The use of protocols is essential to a smoothly functioning practice.
Does your office run efficiently like a well-oiled machine? When your key people are absent, does everything continue to operate smoothly? Are you able to access practice statistics whenever you need them? Do things seem under control even when your practice is busy?
If you answered no to any of these questions, consider what using protocols can do for your practice.
In a protocol-based practice, the office is viewed as an interlocking series of functions. Each function has a specific protocol such that, once put into place, can be taught by one employee to another and learned by anyone in the office. Protocols look to put practice functions on autopilot, and thus reduce the possibility of errors.
Critical applications
Several main areas of your practice should operate according to a protocol. These include your front desk, billing and collections, human resources, and clinical procedures.
The front desk in a typical small- to medium-sized practice includes both the tasks performed by front-desk personnel such as checking patients in and out, as well as any managerial duties performed by an office manager in a larger practice. There should be a protocol in place for each function.
For example: Opening the office in the morning, scheduling patients, ordering supplies, and patient recalls should all be protocol-driven. So many functions are performed by a front-desk and office manager that an office run without definite protocols is bound to be disorganized and less productive than one that does.
Billing and collections is a vital function of your business. Getting new patients and retaining them is undeniably important, but if you don’t get paid or it takes an inordinate amount of time to collect moneys owed, your business will suffer and might even die. For this reason, you must have a strict step-by-step protocol for collections that includes a chronological log of all collection efforts, a system to analyze receivables, and regularly scheduled meetings with the practice owner to go over the collections and receivables.
Human resources includes a number of items, including general employee issues. You should have a manual that outlines a brief job description for each staff member. There should also be a protocol for evaluations and one for disciplining poor or unacceptable performance. Clinical issues aside, you can include professional providers. To illustrate, coming in late is unacceptable for people who work at the front desk as well as medical specialists who may work for you.
Clinical protocols are used to ensure your providers are delivering optimal care to your patients and that you are getting the reimbursements to which you are entitled.
Know the limits
Because the healing arts are a special kind of business, these protocols may be considered guidelines that you override on occasion. For example: You may have a protocol that calls for PT three times per week, but the patient in question might be in too much pain to comply with it.
In an integrated practice that employs MDs, note that in most if not all states there is a provision that neither a corporation nor a chiropractor may direct the practice of medicine. What this means in practice is that you may have a guideline that calls for injection treatment if conservative care fails, but the final word is always up to the medical doctor. This should be clearly spelled out.
In addition to providing order and efficiency, protocols can serve as an early warning system and a quick way to review productivity. It is much easier to spot a failure when it contradicts a regularly followed clinical protocol.
Using protocols will enable your practice to fly on autopilot, and if you ever want to sell your practice, you will have an efficient, tightly run business that will easily transfer to a new owner.
Marc H. Sencer, MD, is the president of MDs for DCs, which provides intensive one-on-one training, medical staffing, and ongoing practice management support to chiropractic integrated practices. He can be reached at 800-916-1462 or through mdsfordcs.com.
