Successful orthopedic practice administrators must have a clear understanding of how to keep practice costs low while also earning respect from the physicians in their practice. Patrick Hinton, executive director of the Jacksonville (Fla.) Orthopaedic Institute successfully leads a group of seven practice locations. Here He offers six techniques for practice administrators to maintain thriving facilities.
1. Know practice data during payor negotiations. When going into payor negotiations, know the practice's statistical data to prove that the practice is maximizing return on the payor's premium dollars. This data includes, but is not limited to, the number of x-rays and MRIs the physicians order, the number of rehabilitation days and the number of days patients spend at hospitals for inpatient procedures. Practice administrators should also be able to explain how the physicians work with hospital staff to make sure patients are spending the least number of days in the hospital within the appropriate standards of care. "This forces the insurance companies to go back and look at their own data if they haven't done that already and that puts the administrator in a strong position," says Mr. Hinton.
The administrator should also know how his or her statistics match up against other area practices. If the practice costs are higher than they are at others, know how to explain these circumstances to the payor. "Say we have higher costs compared to other orthopedic providers, but we have a higher concentration of subspecialists, so we see a lot of orthopedic complications other physicians wouldn't see, which drives the cost up," says Mr. Hinton. "This helps make the case that the companies are getting value for what they pay for."
2. Physician awareness of workers' compensation. Practice physicians should be aware of the workers' compensation programs in their state to best work with employers and case managers to return patients as quickly as possible to work. Physicians and employers can work together to create a return-to-work program for the employee, which keeps the workers' compensation premium cost down, says Mr. Hinton. Having low premiums in workers comp cases is an attractive statistic for payors.
3. Negotiate supply costs with vendors. Practice staff should keep track of inventories and supply costs so when contracts are expired, the administrators can negotiate competitive vendor prices. This means practice administrators should keep track of all the supplies, down to every pencil, so that they can see where the high costs are, says Mr. Hinton, and then know whether those costs can be negotiated down. "There are a lot of costs that are fixed and there isn't a lot you can do about that," he says. He also recommends keeping the number of facilities in check so the practice doesn't duplicate or replicate staff and equipment.
4. Emphasize patient communication. Patients have a much better experience at the practice when they understand their treatment and feel important to the physician. Strong communication skills are essential when promoting patient involvement in their care, says Mr. Hinton. "A lot of physicians won't take the time to talk with the patients in their practice," says Mr. Hinton. "If you forget the caring side of care, you're not adding value to the patient's visit at all. We really do emphasize with the physicians the importance of communication with the patients."
At JOI, physicians are encouraged to smile as the enter the patient's room; reach out and touch the patient, whether that means shaking hands or patting the patient on the shoulder; look the patient in the eye when speaking; sit down near the patient (which makes it feel like the physician is in the room longer than they actually are); and, before the physician leaves, he or she is instructed to face the patient and ask if there are any further questions. "Having good communication skills gives the patient the sense that the physician is stopping long enough to care for them," says Mr. Hinton.
5. Share data with physicians as news briefs. When including physicians in the decision-making process, administrators should share practice data, such as financial statistics or patient evaluations, with physicians using a "Presidential" brief form. "Physicians like and enjoy data but they don't want to be overwhelmed by it," says Mr. Hinton. "If you give physicians the facts in a brief and concise way and then give them a recommendation as to what course of action they should take, they will be supportive of your decision making as an administrator."
Additionally, when the administrator provides a synthesized report about a potential change in the practice, it shows that the administrator is able to competently research the topic and is coming to them with a realistic and valid request.
6. Admit to mistakes. An important aspect of maintaining respect from physicians is earning their trust, which means admitting to failures. If, after extensive consideration, the administrator's decision produces negative results, the administrator must identify these failures and collaborate with the physicians to work through them. "If the administrator makes a mistake, he or she should go to the physicians and tell them and then figure out what needs to be done," says Mr. Hinton. This will earn the physician's trust, he says.
Learn more about Jacksonville Orthopaedic Institute.
