With the advent of managed care (we call it managed cost), medical and specialty practice is now much more complex, particularly regarding the “business of practice.” When we first started out, a patient would come to a practitioner for services, we performed the services to the patient’s satisfaction and the patient paid for the services. If they were pleased, they would refer their family and friends, and they would return again as needed or for routine care. Over the years, our practices grew, and so did our incomes. But, that was then and this is now.
Now we get calls every week from sad patients who tell us their company or employer now has a different program, and they can only use panel doctors. Even if services are required that are not covered by the program, they have to first see the gatekeeper physician who often redirects them to someone else, and not to the person who has been taking care of them for years.
Now practitioners find themselves competing for patients, competing for locations and referrals, entering the arena of practice marketing both internal and external, and a host of new challenges that were not part of the college curriculum. Enter the practice management consultant.
Almost every doctor we know uses tax consultants when tax time rolls around. Unfortunately, they also regularly have use for a friendly lawyer. We also have insurance specialists and estate planners to help us legally shelter whatever the government allows. However, there is a huge difference in the potential between revenue enhancement and cost containment. The former looks at ways to grow the practice income. This is virtually unlimited on the upside potential. The latter, although essential because it helps to determine how much you legally get to keep, is still limited. It becomes very obvious that when it comes to the business of practice, every professional can use the help of an expert in one or more areas. So, how do you select a consultant?
In our opinion, the best way to approach this challenge is to get very clear on your desired outcome. Be as specific as possible. Do you want to generate more patient traffic? Do you need to improve patient flow within your facility? Do you have the best possible staff of trained assistants so you can concentrate your time on the functions only you can perform? Do you have clearly defined office procedures? Is there accountability and measurability? Are there frequent communication breakdowns between doctor and staff or staff member with each other? This list is by no means complete. It is intended to serve as a memory-jogger to help you focus on those areas where improvements could give you the highest immediate returns and long-range benefits on your investment.
Once you are clear on the desired outcome(s), selecting a consultant becomes easier. However, it has been our experience that the most successful practices use consultants on a regular basis, but the ones who are struggling, which could probably benefit the most, seldom do.
The fact is that hiring a good consultant does not cost, it pays. Good consultants will return to the office gross, net and peace of mind value that has several times the multiple of the initial and ongoing fees charged. For example, when we work with a new client, we have no reservations about offering a one-year money back guarantee. If the doctor can show us he or she implemented the plan for progress that was designed for their practice and their net does not increase by an agreed multiple or our fee, we will send a refund.
We do this to put the doctor’s mind at ease because we want them to focus on the implementation of the program. Once the plan is implemented, revenues always go up.
When you are ready to hire a consultant, use the following sequence:
- Make a wish-list of the positive changes you would like to see take place in your practice.
- List changes in order of priority.
- Determine how you will know when the goals have been reached. Be very specific. Example, instead of listing, “I want a bigger practice,” state, “I want to increase the number of patients I see by 20% in the next twelve months compared to the past twelve months.”
Then, visit or call the most successful colleagues in your city or state. Initially, it is better not to select someone in your immediate vicinity or “draw radius” for obvious reasons. You will then be pleasantly surprised at the doctors’ willingness to share success secrets. (When Dr. Jay first started to expand his own practice, he visited the top five offices in the United States. He traveled a great distance so they would not fear him as potential competition.)
Then ask these successful doctors if they have ever used a consultant in the areas of your primary interest (for example, practice marketing, patient recall, etc.), and if they would be willing to refer the consultant to you or permit you to contact the consultant directly.
A second method is to review your professional journals, both in the articles and in the classifieds. Call or write for information. If you read articles by a particular consultant and you like the messages and the writer’s style, get names and phone numbers. Call them, describe your situation and find out if they will visit your practice. Ask key questions. Determine if their fee is in your budget. How much time will they spend with you? What type of follow-up will you receive? Do you get a written report? Are you permitted to tape record your meeting with the consultant for later review?
It is OK to interview a consultant as you would an employee. Clearly defined objectives eliminate disappointments later. Not all consultants are experts in all areas that you may want improvement. Be realistic.
A third excellent method of locating consultants is when you attend conventions and continuing education courses. Review the program outline well in advance, call any speaker who has a program on a subject of interest to you, then ask if they do consulting and if they are willing to visit your practice for a fee.
You can attend their course and decide for yourself if you would feel comfortable working with this individual. This method has virtually no risk and the only cost is what they charge you to attend the lecture. Or perhaps you can both block some time while you are at the convention. Offer to pay them for one or two hours to go over a few specific topics and share how they have been so successful.
Remember, it does not cost to utilize the services of a good consultant, it pays! Do your homework. Select a consultant as you would select a surgeon. Your practice life could depend on it.
John W. Gay, II, LLD, RFC, CIS, President of the Denver-based consulting firm, John Gay and Associates, has assisted more than 2,600 medical professionals with the management of their practices for more than 16 years. He is a registered Financial Consultant and a Certified Investment Specialist who speaks to professional groups throughout the US and Canada, and has written articles for many professional journals, including Dental Economics. Please contact Dr. Gay at 303-692-8001.
Dr. Erwin Jay is a Certified Master Practitioner in Neuro-Linguistic Programming and is a consultant with John Gay and Associates.