Implementing Change in Your Medical Practice

Over the past two weeks, we've identified areas within your medical practice which can be easily modified resulting in immediate improvement, as well as how you can evaluate your current set of resources in order to elevate your business to the next level. This week, we will be focusing on the implementation area of process control.

When you introduce change into any situation, the dynamic will shift as states the “Law of Constant Change.” However, with change and growth, comes the need for balance. As you implement the necessary changes in your practice, you will need to keep this in mind. Some of your employees will feel relief that a situation is being remedied, while others might feel threatened by any small change. Since you've evaluated your resources and have spoken with your staff, you know how each person might respond to implementation of change. While it is important to respect your employees and how they are feeling, you must endure the consequences, both the good and bad, in order to move your business forward.

The most important aspect of change is knowing that you can implement it all at once (not recommended) or very slowly and methodically introduce it into your daily procedures. You have all of the control over how long and to what extent your change will happen.

Begin by identifying what you want to change.

For instance: You want to make sure that every patient has an insurance verification performed prior to their appointment. Your staff complains that there is simply not enough time to call or go online for these verifications. Before you implement a new policy stating this will now be a necessary component of the daily tasks, you need to really know what is at stake if you do not implement this change. Call up your billing company and ask them to give you a dollar amount that is adjusted negatively on a monthly or quarterly basis due to anything related to the lack of insurance verification task. If you do not have the time for this conversation, a great idea is to pull one of your hesitant-to-change staff members aside and ask them to assist you. Once they start understanding the “whys” of change, they will be more likely to become your best ally of implementation.

Not sure you know what the real issue is? Often troublesome issues are masked behind other, very obvious issues. I have a tool that I use I call the “Five Whys.” You write down the obvious issue, and then ask yourself why (be as honest as possible), write down that answer, and ask why again, etc.

For instance: My front office person never answers the phone when it rings.
Why?
She claims that she cannot get the rest of her work done, and it’s easier to deal with voicemail.
Why?
She's been yelled at by patients who cannot get in to see their physician
Why?
The schedule is so compact we cannot leave room for last minute visits
Why?
We need to hire another support staff person, but cannot afford to do that this year.
Why?
Inflow is low and clinic errors resulting in write-offs are high.

So what started out as a front office staff behavior problem really turned into a staffing issue that can be fixed as we start to focus on your A/R in the next few weeks. After asking “why” five times, you are really at the heart of an issue. No, it's still not acceptable that your front office staff member lets the calls roll into voicemail, but perhaps there is another reason that can be investigated and that issue fixed.

Now that you have identified the areas of opportunity for new change, communicating with your staff is key. You do not have to divulge private or fiscal information. However, sitting down with your staff and explaining why you want to modify a procedure, or update a policy will go much further with compliance, and compliance is critical. If your staff does not understand why something has to change, your process will feel like you are pushing a rock uphill. Ask them for feedback. It doesn't have to be performed exactly the way you want. If someone has a better idea, and it will produce the same result, do it! You've just empowered your staff and they will continue to follow you in your business with the respect you've just provided.

So, identify what you want to change, use the “Five-Whys” if you are struggling with the true issue, and involve your staff. If you implement using these concepts, the change will stick. Always keep in mind that the world is dynamic and your procedures should be as well. As your staff becomes more and more involved, you will find that some things can be dropped, and others tweaked just a bit.

How do you know if your billing company is the right fit for your practice? Next week we will begin this discussion and provide some basic questions you can ask your billing company today. These will provide you a snapshot of their performance.

Find out more about P.J. Cloud-Moulds and our other Practice Notes bloggers.