What Makes a Practice Great?

Being an outstanding physician is undeniably a great way to earn a comfortable living while also giving back to your community. But a well-managed, thriving medical practice can contribute so much more than a single doctor, however skilled. Great practices provide satisfying, enduring careers for their physician-partners and staff, and accessible and high-quality medical care for patients.

Practices achieve greatness by focusing on key attributes that allow for financial prosperity, professional growth for staff, satisfied patients, and continuous improvement of operations. Some of the key traits we've observed in great practices:

Doctors set the tone. An excellent practice manager is a priceless asset to any practice. But, even the best practice manager needs strategic direction and support from the physicians who own the practice to drive the practice to its highest levels.

Doctors set the tone by defining the practice's mission and culture, collaborating with the manager to set key performance goals for the practice, and working with the practice manager and staff to address problems early. And they meet regularly with their manager and staff to check in and discuss problems. Business issues needn't take much time - brief weekly meetings and a monthly session are usually all that's needed to air out any issues and agree on a plan to address them - but, having set time for problem-solving is essential to nipping problems in the bud.

Metrics matter. There's an old saying in business: "You can't manage what you don't measure." When you're seeing patients daily and making a profit, it can be easy to assume your practice is doing just fine. But, what if you're leaving money on the table - money that could be reinvested in strategic goals like implementing EHR or training staff, used to fund charitable efforts like free clinic days, or even just shared with physicians and staff through a retirement program or higher compensation?

Measuring your practice's performance is the only way to ensure you're moving in the right direction. Learn the key benchmarks you need to assess your practice, and review these measurements routinely. Some useful benchmarks - which can be compared against other practices by using data from MGMA and other sources - include charges and visits per physician, accounts receivable days, percentage of copays collected at time of service, staffing levels per physician, staff turnover, and expenses per physician. Practice management consultants will also often provide a set of benchmarks as part of an analysis of your practice.

Clarity, consistency and control in operations. Great practices figure out efficient and effective ways to perform important tasks - and then set systems to be sure they're done the right way all the time.

One important tool to this end is documentation. Great practices document their operating procedures - so that if an employee unexpectedly leaves, for example, it's relatively easy for another person to step in. And clear job descriptions guide important personnel decisions, like hiring and compensation.

Establishing tickler systems for controlling key contracts ensures your practice doesn't miss out on time windows for renegotiating - especially since many insurance contracts today include evergreen clauses that automatically extend their terms if not renegotiated. Missing out on a rate increase from an important payer can be enormously costly.

Internal management controls are crucial, too. Too many practices are victims of embezzlement. One way to avoid it is by setting up appropriate internal controls - for example, separating check writing authority from account reconciliation. Good practice managers understand this, and support such controls - even if it means a few extra bookkeeping steps.

Hire well. Staffing costs are usually the single biggest expense for medical practices - and, staff members play a huge role in how a practice is perceived by its patients, how promptly it is paid, and how profitable it is over the long haul. With so much at stake, great practices are picky about who they hire. They don't hire when they're unsure about the candidate's fit with the practice's culture and spirit. And they hire the best people they can afford.

Once they've hired a new employee, top-performing practices give them the skills they need to succeed by training them thoroughly. And training doesn't stop with the introduction to the practice - employees are encouraged to cultivate their skills throughout their careers.

Success is a journey, not a destination. Perhaps most important, the best-run practices recognize the need to continuously improve. The one thing that's constant in the medical field today is change - whether in the form of shifting payment responsibilities, legislation, technology advances or therapeutic innovations. The formula that brings success today might be outdated tomorrow. Great practices are committed to learning, adapting and growing. Besides keeping your practice on a prosperous path, this spirit makes work life more interesting, dynamic, and engaging for your employees.

Laurie Morgan is a healthcare consultant with Capko & Company. She can be reached via lmorgan@capko.com or through the website at www.capko.com.