Repurpose the Ghost of Holidays Past

In many practices, staff members get a check each December as a bonus for their efforts throughout the year. Well, forgive me -- I don't wish to come across as Ebenezer Scrooge -- but that's no bonus, or even a gift. It's an expectation -- an expectation that does not result in improved performance related to any key practice goals. Pretty much, holiday bonuses are simply a way for employees to supplement their holiday spending budgets each year.

You can do better than that. Develop a true bonus program, based upon key performance goals and measures, and implement it starting January 1st.

To be effective, a bonus program must be:

• Based upon measurable outcomes -- Your 2008 goals might include a 5 percent increase in new patient visits, an 8 percent increase in net income (based upon the addition of new services), a 97 percent satisfaction rating (based on your new patient satisfaction survey), or a 25 percent reduction in denials from one or more of your payers.

• Timely -- Make haste to bestow the reward before memories fade so that the bonus is firmly connected to achieving the stated goal. For example, supply your doctors and office manager with $500 worth of gift cards in $10, $25, and $50 increments. Empower them to award cards on the spot to employees who do something incredible. Perhaps a staffer deftly handles an upset patient or, say, processes a referral quickly to help Mrs. Grover make her 2:00 appointment with the specialist. Instant gratification and recognition for a job well done will yield more good acts.

• Reflective of the goal accomplished -- Just as the punishment should fit the crime, the reward should fit the good deed. As such, monetary remuneration is fitting for attaining a targeted increase in net income, while parking in the "Star Employee" spot for a month makes sense for someone who finds a way for the practice to reach that never-before-seen 97 percent patient satisfaction rating.

For this year, go ahead and write that "bonus" check, because everyone -- including your own budget -- is expecting it. But tell your staff that this will be their last bonus based on a holiday. That way they'll have a year to adjust and figure out better ways to finance their shopping.

Worried about getting a Scrooge reputation? Don't be. You can still give a holiday gift of some sort next year -- just not in the form of a check.

Certainly, implementing your new-and-improved bonus program will require an upfront investment. But, the end result will more than make up the difference in terms of actual revenue increases and practice efficiencies. But with careful forethought and planning, the return on investment for your practice -- in terms of increased revenue and intangible measures, such as patient loyalty -- will be more than worth the effort and expense.

Owen Dahl, FACHE, CHBC, is a nationally recognized medical practice management consultant with over 24 years of experience in consulting for and managing medical practices, and he is the author of "Business! Medical Practice Quality, Efficiency, Profits." He can be reached at odahl@houston.rr.com or 281 367 3364.