A Question for You

When I started this blog, I concerned myself only with writing something that mattered to me and the people who shared my profession. It was a place for me to express myself and share what I know.

It was also a place where I could read the reactions and comments of my colleagues, and hear other perspectives. I have learned more from this blog than I ever dreamt possible, thanks to the intelligent and informed readership.

Recently, my son noticed my blog and asked why I didn't have any ads or other forms of promotion on it. I told him it didn't interest me to do so. He went on to explain that if I wanted the blog to grow and progress, it would be smart to add some things like banners and advertising, to develop it into a more official site.

I love my boy, and the fact that he wants to work with me to make my blog become more popular and savvy is exciting. It's like a project we can share, which doesn't happen often now that he's a teenager.

My question to you, dear reader, is what do you think? Would you be bothered by a few inconspicuous banners or advertising? Your opinion matters the most, so I will seriously consider whatever you have to say on the subject.

A Room Without a View

Few things are more annoying than a summer flu, and last week I caught one. I felt bad enough that I wound up going to see my personal doctor, which I must confess I hadn't done in a while. Sometimes those of us in the healthcare profession make the worst patients.

Anyway, you may recall my recent post on office decor. My doctor visit was an eye-opener on that count. It's one thing to view a waiting room as an employee trying to stay within a budget, and quite another when you are an easily-irritated sick person.

The first thing that really bothered me was the uncomfortable, bargain basement furniture they used. I didn't have to wait long, but the hard chair I was in made it seem like I'd spent twice as much time. Also, the chairs and couches were poorly spaced, so the sense of personal space (for myself as well as the others waiting) was almost nonexistent. When I'd been there previously for a check-up, I hadn't noticed, but since I had made this appointment at the last minute on a Friday and I was feeling toxic, I really became aware of everyone around me.

Another thing which really bothered me was the music they played. I realize muzak is a bland choice designed not to offend anyone, but I'd really prefer no music at all if I had a choice! It made the waiting room seem like a giant elevator.

Finally, I would've loved a magazine that was published in the last five years or so to read. When you're in that situation, you crave some kind of distraction. A television discretely in the corner can be good, but at the very least some recent magazines targeted to your patient demographic are a must.

Of course, I said none of this to the staff or my doctor. The latter is one of the best in the area, and we are friends as well, so I didn't want to offend her. I just took note of everything and thought I'd discuss it in my blog. What do you think? Is your waiting room a point of pride or a means to an end? As always, I'm interested in your opinion.

Office Morale

(Note: Recently, some of you responded to a post I'd written about administrative pitfalls with suggestions on improving office morale via gifts and recognition. Your comments were much appreciated, and inspired me to write today's post.)

I'm lucky. The office I manage is able to pay a competitive wage, which is invaluable in both attracting and keeping a high quality staff. However, it's been my experience that while a satisfactory paycheck is vital, it's not the only way to keep office morale high.

One of the main things I do is recognize achievement. When someone does something noteworthy or makes a valuable suggestion, I make note of it and during the next office meeting, I take the time to mention publicly just how grateful I am to that particular person. Praise, when legitimately given, is a terrific way to make an employee strive for excellence.

I also will send out the occasional complimentary email for the whole office to read, or even something as personal as a post-it on someone's computer. I'm careful not to go overboard or say too much, but I've found that people really appreciate the fact that their deed was remembered. Granted, we're all professionals, and should routinely be doing outstanding work, but that doesn't mean we don't like getting complimented for it on occasion.

Another thing I do with everyone in the office is plan small events like a dinner out together or even something informal like a bowling party. Nothing reinforces the sense of working in unison like bonding outside of the workplace. It also helps break down the barrier between doctors and office staff, keeping everyone approachable and on good working terms.

Sometimes I jokingly refer to our office as a lifeboat. We sink or swim together. It isn't necessary that we like or care about everybody on board, but it sure does help.

How about your office? What are the ways in which you bolster office morale?

Some Notes on Collections

Recently, I've been giving some thought to making sure we collect OTC (short for over the counter) payments on a more timely basis. I've made it my personal quest to reduce aging accounts in accounts receivable. I've had some luck with this, so I thought I would share a few handy tips.

First, I made sure our staff knew how to use the internet to find out the nature of every patient's insurance status. For those who aren't covered, I made sure there were signs posted prominently in the waiting room detailing our policy.

When patients who had no insurance arrived, I made sure a staff member politely explained our policy so there would be no misunderstanding. This was also done prior to their visit, when the receptionist called them to remind them of their appointment. The key was persistence combined with good manners.

As many of you know, I like incentives for staff members, so in this instance I offered little perks like free movie tickets and free dinner at a great local restaurant for employees who demonstrated a commitment to our new policy. (One staff member even went to the trouble of redesigning our billing statement so that it was easier to read.)

