, and developed an increased sensitivity to both the physical and psychological components of a sports injury. After attending graduate school in physical therapy, Bell opened up her own practice in the San Francisco Bay Area.
The fantasy aspect came through pure personal interest in fantasy sports—football and baseball in particular. After she let it be known to one league that she was a physical therapist, a fellow fantasy player begged her for a medical assessment of an athlete’s injury. Soon enough, she became the go-to gal for injury tips in her league. Through connections, she landed a gig writing a column for fantasy-sports site Rotowire.com, which led to gig on XM Satellite Radio and ultimately caught the attention of ESPN. The sports channel flew her out to its headquarters, in Bristol, Connecticut, for a screen test and made her a regular on-air expert.
The key to successful marketing: Practice identity
With the level of competition for patients and referrals constantly growing it is key for a successful practice to have a marketing strategy. In order to develop a strategy that fits the provider’s personality and desired practice demographics one must establish the “identity” of the practice.
An article in Advance My Practice describes five steps to building the practice you want.
Build your reputation with an identity that is your very own, unique to you. Don’t waste time and money on advertising and marketing without having an identity that is interesting and engaging, so that it will attract people to you.
I believe it all starts with establishing your identity.
Choosing the right practice management software for your practice
I wrote this article for the April 2008 issue Impact magazine, a professional journal that is read by owners of private practice physical therapy clinics throughout the U.S. The information is applicable to all types of healthcare practices with regard to choosing a practice management software package that is the right fit.
We all know that practice management software is here to stay. And while this is the case, there are still challenges associated with the use of management software in today’s physical therapy practices. It is not inexpensive to implement a comprehensive software or service, and practice owners can be left with a feeling of buyer’s remorse if expectations are not fully met.
Having a clear understanding of the benefits and exactly how they will affect your practice is of paramount importance when choosing practice management software or service that is right for you.
This article will focus on (1) the benefits of using practice management software, (2) a process that can help determine if a software or service is right for your practice, and (3) recommendations to consider in your personal pursuit of the right practice management solution for your facility.
Finding a physical therapy business consultant
From strategic planning to financial analysis to marketing plans, there’s a lot to know about how to position and operate a successful physical therapy (PT) practice. Because of the vast, yet specialized scope of services for which business consulting is used in private practice physical therapy clinics, we believe the due diligence process to be extremely important to identifying a consulting firm that will provide PT practices with the most appropriate consulting services available. We’ve found the following criteria useful in evaluating the expertise and resources available from business consultants in this area, and we recommend that they be used if you are considering such services:
1. Always request a non-disclosure agreement (NDA). NDA’s should outline the way in which information you share with the consultant may be used, as well as what is prohibited. Consultants are exposed to some of the most intimate details of financial structure, marketing strategy, and referral networks, and this information must always remain confidential. NDA’s aren’t difficult to produce, and if a consultant doesn’t have one, or doesn’t want to use one, this is a red flag.
2. “Try before you buy.” Consultants should have a plethora of knowledge in many areas of business and private practice, and it shouldn’t hurt to give some helpful information away for free. I personally like to make sure that clients not only get a feel for the core competency of our services, but that they get a feel for our personality and way of doing business as well. Good client-consultant relationships are very close and require a good working relationship, so if you aren’t 100% comfortable with your consultant or consulting firm, you probably aren’t going to have a great experience.
3. Check references. Always, always, always check references. As stated above, there is a lot to know in the world of private practice physical therapy consulting, and knowing what you’re getting upfront is difficult unless you really do your homework. Checking in with references provided by the consultant is a good way to do this. Also know that consultants will naturally guide you toward those clients that have had an especially good experience with the consulting firm, so it is also prudent to set some of the criteria yourself. Asking a consultant for references in a certain geographic location, or that have received a specific area of consulting service (e.g., marketing strategy, brand development, financial projections, business planning, startup, etc.) is a good way to lessen the selection bias of the consultant.
4. Know the deliverables. Understanding the expectations are key to finding value in the services provided by a PT business consultant. Even the best consultants that provide services that weren’t contracted for or that provided unclear value come away with disappointed clients. In the proposal or statement of work provided by the consulting firm, make sure you understand EXACTLY what will be provided, how the process will work, and all of the fees associated with the project. If you like all of the above and it is delivered by the consultant, chances are you’ll be a satisfied client.
5. Understand the fee structure. Consultants are generally paid based on the time required to provide their service. As the scope of consulting projects can vary drastically, so can the fees charged to a client. A good consultant will be able communicate how fees are determined very quickly and very clearly to a potential client. It is typical for there to be a range of hourly fees associated with varying level of expertise required (e.g., legal and financial consulting will commonly dictate higher fees than projects that are more general in nature, such as marketing strategy or competition analysis), and fees will naturally be higher the more “hands-off” the client wishes to be during the project. Projects that require more data mining, research, concept development, and copywriting by the consulting firm will be more expensive than those in which the consultant is acting in more of an advisory role.
The criteria outlined above applies not only to physical therapy practice consultants, but also to consultants specializing in dental practices, medical clinics, optometry practices, and many other allied healthcare disciplines. Unfortunately, some of the smaller healthcare markets such as physical therapy sometimes lack the geographical availability of specialty consulting, and practices often employ the services of general business consultants. While in some circumstances this can work out well, the specialty nature of the physical therapy profession often benefits most from the business expertise provided by specialty consulting firms, and always requires a high level of due diligence to find the right fit.
