HEALTHCARE NAVIGATOR

Are You REALLY Managing Your Practice?

Managed care requires a managed practice—here’s how to get one

it’s funny how the pendulum swings. Here in the United States, it’s all about managed care. But already we see signs of some things “un-managing.”

In Canada, where optometry was once completely managed, de-insurance has left it to practice owners to do as they please. Already third parties are clamoring over creating managed care arrangements for patients now responsible for their own eyecare costs.

In organized society it seems we do things, then others come into power and we undo them, then we redo them, then undo them, and on and on and on. This must be why history repeats itself.

All that said, no matter where we are or at what point in the swing we find ourselves, the key is not the managed market. It’s the managed practice.

What Is a Managed Practice?

Let’s define management, then. I think that “management” is, as a working definition, simply “choosing to control the outcome of something.” Management is first, a decision, long before it is something strategized and implemented. That is true for whatever it is to be managed—whether it’s a patient condition like glaucoma, or a business concern like productivity, culture, profit, scheduling efficiency, patient retention, or capture rate.

So profitability is a decision first, then a set of initiatives. Same with staff productivity, workplace culture, or patient retention. As the CEO and leadership team in the practice, you must first make that decision, then bring the team on board.

Have we decided to impact profitability? Are we going to leverage staff differently than in the past, to get out from under the burden of too much work?

Are we going to make culture a deliberate thing and, therefore, create a self-fulfilling prophecy?

Management is a decision before it is a set of initiatives. It’s about choosing to control our out-comes because that’s what we’re going to do, rather than just tumbling in the waves and hoping for the best. Management by decision beats management by hope every time.

Do You Have Objectives?

Management, or choosing to control the outcome, is second, a set of objectives. Note the word “objective” and not “benchmark.”

Benchmarks are overrated. Not that they’re not helpful, but I’m much more interested in what you and your team actually desire to accomplish than what someone having nothing do with it is accomplishing in some other set of circumstances.

So, after we’ve made a decision to impact an outcome, the next step is to define exactly the outcome for which we will strive. You might be amazed to know how few practice teams actually define their goal.

We do the work, and we might even measure the results, but we didn’t decide together the object of our labors in the first place.

For example: We need to define the exact desired outcome for recall success (which I recommend be at least twice the benchmark!) before we could ever know if we need to scrap our recall system and start anew. How can we know what to do if we don’t know what we want?

Do You Have Exact Initiatives?

Management is third, a set of initiatives. When we’ve made the decision to effect an outcome, and we’ve clarified the objective of that outcome, we now need to form the exact set of initiatives that ensure we accomplish that objective. After 30 years of helping teams do this, I conclude this is actually the easiest part.

As we discussed in the last column (September 2016 issue), it’s the “Tale of Two Practices.” One practice has a net profit of 40%, while another is at 10%. One team averages productivity per person per hour of $115, while another averages $75. One doctor has an average patient transaction of $450, while another doctor, in exactly the same practice, is at $250.

There’s the proof, right before our eyes. We know it’s accomplishable, because we see it being accomplished. The question is: What exact set of initiatives can we implement to make it so, here and now?

Do You Have a Plan?

What if you went to optometry school and never practiced? Would all the information and all the learning have brought any results in your life?

Thus, management is fourth, creating a strategic plan that makes it impossible not to implement those initiatives. I mean this literally.

If determining initiatives needed for a certain result is the easiest part of management, getting those initiatives implemented is definitely the hardest. This is where the real difference is made in the “Tale of Two Practices” we discussed last time.

This healthcare market demands more of you. It demands that you actually create a time-bound plan of action, involve each member of your team in a defined contribution, and have a reporting system to ensure we’ve held ourselves accountable.

The key here is simple: It’s what we do, not what we learn, that brings the results we desire.

—Tom Bowen

TOM BOWEN is executive vice president and co-founder of Williams Group, a firm offering specialized consulting to eyecare practice owners.