OPTIMIZING A UROLOGY OFFICE PRACTICE JUAN A REYNA MD PRESIDENT EMERITUS-UROLOGY SAN ANTONIO...
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Transcript of OPTIMIZING A UROLOGY OFFICE PRACTICE JUAN A REYNA MD PRESIDENT EMERITUS-UROLOGY SAN ANTONIO...
OPTIMIZING A UROLOGY OFFICE PRACTICE
JUAN A REYNA MDPRESIDENT EMERITUS-UROLOGY SAN ANTONIO
PRESIDENT ELECT- LUGPA (AIUG)
Who Are We?I just resigned as the president and CEO of USA.
I began the practice by myself in 1981 in the heart of San Antonio
We grew one by one and later by merger and acquisition to 30 urologists, 8 clinics, a major cancer center and almost 200 employees
I am president-elect of LUGPA
I am also on the board of AICC
Starting Point
Will optimization improve the quality, access and convenience to your patient
The optimizations should be integral to improving the care of your patient. It has to be more than just about the money
As you begin to optimize and integrate be careful to garner support and in the current political environment be ready to defend and protect them
Do Not Forget That We Are A Service Industry
Everyone of you has your own style of communication and interacting with the patient
Have your ever measured your patient’s level of satisfaction
The most critical thing to do is make sure that your entire organization is meeting your patient’s needs. You may think you are a great doctor but your staff may be turning people off or is it you
QUESTIONS TO ANSWER
WHO IS GOING TO TAKE CHARGE?
WHEN IS THE BEST TIME TO DO THIS?
WHAT DO YOU ALREADY HAVE?
WHAT IS YOUR STRUCTURE?
WHO IS GOING TO DO THIS WITH YOU?
WHO IS GOING TO TAKE CHARGE OF THE PROCESS
Many urologist are not skilled in the area of optimization and development
If this in is your skill set, go for it
If not, get some help (AUA, MGMA, MBA, LUGPA)
Consider starting with a business plan for the next 2, 3 or 5 years. Setting goals are important
NO PAIN, NO GAIN.............NO HELP
When Is The Best Time To Optimize and Develop a
PlanWell, if you have not done it in the last 2 years, you are already behind. In fact, it should be an ongoing process
There are few things that you can do that will not cost you money. So be prepared for some capital outlay and you may want to consider a yearly budget and some dedicated staff people
I truly feel that the new ACA with all its shortcomings will provide opportunities. Every crisis has brought us opportunities
What Do You Have Already?
Aside from an efficient and courteous staff, pleasant surroundings and some basic equipment
Is your EMR in place. Talk about a game changer. Few advances in our offices have caused the level of whining early on. Now, we cannot live without it and it actually brought each of us an extra $18,000 (ACA)
Do you have a web site
Do you participate in social media (Linked In, Facebook and twitter)
People Are Looking
An amazing number of patients will google you and then go to your site to see what you actually provide or do not provide
Other professionals will want to know who you know and what you know. Bragging is OK
People are documenting their experience in your office in a very public way and in potentially less than flattering tweets
People Are Wanting
One stop shopping when possible
Do you have a lab or at least do your own blood draws
Do you have full ultrasound capability to include biopsies and/or do you have CT. Conventional X-ray is a lost leader in this area
Do you have a surgery center
Specialty WantsDo you do infertility
Do you have laparoscopic and robotic surgeon
Do you have females in your practice/are they specialized
Do you do the big cases or refer out
Do you match your demographic*
Do you provide radiation therapy/cancer center
Do you have your own lithotriptor
Specialty Wants
Do you do significant volumes of prosthetics
Do you employ or contract with a radiation oncologist
Do you provide urodynamics. Our NP who runs this for us bills more than any doctor in the group all while going back and getting her doctorate degree
Do you provide neuro modulation implants or PTNS
Internal Wants
Do you have a pathology lab
Do you participate in research/clinical trials
Do you have a competent administrative team
Are you working harder because your compensation methodology promotes productivity
If you are, do you have a work flow analysis to facilitate appropriate changes to the clinic
WHAT IS YOUR STRUCTURE
How is that working for you
What is your geographic approach. Ivory Tower vs city wide clinics
Governance model. CEO/COO with board support or board centric with President picked by the board
What drives your decision for new partners. Have you had someone examine your time to next visit
How Big Do You Want To Be
Single urologist vs small group vs large urology group
I have had all 3 opportunities
Large group provides for the addition of ancillary services. We like to call these integral services in an integrated model to optimize services for your patient while benefitting from the revenue of these services
“Mas peros, mas pulgas” larger can be advantageous but has its complexities
New mindset: it has to be about the group
Integrate Model
This model has allowed us to provide more services in house with the overall result being a happier, more compliant patient
We are at the point that these services now represent a significant portion of our income
Monitor closely such that others will not accuse you of self referring for monetary gain only
The data we have shows no difference between how often we use these service vs non integrated urologists
Conclusion
For maximum optimization consider the integrated model
Do it first to take better care and provide convenience for your patients
We have truly optimized our office practice while having a happier patient and maintaining a high quality level of care
THANK YOU
QUESTIONS?