Read other coverage on orthopedic practice management:
- Challenges in Spine Practice Management: Q&A With Laser Spine Institute Executive Director Lester Morales
- Manipulation Under Anesthesia: A Possible Revenue Source for Orthopedic ASCs
- 10 Articles to Improve Orthopedic and Spine Practice Coding
1. Know practice data during payor negotiations. When going into payor negotiations, know the practice's statistical data to prove that the practice is maximizing return on the payor's premium dollars. This data includes, but is not limited to, the number of x-rays and MRIs the physicians order, the number of rehabilitation days and the number of days patients spend at hospitals for inpatient procedures. Practice administrators should also be able to explain how the physicians work with hospital staff to make sure patients are spending the least number of days in the hospital within the appropriate standards of care. "This forces the insurance companies to go back and look at their own data if they haven't done that already and that puts the administrator in a strong position," says Mr. Hinton.
The administrator should also know how his or her statistics match up against other area practices. If the practice costs are higher than they are at others, know how to explain these circumstances to the payor. "Say we have higher costs compared to other orthopedic providers, but we have a higher concentration of subspecialists, so we see a lot of orthopedic complications other physicians wouldn't see, which drives the cost up," says Mr. Hinton. "This helps make the case that the companies are getting value for what they pay for."
2. Physician awareness of workers' compensation. Practice physicians should be aware of the workers' compensation programs in their state to best work with employers and case managers to return patients as quickly as possible to work. Physicians and employers can work together to create a return-to-work program for the employee, which keeps the workers' compensation premium cost down, says Mr. Hinton. Having low premiums in workers comp cases is an attractive statistic for payors.
3. Negotiate supply costs with vendors. Practice staff should keep track of inventories and supply costs so when contracts are expired, the administrators can negotiate competitive vendor prices. This means practice administrators should keep track of all the supplies, down to every pencil, so that they can see where the high costs are, says Mr. Hinton, and then know whether those costs can be negotiated down. "There are a lot of costs that are fixed and there isn't a lot you can do about that," he says. He also recommends keeping the number of facilities in check so the practice doesn't duplicate or replicate staff and equipment.
4. Emphasize patient communication. Patients have a much better experience at the practice when they understand their treatment and feel important to the physician. Strong communication skills are essential when promoting patient involvement in their care, says Mr. Hinton. "A lot of physicians won't take the time to talk with the patients in their practice," says Mr. Hinton. "If you forget the caring side of care, you're not adding value to the patient's visit at all. We really do emphasize with the physicians the importance of communication with the patients."
At JOI, physicians are encouraged to smile as the enter the patient's room; reach out and touch the patient, whether that means shaking hands or patting the patient on the shoulder; look the patient in the eye when speaking; sit down near the patient (which makes it feel like the physician is in the room longer than they actually are); and, before the physician leaves, he or she is instructed to face the patient and ask if there are any further questions. "Having good communication skills gives the patient the sense that the physician is stopping long enough to care for them," says Mr. Hinton.
5. Share data with physicians as news briefs. When including physicians in the decision-making process, administrators should share practice data, such as financial statistics or patient evaluations, with physicians using a "Presidential" brief form. "Physicians like and enjoy data but they don't want to be overwhelmed by it," says Mr. Hinton. "If you give physicians the facts in a brief and concise way and then give them a recommendation as to what course of action they should take, they will be supportive of your decision making as an administrator."
Additionally, when the administrator provides a synthesized report about a potential change in the practice, it shows that the administrator is able to competently research the topic and is coming to them with a realistic and valid request.
6. Admit to mistakes. An important aspect of maintaining respect from physicians is earning their trust, which means admitting to failures. If, after extensive consideration, the administrator's decision produces negative results, the administrator must identify these failures and collaborate with the physicians to work through them. "If the administrator makes a mistake, he or she should go to the physicians and tell them and then figure out what needs to be done," says Mr. Hinton. This will earn the physician's trust, he says.
Learn more about Jacksonville Orthopaedic Institute.
Read other coverage on orthopedic practice management:
- Challenges in Spine Practice Management: Q&A With Laser Spine Institute Executive Director Lester Morales
- Manipulation Under Anesthesia: A Possible Revenue Source for Orthopedic ASCs
- 10 Articles to Improve Orthopedic and Spine Practice Coding