ARE PROBLEMS STALLING YOUR PRACTICE’S GROWTH?
Solution-based thinking to the rescue
By Kathy Mills Chang

The new buzz word in recruiting circles, as evidenced by a review of managerial job listings on Monster.com, is “solution-based thinking.”

And managers aren’t the only ones who need this skill. Every employee who becomes a team member in a business or practice should possess this skill. Gone are the days when workers were expected to check their brains at the door and do only as they were told.

In healthcare, team members need to be able to think critically, solve problems, and make decisions — individually and as team members — and then communicate solutions to the doctor, office manager, fellow workers, and, when appropriate, patients. 

What’s the best way to hone your decision-making skills and come up with quality solutions to problems? Here is a simple five-step plan:

1. Identify and clarify the problem. Your first task is recognizing a problem exists.

Some problems are immediate and unmistakable, such as a patient who comes in angry because of an incorrect bill. Other problems may be continuing annoyances, such as the doctor regularly running 20 minutes to 30 minutes behind schedule. Both are serious problems that can affect your practice in a profound way. The first step in reaching a solution is to pinpoint the problem area.

2. Gather information. Learn more about the problem situation. Look for possible causes and solutions.

For example: In the case of the patient who complains about a bill, check the files, audit the account, and review the computer itemization.

Gathering information may involve more critical thinking and teamwork when you are dealing with a systemic problem, such as appointments running consistently 30 minutes late.

In the scheduling problem, to define the problem (when it occurs), keep a time stamp on every patient — clocking the time each patient arrives and departs.

3. Evaluate the evidence. Where did the information come from? Does it represent various points of view? What biases could be expected from each source? How accurate is the information gathered? Is it fact or opinion?

For example: When you audited the patient who complained about an incorrect bill’s file, you found that when you estimated her financial responsibility, you believed her deductible had been met.

In fact, the deductible had not been met and was applied to the bill. This caused her to owe more to your practice and less to another provider.

What about that scheduling concern? After you identify when the problem occurred, find out why: Was the doctor socializing with the patient(s)? Were patients running late for appointments? Or, were appointments, such as report-of-findings and new-patient visits, incorrectly booked?

4. Consider alternatives and implications. Either as a team or individually, come up with conclusions from the gathered evidence and propose solutions.

Weigh the advantages and disadvantages of each alternative: What are the costs, benefits, and consequences? What are the obstacles to implementing the solution, and how can they be handled? Most importantly, what solution best serves your goals, patients, and practice?

This is when creativity becomes especially important.

For example: In the billing situation, how can you keep better track of additional balances that come due for a patient, other than what they believed to be so? A solution: When you see services immediately applied to the deductible, apply that in your computer system as a line-item entry, and transfer the balance to the patient. Then send an explanatory note with the bill to the patient, with a copy of the explanation of benefits.

If the schedule problem continues to be clogged during busy times, consider setting aside certain hours for new-patients, report-of-findings, and other special appointments.

5. Choose and implement the best alternative. Select an alternative and put it into action. Then, follow through on your decision by monitoring the results of implementing your plan.

For example: Perhaps, in your definition of the scheduling problem, you discovered that when wellness patients came in once every month, they tended to stay in the room longer. Your solution: Set aside certain mornings for wellness visits only. This will allow you to spend more time on patient education without the pressure of a tight schedule.

Implement the solution and monitor its effectiveness over several months.

Not every team member has the authority to make decisions and change policy. However, when team members come to you with a problem and several possible solutions, your job (or your office manager’s job) gets easier.

Encourage each team member to take ownership over problems that occur in their job and take responsibility for solutions. When you make solution-based thinking a requirement of each job in the practice, watch your team meetings transform from gripe sessions to solution machines.

Not only will each team member be empowered to contribute, but the mastermind quality of your team will shine. Remember: The sum of all parts is greater than the whole.

Kathy Mills Chang is celebrating her 24th year in the chiropractic profession. She is the founder of her own chiropractic financial-consulting firm and serves as the national insurance advisor for Foot Levelers. She can be reached by e-mail at Kathy@kathymillschang.com or through her Web site at www.kathymillschang.com.