I also reinforced with physicians the need to direct any financial questions from patients to the staff. The key again being a strong follow-through that showed this was a priority, but not at the expense of the patient's healthcare.

I must say this recent focus has met with some success. I have written previously on collections, and how draconian they can seem, but I am also well aware of the bottom line. My new approach now mimics preventative medicine. We seek to prevent potential financial crises before they arise.

Still, I'm curious what any of you are doing to reduce the dilemma of nonpayment for OTC services. Any thoughts or suggestions would be welcome.

The Right Fit

We recently went through the ordeal of hiring a new physician, and so I thought I'd review some points which I feel are relevant when recruiting. I recently read a study that said doctors are most likely to leave a new practice within three years. The key to enticing someone to stay is to offer them a good fit in terms of their personal needs. Modern medicine is a rigorous pursuit, but doctors nowadays also like to give their home life the same attention and devotion. It is crucial to offer such things as flexible scheduling, and an accomodation of family life.

Although the senior staff physicians tend to do the heavylifting when it comes to hiring their own personnel, they trust me to help provide input and I usually sit in on the interviews. I always stress the importance of open-ended questions that allow the person being interviewed to give a full answer. Here are some sample questions:

1. What areas of clinical practice are most challenging to you?



2. What’s your technique for handling phone calls from your patients during the day?



3. What are the most important contributions you feel you’ve made to your current organization?

The key is to find out how they did something, since success in the past predicts success in the furture. I can usually tell if a doctor will be a good fit by how they answer questions like those above.

Never underestimate the social aspect when contemplating a new physician. The worst thing that can happen is when you hire someone who is a fantastic interviewee, but within the first month or two of employment, they seem to withdraw and not be a full participant in the practice.

Of course, there's no guarantee of success, but I'd be curious to know what you readers look for in a new physician. Any telltale signs or red flags you look for? As always, comments are encouraged.

The Art of an Office

An important part of any medical office is the art which hangs on its walls. This rarely gets discussed, but the mood established when a patient comes into your practice is very important.

When I first started managing at my current office, they had paintings of animals and clowns. I guess they were going for a circus atmosphere.

A friend who runs a local cafe, suggested that I do what she does, and solicit local artists to hang their work. No price tags, but a card noting where they can be reached. I looked into it, and after reviewing a few people, I found some nice oil paintings that gave a warm feeling (usually featuring families, I'll admit).

I also had some photos of our doctors and staff framed and placed in the examination rooms. It was my feeling that this would humanize us to the patients, and I can't tell you how often people comment that it's a nice, personal touch.

Another thing I did recently, was to dedicate a wall to the children who come to our office. While they are waiting, we give them crayons and paper, and let them draw to their heart's content. We then display their work on a rotating basis. Sometimes the kids come in when they haven't got an appointment, just to see their drawing on the wall!

A good practice considers every aspect of its operation. Believe me when I tell you that how you decorate your office will make a difference. Yes, the quality of the medical care is what counts, but never underestimate the power of proper presentation. I'd love to hear any of your ideas or stories on office decor.

e-Prescriptions

It's been said that nearly a third of doctors have illegible handwriting. From my own personal experience, I'd say it's more like two-thirds, but luckily for doctors, good penmanship isn't a criteria for medicine.

However, when it comes to filling prescriptions, the ability to read a doctor's handwriting is crucial. The sad truth is sometimes mistakes are made or directions aren't followed because of the difficulty which ensues from prescriptions that end up resembling hieroglyphics.

Luckily, modern day technology has provided us with a tool which makes this problem virtually irrelevant: e-prescription software. The doctor inputs the information directly into the system, and if the pharmacy has the proper equipment, they can immediately fill it to specification. If they lack the EDI set-up, the prescription is converted to a fax. Either way, the information is provided in a clean and legible way.

Another benefit to the electronic system is drug interaction. If a patient is on a medication prescribed by a psychiatrist--unbeknownst to their physician--the system will flag it and help prevent a potentially dangerous drug combination.

Since we've been using this software, phone calls from patients and pharmacies regarding prescription issues have been significantly reduced. The benefit of clearer communication has thus saved on staffing costs, as well as potential malpractice issues.

On a more personal, lighter note, one of our older and more beloved staff doctors, whose handwriting was so bad he once took a class in calligraphy, recently joked that he should have taken one in typing instead. He then added, "I used to feel like in order to practice medicine, I had to practice my penmanship!"

I'm curious if any readers are using e-prescription technology. If so, how is it working for you? If not, what are your experiences with the old-fashioned method of prescription writing? As always, your input is encouraged.