Monday, June 24, 2013

Change? It is the norm!

By: Richard Stroud, MBA FACMPE
UAB Eye Care
I read the blog on March 4th that my colleague, Bill Cockrell, posted about how things have changed in his thirty-two years in healthcare management.  His second paragraph discusses all of the current issues that we all have to acknowledge.  The question that he posed “Is it all bad?” is dependent on where you are in your career journey.  My answer is no, because the constant will always be change.

In my experience, there have always been “issues” that have occurred every year.  Some of these “issues” crossed over to everyone that uses technology, not just healthcare (remember Y2K?).  And then, you have the “issues” that are fairly specific to health care, like HIPAA.  There are always discussions on other “issues” as well, like pay for performance – which is not unique to healthcare.

I recently attended the Alabama MGMA winter conference, which consistently puts together an informative program for physician practice managers.  It was well attended, but I also noticed that many of the attendees I had seen in the past were not there.  I am sure there were various reasons some did not attend (personal, financial, etc.), but I also know that at any given time – less than half of the medical practices in the state attend these meetings.  Why?

During this meeting, I heard a presentation on interacting with others – always a help for me, as I am somewhat dictatorial!  I heard a presentation on independent practices –something that has been on the forefront for a few months – with medical practices being sold (or leased or managed) to hospitals.  There were also presentations on various other topics – legal, accounting, collections, compliance – and all of the changes that are in effect this year.

But, I also was involved in several discussions about the routine stuff, like the “prima donna” employee that does not realize how dispensable she really is (and yes, there are doctors that can be lumped into that category).How about updated job descriptions that reflect what is truly going on in the office.  How about office hours – the pros and cons of early and late hours?  Insurance company problems – procedures not being paid (or paid correctly)?  Credentialing issues – who, how, when? Updating technology – is “the cloud” the way to go?

While I have not been in physician practice management for thirty-two years – I have been around for about nineteen.  I am not an expert in everything involved in the efficient performance of a medical practice!  I don’t think I have met that expert, or even heard of that expert.  But, I do know how to find the answers.  A majority of the questions that come up on a routine basis are not anything new, and many of my peers have already answered the question.  So why reinvent the wheel? 

Attending a state (or national) meeting is usually beneficial if you look only at the presentation content.  The real benefit is the opportunity to network with other professionals that can assist with the change and the day-to-day stuff.  Being able to identify those “experts” in each area – accounting, legal, technology, etc. – can save a lot of time (and money) when your practice is in need.  It is also reassuring to learn that those nagging problems that you have in your office are not unique, but everyone has them from time to time.  So, how do you handle the employee that thinks she is indispensable?  I have three different answers – and two of them she will not like!

In discussing memberships in various state associations, it is apparent that less than half will take advantage of this opportunity.  Cary Kuhlman, Executive Director of the Medical Association of the State of Alabama (MASA) said there were over 11,100 licensed physicians in Alabama, but only about 6,800 are members of the medical association.  Lisa Beard, Executive Director at MGMA-Alabama, said that the membership represents approximately 500 medical practices.  Knowing that many are members but do not participate, along with those that are not even members, what do they do for information?  I probably know the answer to that question, but that is another story – and I would not want to be involved with those practices!

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