Never in all the millenniums that have proceeded our present time have there been so many tools available to accomplish the communication objective. Spoken, written, typed, printed, recorded, faxed, telephoned or e-mailed information is exchanged through media undreamed of not all that long ago. Communication is the one factor that has changed mankind the most in all history. Just as the progressive development of human speech to the printing press has expanded civilization, the computer has impacted the world as great as any human accomplishment. Not the office of the future, but the office of today has the accountability to the patient and the staff to maintain communication. Communication between doctor and staff, staff and telephone, staff and patient, staff and suppliers, staff-doctor-attorney-insurance provider-government and most importantly, doctor and patient has produced mega demands upon today’s Doctor of Chiropractic.
Conditioned from their birth in the profession to see vast sums of patients, Doctors of Chiropractic have collided with reality. To have a busy practice can mean too busy with paper work to see patients, too many patients to do paper work (causing slow practice suicide), or too busy with patients and paper work and searching hopelessly for a miracle solution.
Communication is the dominating factor today in determining business growth or no growth. Whether we like it or not, we must at least attempt to keep up with technology or practice life as we know will disintegrate. So what technology, equipment and practice strategy can assist the doctor in the quest to “just be able to treat the patient?” The office must have a telephone with more than one line and preferably with more than two lines. The fax and computer used for communication outside the office should be on one exclusive line or on two additional separate lines, depending upon usage demands. The telephone should have a service that takes messages instead of giving a busy signal to the new patient who is calling your office.
As an extremely busy Doctor of Chiropractic, I have the demands of staying busy in addition to marketing my services so the future will stay bright, combined with work I do as a consultant to many doctors. As such, I am exposed to others in practice who have not kept up. The fax machine is essential to convey and receive information from those who are keeping up, who are successful and demand instant information transfer. Not to have a fax is not to have a telephone. To spoil yourself, you must have fax capabilities within your computer. With the computer you can eliminate stacks of paper, which propels you closer to the paperless office.
Want to reduce paper work? Add a scanner to your computer. Scanning frequently used forms, letters, articles, pictures, requests, documents and legal papers increases security of material and maintains quality of the products scanned. An original quality copy can always be retrieved via computer, scanner and printer. The new laser printers are now inexpensive and of extremely high quality. Show me an office that still uses a typewriter and I will show you the past.
How do you improve interoffice communication? The layout of the office must have vision and communication via eyes, hand signs or intercom. Video camera assistance is valuable if the structure of the office is a disaster for vision and information transfer. Interoffice communication includes doctors’ orders to staff, such as what exam and x-ray to take, check lists, job descriptions, office policy and a procedural manual with regular inspections to verify that expectations of staff are met. Trusting that the staff will care as much as the doctor is a figment of someone’s imagination. What you expect, you must inspect and inspect again.
For example, the doctor asks the staff to perform an EMG, a cervical exam and a cervical series x-ray. The staff remembers to do half and creates a bottleneck in patient flow. Why not create a check list with all the procedures that could be done for the new patient that can be handed to the exam CA or doctor to provide stability and consistency?
What has managed care created? What do insurance personnel demand and what do attorneys prefer? Office notes. Office notes that include personal abbreviations left with the Neanderthal age. Although, no one likes documentation work, a totally paperless office is still a delusion. What is the salvation to the dilemma? Scanned office notes. Exams, insurance responses to requests, narratives, Medicare and other insurance requests can be less life threatening by utilizing a high tech, quality, cost and time-efficient program offering scannable forms.
The chiropractic profession is prey to those companies thinking they know what is needed in our offices. Before purchasing a note system, talk to userspreferably those who have used more than one system. The expense of changing from one system to a better system is not logical when low overhead has become a priority in practice survival tactics. A company that responds quickly to your needs and provides dependable and prompt service is also a prerequisite.
Pain index forms such as the Oswestry Chronic Low Back and the Vernon Mior Neck Disability forms are invaluable in documenting subjective changes and supporting need for care. Scanning these forms should be quick and easy and the software program you use must incorporate the ability to calculate percentage of subjective disability with comparison of different exam dates. The “right” scannable software system will provide an entire suite of chiropractic forms that include objective, subjective, assessment, progress and treatment information, exams and reports. The software will generate the reports you need that will ultimately lead to fewer insurance requests, more attorney referrals, more free time for staff and doctor, and increased income relative to this new quality of communication.
Dictation is out. Personal, written notes are gone. Scanning daily notes and exams reflects an office that is profitable, efficient and growing. A system must be in place that allows doctor and/or staff to send a report to a referral doctor or an attorney, or to send a patient release to an employer within an hour of the patient’s first visit.
It takes initiative for the busy doctor to investigate, organize and re-engineer the office to catch up to the new dimension of practice life. However, the few hours of work required to catch up will give you days of free time. For me, a scannable notes software system has become a necessity.
Money is no longer the major commodity in demand, free time is now the luxury. By streamlining and simplifying all the microseconds within the office, designing optimum flow, efficiency, practice management, collections, documentation and communication, and by applying a set of proven procedures, this will allow us to ride our bike or sit down and watch the birds without feeling guilty! Consciously devoting yourself to spending time on improving and looking for better ways to reach a higher level physically, mentally and professionally may just make this lifetime worth living.