When customer service matters

Taking money is easy. Providing good service, well that is more of a challenge.
And critical to the long term success of any business.
As a doctor, this means being available to patients 24 7.
Same for an auto insurance company when you have car trouble.
As a write this I sit on the LIE with a flat tire but help is on the way.
I am thankful for good customer service.
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Good luck

A high end men's shoe and socks shop in a high rent space in the village.
Better sell a lot of shoes.
Good luck.

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The Paradox of EMR

I love my EMR. . .and I hate it.
With my EMR, my efficiency has improved, yet I have difficulty staying on time.
My biller can easily submit claims, yet I think the system under-codes me.
My notes have amazing detail, yet it is mostly non-pertinent stuff.
I think it facilitates patient care, yet I tend to look at the computer more than the patient.
I can easily correspond with other doctors, but I risk inundating them with paper.
My staff likes it, perhaps because my payrole has increased, rather than decreased.
The ability to customize has me in awe, yet it is a pain in the ass to do it.
The organization is flawless, yet paper charts are effortless to thumb through.
Typed templates are great, yet handwriting gets to the essence of the encounter.
ICD-9codes are always in plain site, but I think in human-speak.
I marvel at aspects of the system, then curse it in the same breath.

Like a marriage, a very complex relationship indeed.

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The Capitol Dome

Wow
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Capitol Urinals

Don't have BPH here. There are only 2 of these.
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Enough

Do you have to go Paris or the Islands or somewhere exotic to get away?
Of course not!
A weekend with your family in an inexpensive hotel in a nice locale within several hours drive is enough to re-charge and re-energize.
And as a busy, self-employed practitioner, this type of get-away won't hurt the practice either.
I'd rather do 10 of these mini-VKs than take 1 long but exotic trip.
Just me and perhaps just for now, but the truth.
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Nice day

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An evening out with the girls

Nice break from my EMR hassles, etc
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Not bad daddy

My name inscribed in a plaque.
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Road trip with the girls.

My father daughter trip begins
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Make good use of your time

Using time wisely has become more important than ever.
EMRs help here, as they make the most out your precious minutes with a patient.
Tablet PCs can save time as well, since you can use them as both paper and computer.
Electronic faxing saves time by preventing printing problems and scanning issues.
Mobile devices allow me to blog while waisting valuable time at Costco.
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Why now?

Why choose the EMR now? Well, why make any decision at any point in time?
Because I identified problems that needed solving.
Here were my problems:

Too much scanning.
Too difficult to send correspondence
Too many refill and rx issues
Too many documentation problems
Too many scheduling mishaps
Too many remote access disruptions
Too much effort with back-up
Too much paper
Too much effort
Too much work
Too much wasted time
Not enough reward

Yes, it was time.
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A new generation of bloggers

I have some competition now.
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MY FIFTH EMPLOYEE

I currently employ 4 people, including myself.  I have 2 MA's and a part time biller.  All 4 of us make more than $600 per month.  My fifth employee is my EMR system.  It cost me $600 per month, +/- a few.

My fifth employee works 24/7 and never takes a sick day or personal day.

My fifth employee never forgets to do what I ask of it.

My fifth employee doe not make mistakes.

My fifth employee is very organized.

My fifth employee can write prescriptions.

My fifth employee can file labs efficiently. . .and retrieve them with equal efficiency.

My fifth employee can submit claims. . .at 2AM if I ask it to.

My fifth employee can generate letters to referring doctors. . .and deliver them. . .24/7.

My fifth employee is a great employee, my electric one.

Even at the hefty price tag I paid for it, my EMR when viewed as a fifth employee is cheap. . .very cheap.

Here's the thing: people expensive/robots cheap.

That is a good way tolook at an EMR investment.

Email back-up

I just had to do a massive re install of the OS on my Tablet PC. I do back up daily so I lost nothing, but I do have a warning regarding Outlook back-up. You need to take an extra step to insure that all emails are saved. I just hit the folders I want saved, hit ctrl A, save as a text file onto you back-up drive.
Then all emails are easily restorable as text files than can easily be read.

In back-up, it is the ability to restore that matters.
Good luck.
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Mobile Ideas

Sometimes, in fact often, I find myself in car with sleeping child. There, alone and in piece and quiet, I often come up with my best ideas. Many blog posts, many practice decisions, even iLabTQM, my new CLIA Compliance Solution, have been launched from my Honda, with sleeping child aback.
I always keep pen and paper handy for such occassions, though now I have a Blackberry, so when idea comes, I compose it into an email or MMS and blast it off.
Makes for a good use of time--my alone time.
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"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.

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.

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.