Improving the Productivity, Efficiency, and Profitability Dr. Neil Baum New Orleans, LA

1. Improving the Productivity, Efficiency, and ProfitabilityDr. Neil BaumNew Orleans, LA

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

3. Effective Scheduling “Languishing in the waiting rooms causes more patient dissatisfaction than any other aspect of medical care including fees.” Study by AMA

4. 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

5. Effective Scheduling Create “sacred time”

6. Before and After Using Sacred Time (ST)* Minutes *Data from my practice

7. Take Home Message... • FEW of us can change health care policy • ALL of us can be more sensitive to the patient’s time

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

10. Use Videos to Improve Efficiency

11. 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

12. Topics for Urologist • PSA screening • Ultrasound and prostate biopsy • Treatment of localized PCa • TSE • Evaluation of ED • Hematuria • Vasectomy

13. Equipment for Office Videos • Video camera-Flip camera ($100) • Tripod • Script

14. Creating the Video • Make a movie using a digital camera, web cam, or cell phone

15. 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

16. 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.”

17. Advantages of Do-It-Yourself Videos • Improves efficiency • Medical-legal protection • Nice take-home value

18. Advantages of Do-It-Yourself Videos • Improves efficiency • Medical-legal protection • Nice take-home value • Can use to demonstrate patient understood the material

19. Communiate With Referring Physicians Efficiently Company Name

20. Why 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% • Gifts1%

21. Traditional Referral Letter • Long • Arrives in 10-14 days • Expensive

22. Key Ingredients of a Referral Letter • Diagnosis • Medications • Treatment plan

23. Goal of an Effective Referral Letter: Letter arrives before the patient returns to the office

24. 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

25. Example: • Jane Doe referred by Dr. Bill Smith • Diagnosis OAB, a. vaginitis • Plan OAB drug XXXX topical estrogen no response, UDS

26. 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

27. 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

28. Real Time Adjudication

29. Ensures • Increased profitability • Improved bottom line • Increased productivity and efficiency Collects more money, and collects more often My practice: 7% increase in collections Collects Patient Payments @ POS

30. Use of Check Lists

31. 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

32. New Use of Checklists in Office • Checklists for all outpatient procedures: vasectomy testosterone implants minimally invasive therapy for BPH bladder biopsies UDS and cystoscopy

33. 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

34. Using the EMR To Improve the Efficiency of Your Practice

35. How I use a scribe • Scribe takes • HOPI • PMH • ROS

36. 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

37. 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

38. 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?

39. A few comments about Social Media

40. Bottom Line • If it’s good for Mayo Clinic, it’s got to be good!

41. Suggested Reading To Get Started

42. Blogging • Easiest way to communicate with patients and potential new patients • Best venue for starting getting yours feet wet in Social Media

43. Blogging • Hosted on your own server with software-WordPress, Blogger, MovableType, LiveJournal • Blogger.com, GoingOn.com, Wordpress.com

44. Blogging • Requires regular posting • Want to keep the eyeballs returning • Promotes a forum to exchange between you and your existing patients as well as potential new patients

45. 5 Steps For Blogging On WordPress.com • Go to WordPress.com • Create a free account • Select “New Post” button • Type your content • Hit “Publish”

46. Writing “Kick-Butt” Titles • Title shows up in so many places on the web and speaks volumes about your blog • You have just a few nano-seconds to capture the attention of readers

47. Example of title writing • Boring: “Incontinence-Diagnosis and Treatment” • Better: “Incontinence-When It Gets Wet Down There” • Best: “Incontinence-How Not To Depend On Depends!”

48. Bottom Line On Titles • The ideal title balances flair — words like “dry”, “Depends”, and “diaper”— with specific and practical keywords, so you have a title that’s not only fun to read but also ranks well

49. Does Social Media Work?

50. Need to be on the firstpage of the search engines 1. Organic search engine optimization 2. Pay per click