Saturday, January 31, 2009

Are we next?

Employment lawyers have seen a sizable increase in wrongful discharge claims.  Are we next?

I've always thought so.  It seems to me that claims of all sorts would rise during tough economic times.  For doctors, I think this is especially true.  Any adverse outcome that results in lost time from work or out of pocket expenses could quickly change a good doctor-patient relationship into a bad one and result in a claim of medical negligence.

I'm not sure what to do about, other than make sure you dot your "i's", cross your "t's", and make every effort possible to manage risk in the office.  Perhaps now is not the time to increase risk by adopting new techniques and procedures in the office.

I don't know.  Scary stuff!

Tuesday, January 13, 2009

The hiddden costs of any marketing campaign

Marketers are very quick to sell you on the upside of any campaign, whether it is TV, radio, print, email, or direct mail.  Skilled marketing companies can even supply you with data on conversion and response rates and how much return on investment you can expect.  But beware of the hidden side to any marketing modality.


Newton's third law of motion states that for any action there must be an equal but opposite reaction.  While in marketing, the opposite-than-intended reaction may not be equal, it is present and you ought to be aware of it.  Lets use a mailing as our example.

Let's say you send 2000 newsletters to your established patients.  Conservatively you can hope for the following:
  • Cost of the mailing ~$2500
  • 1% positive response rate, max = 20 patients who call to come in and be seen
  • Each encounter  = $150 = ROI of 120% or the campaign paid for itself + $500.
Sounds good, right?

Now lets factor in the turn off factor.

  • Of the 2000 mailings, you annoyed 1% 20 patients
  • 20-60 patients x $150 = $3000 in lost revenue for those patients who decide to hopefully just leave you.
  • Factor in an additional small percentage of really mean people who will use the mailing as a reminder to bad-mouth you to others.
Obviously, this is an extreme example, but the turn off factor is probably in the 0.1 percent range, or 2 patients out of 2000 = $300 plus any additional bad-mouthing damage that they may do.

Just think about all the possible outcomes before you do a mailing, or any other brand of unsolicited, in-your face, type marketing campaigns.

Good luck,

Dr S

Thursday, January 08, 2009

Clueless? Design the Front End First

Let's say you wanted to start a web-based business but did not have any web design, programing or software engineering experience, you might think that it would be impossible to proceed with your plan.

You'd be wrong.

Using simple and inexpensive software, such as Balsamiq or even MS Publisher, you can actually build your site from the front end first, ie from the experience of the user. Then, you just have to find a coder to build you the site and then find someway to pay for it all.

If you are going into a new, solo medical practice, you can adopt this type of backwards planning strategy to achieve your ultimate goal even if you lack the knowledge to see the all the details involved in the project.

For example, perhaps you want to leave a group practice to start your own one, but have no experience with the business aspects of medical practice, you can use your knowledge of how you want to experience life in your practice and then step by step find out how to accomplish the seeming impossible. You may know that you want to see 20 patients a day, take insurance, do in-office procedures, major surgery in the hospital, and have a lab. Using this knowledge, you can back-step the route to the goal.

This strategy takes some practice, but you'll be amazed at what can be accomplished by using it.

Good luck and let me know how it goes.

The IU.

Monday, January 05, 2009

Solo Practice Amidst A Huge Team

Whether you are in solo or group practice, you work as part of a large team.  You rely on yourself and your employees to get stuff done, but you also rely on other people who you may never have met to act on your behalf and that of your patients'.  When I schedule a surgery in the OR, for example a penile implant, at least 7 people are involved in the process, not including the patient.  If anyone of them fails to do their little-but-critical part, the process comes to a halt, or worse.

It is a wonder that the system ever works at all.

Here are some things that we do so that we can trace the course of an order through the multiple levels that have become our health care system.
  • Save fax confirmations
  • E-prescribe
  • Take notes
  • Send letters by certified mail
  • Document, document, document
. . .and really we question everything and take it to the next level when something is not quite right. 

Modern medicine is a team endeavor whether you are solo or not.  Anything you can do to make it easier for someone else to do their job will ultimately make it easier for you and your patient.

Friday, January 02, 2009

Who else is listening?

Have you ever had the nagging feeling that your words are being recorded?

Recording a phone conversation in which you are not taking part, ie between 2 other people, is wiretapping. This is illegal without a court order. Recording your own conversation, even without the other conversant's consent, is legal and done frequently.

Sometimes, I get the feeling that I am being recorded. I don't mind when this happens, because I tell the truth in the presence or absence of any recording devices, but I do question the motives of the person who records me surreptitiously. Are they building a case against me?

Here are some tell-tale signs that you are being recorded by an amateur on the QT.
  • They keep on asking you to repeat yourself.
  • They really try to pin you down to a guarantee on success or a particular outcome.
  • The caller seems preoccupied with some of the technical aspects of the call.
  • The caller says they just want someone else to listen in, yet there is no one there.
  • The caller tries to manipulate the conversation so that you say something they may want to hear.
Of course, an expert can record your conversation without you ever knowing or suspecting it. But most people are amateurs.

And also, most of the time any recordings will pnly go in your favor in the case of a civil action since it will support you in the typical he-said-she-said game.

Good luck.