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Friday, February 27, 2009

"For your convenience. . ." Who are they kidding?

Beware when a company changes its operations "for your convenience. . ."  For your convenience actually means for their convenience.  While you may be helped by the change, that is mere coincidence.  The change in operations was made for cost savings. . .or increased profit, etc.  But certainly, it was not made primarily for your betterment.

When the customer service department notifies you that service queries must now be made on-line rather than by phone--"for your convenience"--it probably means that you'll have to wait longer to get help.

When statements can be sent by email, rather than mail, the company benefits by saving money on postage and envelopes.

Just my cynical observation made for your convenience.


Thursday, February 26, 2009

In a rough economy, give patients value

In this challenging and down economy where insurance companies and Medicare attempt to remain viable by raising premiums and co-pays, patients may balk at having to come to the office merely to "discuss lab results."  Now I know as well as you do that the cognitive aspects of medicine are important, valuable, and worthy of pay.  Even the insurance companies recognize this fact.  But patients, on the other hand, get pissed off when they are asked to pony up $50 when you don't "do anything."  While I disagree with the patients on this one, I do understand their gripe.  As a result, I try to offer something "of value" to them on every visit.

You may want to try the following: have patients come in to discuss results
  • . . .and have a repeat physical exam.
  • . . .and have a urine culture
  • . . .and have a blood draw
  • . . .and have a ultrasound
  • . . .and review radiologic studies in their presence
  • . . .and draw diagrams for them
  • . . .and complete forms
etc.

Just something I've figured out over the years.

Wednesday, February 25, 2009

From Idea to Implementation: 5 Steps

My friend Steve once told me, "ideas are cheap."   He was right.  They are cheap.  The real challenge is taking an idea from concept phase to market place, or FROM IDEA TO IMPLEMENTATION.  After you have come up with the idea or have identified a problem that needs solving, here's how to begin.


  1. Commit the idea to paper.  This gives it life.
  2. Develop a revenue model around the concept, ie subscription, advertising, affiliate, etc.  If the idea survives this test, proceed to step 3.
  3. Write a business plan.  This converts the idea, which is really just a 1 cell embryo, into a 6 week old fetus: you may not tell anyone else about it, but you are starting to get excited.
  4. Do research: Nothing fancy needed here, but some gentle field research, Google searches, informal focus groups may let you know that the fetus can develop into a baby or perhaps it can not.  But you'll discover it's fate before you invest more time and money into the project.
  5. Speck-it out: Build a mock-up version of the business.  In-expensive software can help here, or pen and paper works as well.  Be as detailed as possible.  Re-visit, re-work, & re-imagine the project often.  Try to poke holes into it.  Pick it apart.  Because the next step is either. . .
  6. Abandon or commit.
Good luck with your endeavor.

My respite.

In case you have not noticed, I've been inactive for the past few weeks on the blog. Lots have been going on, good stuff, just lots-o-it.

I am in the midst of an EMR conversion and this eats up an enormous amount of time and energy.

I have been very busy in the office, knock on wood.

Insurance companies, in general, seemed to have slowed down their disbursements to me. From comments on various list-serves, this seems to be a national trend. BASTARDS! But working claims has become a team approach.

I have developed software that automates and facilitates the quality assurance and CLIA compliance processes in my lab. Since it has worked so well in my office, I have decided to turn it into a business. Beta-testing will start soon for interested practices. Very time consuming indeed, and exciting. Here is the link: www.ilabtqm.org.

I'll start posting again a bit more frequently soon.

Again, sorry for the respite.

Monday, February 09, 2009

Saturday, February 07, 2009

How an EMR changes you and your practice forever.

Forget everything about how you used to do things.  Just let it go!  When you adopt a high-end EMR product, you'll find that business as usual is over, and forever. 
  • Workflow: Old way: front desk staff checks in patients, then doc takes the entire history.  New way: patients can check themselves in and staff takes the majority of the history, such as the PMH, Allergies, Social History etc.  Doc reviews, completes, and cognates.
  • Back-end: Old way: complete charge sheet, give it to back end staff, they enter charges, submit claim.  New way: after the encounter, doc completes the note, signs, and voila, off it goes to the clearinghouse.  Billing staff now freed up to "work" the claims.
  • Scheduling: Old way: patients call, overload phone lines, and staff assists in booking while waiting room fills up.  New way: patients book themselves on-line, enter their own information, doctors phone lines freed up, staff freed up.
  • Precriptions: Old way: scribble, give to patient, often gets lost or handwriting issues, leads to call backs, refills, torture.  New way: click on favorites, click on med, click on pharmacy, click.
  • Coding: Old way: document as much as you can given time and hand-cramping restraints, stay within the bell curve for your specialty, then hope you don't get audited.  new way: predesign your templates with appropriate level of E&M coding, see patient, hit enter, next.
  • Lab and study tracking: Old way: give patients requisitions and hope they go and hope you get lab and hope lab is filed correctly and hope you don't miss anything bad.  New way: select tests from check boxes in template, hit enter, system flags non-compliant patients, all results come to you automatically, electronically, effortlessly, and if you want it, graphically.
  • Practice patterns: Old way: "this is how I do it."  New way: pre-program best practice guidelines from professional organizations into your templates, then all appropriate tests and studies are orderd automatically, effortlessly.
  • Coordination of care: Old way: dictate, wait for transcription, mail.  Call doc, wait on hold, disturb.  New way: select letter template, recipient, hit enter.
Ahhhhhhhh!

The IU.