improving the productivity, efficiency, and profitability dr. neil baum new orleans, la

Improving the Productivity, Efficiency, and Profitability

Dr. Neil BaumNew Orleans, LA

Improve the efficiency by being an “on-time” physician

Effective Scheduling“Languishing in the waiting rooms

causes more patient dissatisfaction than any other aspect of medical care including fees.”

Study by AMA

Time and Motion Study____ Time patient arrive in the office____Time patient taken to the exam room____ Time spent with the provider____ Time patient left the office____

Total time in office / total time with MD

Effective Scheduling

Create “sacred time”Create “sacred time”

Before and After Using Sacred Time (ST)*

Min

utes

*Data from my practice

Take Home Message...• FEW of us can change health care

policy• ALL of us can be more sensitive to

the patient’s time

Answer All Patient QuestionsWhen You Are in the Exam Room With the Patient

Use Videos to Improve Efficiency

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Improve the Efficiency of the Practice

• In the past, we enjoyed the luxury of low volumes of patients and high profit margins

• Today, we can expect large volumes of patients with narrow profit margins

• Therefore, we will need to see more patients in the same amount of time without sacrificing quality and patient satisfaction

Topics for Urologist

• PSA screening• Ultrasound and prostate biopsy• Treatment of localized PCa• TSE• Evaluation of ED• Hematuria• Vasectomy

Equipment for Office Videos

• Video camera-Flip camera ($100)• Tripod• Script

Creating the Video

• Make a movie using a digital camera, web cam, or cell phone

Getting Started

Gather information• Tape record a conversation with a patient• Review pamphlets and educational materials

from pharmaceutical and medical manufacturing companies

• Review other videos

Prepare the Script• Describe the topic• Why is it important to your health?• What are the risks and complications?• What are the alternatives?• “I will return to the room after you have completed

the video to answer any questions that you may have and provide you with a summary of the video.”

Advantages of Do-It-Yourself Videos

• Improves efficiency• Medical-legal protection• Nice take-home value

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Advantages of Do-It-Yourself Videos

• Improves efficiency• Medical-legal protection• Nice take-home value• Can use to demonstrate patient

understood the material

Communiate With Referring Physicians Efficiently

Company Name

Why Do Physicians ReferWhy Do Physicians Refer?? Returns patients 38% Reports back promptly 33% Availability 13% Friendliness 11% Scientific talks 7% Give RPs an active role 5% Teaching in hospitals and schools 7% Entertaining 1% Publish professional articles 1% Gifts 1%

Traditional Referral Letter

• Long• Arrives in 10-14 days• Expensive

Key Ingredients of a Referral Letter

• Diagnosis• Medications• Treatment plan

Goal of an Effective Referral Letter:

Letter arrives before the patient returns to the office

Computerized “Boiler Plate” Referral Letter Example

Dear <Name of Doctor>

<Name of Patient> was seen for a problem of <diagnosis>.

I recommended <medications and treatment plan>.

I will keep in touch with you regarding her progress.

Sincerely,

Neil Baum

Example:

Jane Doe referred by Dr. Bill Smith

• Diagnosis OAB, a. vaginitis• Plan OAB drug XXXX

topical estrogen no response, UDS

Boiler Plate Referral Letter

Dear Bill, Jane Doe was seen for a problem of urinary frequency

and urgency as well as atrophic vaginitis.I recommended XXXX, and topical estrogens. If she does

not have a favorable response, I will proceed to a urodynamic study.

I have provided her with educational information on the proper use of the medication.

I will keep in touch with you regarding her progress.

Sincerely,

Neil Baum

Advantages of boiler plate letter:

• Reduces the cost $15 to $1

• Increases the efficiency of your practice

• Keeps the referring doctor as the “captain” of the patient’s health care ship

Real Time Adjudication

Collects Patient Payments @ POS

• Ensures– Increased profitability – Improved bottom line– Increased productivity and

efficiency• Collects more money, and collects more

often• My practice: 7% increase in collections

Use of Check Lists

A True Story

• 40 y\o with hypoandrogenism• Was on Coumadin and told to stop medication

before inserting testosterone pellets• Procedure performed without checking on the

discontinuation of the anti-coagulant• Developed a post procedure hematoma

New Use of Checklists in Office

• Checklists for all outpatient procedures: vasectomy testosterone implants minimally invasive therapy for BPH bladder biopsies

UDS and cystoscopy

Bottom Line

• Checklists are becoming part of our routine in the hospital setting

• Checklists can be used in the office setting as well and will certainly improve the efficiency and the care we provide our patients

Using the EMR To Improve the Efficiency of Your Practice

How I use a scribe

• Scribe takes – HOPI– PMH– ROS

Advantages of a scribe

• Doctor sees other patients while scribe takes the CC, PMH, ROS

• Doctor does not need to touch the computer• Doctor does not need to type • Significantly improves efficiency and

productivity

Bottom Line on Scribe

• Doctor eyeball to eyeball time with patient reduced from 15 - 20 minutes to <5 minutes

• You are more efficient and can see more patients and do more office procedures if you use a scribe

Economics of A Scribe

• If you Increase just 1 patient\hour• Work 7 hours\day• 7 additional patients\day• Each patient increases revenue by ~$75• Work 5 days a week and 48 weeks\yr• Bottom line: Increase of revenue of

$126,000!!Who needs ancillary income?

A few comments about Social Media

Bottom Line

• If it’s good for Mayo Clinic, it’s got to be good!

improving the productivity, efficiency, and profitability dr. neil baum new orleans, la

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