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Vantage Clinical Solutions is a private practice consulting, management, and financing firm that specializes in small to medium-sized physical therapy and medical practices nationwide.
Marketing is really no different in healthcare
There’s a lot to be learned from the cross pollination of marketing and business techniques between industries. Our company provides marketing services to medical, dental, physical therapy, and other types of healthcare practices, and we’re always a bit quizzical when competing medical marketing companies approach the topic in a way much different than is found in retail or entertainment. No matter what the industry, you’ve got a customer (we call them patients), you’ve got a product (we call it healthcare), and you’ve got a price (we’d like to call it cash, but usually agree to “reimbursement.”).
By overcomplicating the marketing of healthcare practices I think we’re doing more damage than good. Remember that the principles of marketing are not too terribly complex, and are almost completely transferrable between industries. What made you choose to buy Coke over Pepsi just might have more to do with getting patients in your door than you think. You need to see a product or service (impressions), you need to recognize the value a product or service (the value proposition), and you need to have access to a product or service (distribution). In a nutshell, that’s it.
This article from Medical Economics does a good job at speaking to many of the most common marketing techniques used in the marketing of medical practices, and you might be surprised to know that the same techniques also work for selling cars.
For many practices, marketing is a survival tool. But with so many ways to approach it—public speaking, print media, radio ads, the Web—it’s a tool that doctors often use haphazardly, or not at all. “One of the biggest mistakes physicians make is that they don’t develop a marketing plan,” says Keith Borglum, of Professional Management and Marketing in Santa Rosa, CA. “In medical terms, it’s like doing treatment without a diagnosis.”
In marketing, as in medicine, you’re much more likely to achieve your goals if you take the time to determine what they are. Begin by setting quantifiable parameters. How many additional patients do you want to attract? Can your practice’s staff and internal systems handle that number of new patients? How much time and money can you invest in marketing? Are you seeking a particular type of patient? If you’re hoping to attract 20-and 30-somethings, say, you’ll probably need to develop a website and fashion an ad campaign aimed at luring that cohort to the site.
Flat panel TV’s: The biggest competitors to cash only medical practices
Business schools teach of the importance of knowing one’s competition: the strengths, weaknesses, marketing techniques, customer sources, and on and on. Knowing one’s competition when running a medical practice uses much the same theory, and knowing about the practice across the street is just as important as knowing your own practice if you’re going to effectively spread the word about why your practice is different, if not better.
As healthcare reimbursement has evolved over the years, we’ve seen medical practice revenue models morph from primarily 3rd party payment to a mix between insurance payments and out-of-pocket cash from patients. Many practices have moved to a completely cash based model, and you’ve seen examples of this through the development of cash pay retail clinics as well as in the rise of cash only concierge medical practices.
With this shift in revenue stream comes a whole new complexity as pertains to the “sale” of healthcare services to the public. If a practice is now going to ask a patient to pay out-of-pocket for a greater share of their healthcare expenses (and in many cases, 100% of the payment), the service-based competition between that practice and the practice across the street becomes less relevant. The bigger issue becomes how to compete for the dollars that patient might like to spend in the retail, automotive, or entertainment industries.
One part of the marketing equation has to do with differentiation; the how-to of making my practice look different from the one across the street. This part of the equation is fairly easy in the case of cash based practice models. By charging cash, service quality can increase dramatically through a smaller per-provider patient base, and often times the environment of care will be highly differentiated through more of a personalized, perhaps even spa-esque facility.
The tough part about cash pay medical practices is not competing against the neighboring practice though. The tough part is competing against the purchase of discretionary items such as new cars, vacations, and flat panel televisions. Unfortunately, (or fortunately, depending on which side of the coin you’re looking at), Americans view out of pocket expenditure for healthcare services to be discretionary. For the most part, I believe this to be true, as when given the option between paying 100% cash for healthcare versus using a traditional healthcare practice that bills to 3rd party insurance, we do have a choice to keep more money in our pocket by using the traditional medical practice that will both delay and reduce our out-of-pocket responsibility. Convincing the public to pay for healthcare, which can often be covered by insurance (or worse, not provided at all), when there is no alternative payment system that will put a flat panel TV in the home, is a challenging proposition. To do this requires significant differentiation of the entire healthcare experience, such that patients are not merely buying an EKG or physical exam. They need to be buying convenience, experience, and perhaps even status, when paying for concierge medical services or physical therapy sessions from a cash pay PT clinic.
Many have tried to integrate cash pay models into their medical practices. While many have found a market and niche that works perfectly to support such models, others have come up against some of the issues discussed above. This article from Medical Economics tells the story of a physician practice that wasn’t so fortunate, and I feel there are many lessons to be learned about how, when, and where to choose a cash pay model, and how to limit your risk along the way.
Our policy of trying to save patients money—combined with our patients’ reluctance to file claims because of the hassle—had backfired. And so, while we had more than a thousand patients, with many new ones coming in every day, few came for follow-up visits. And with receipts stagnant, the prospect that the business would somehow grow in the future was unlikely. I held on a little longer, but, five years after opening my cash-only practice, I finally sold it—lock, stock, and barrel—to our local hospital system. I’m now an employed physician, seeing many of the same patients I saw as a private practitioner. When I ask, they tell me they preferred the level of care they were getting before.
Looking back, the reality of what happened still stings. Despite our best intentions, sound financing, and perseverance, we couldn’t make our model work. That’s the message I deliver to any physician who asks me about my experience. Not only must patients value your service, but you must realize your own worth as a physician and act accordingly.
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