Physicians Need to Focus on the Business of Medicine
By: John Roth, MD
The current economic downturn and looming healthcare reform should motivate physicians to carefully examine their business and make changes to enhance their practice. This should include analyzing their billing, collections, and accounts receivable and the methodologies used to sustain their cash flow. Physicians should review and reread their contracts with payers and using explanation of benefits( E.O.B.’s), determine if their reimbursements are at the contracted rates. An analysis of those rates should be done to determine which payers are reimbursing the practice at acceptable levels. Physicians should consider contracting with outside sources, such as the Center for Healthcare Reimbursement, to determine if their reimbursement is comparable to those in similar specialties in their geographic region. Those who are not satisfied with their payments should open negotiations with their payers.
Practices should develop annual budgets and examine all expenses, looking for ways to lower costs in order to improve the bottom line. Joining buying groups may help in lowering the costs of supplies etc. In addition, physicians should review their coding profiles in comparison with those in their specialty to determine whether they are in line with their peers. They should annually be aware of changes in the codes and code accordingly.
Healthcare reform already has some funding prioritized for electronic medical records(EMR) in the stimulus act. For those practices that do not have EMR, now is the time to begin investigating the programs available for their specialty and planning their implementation and funding. Whether EMR will enhance payment or not by documenting coding, it certainly will help physicians document their diagnoses and treatments and improve their communication with others and reduce some malpractice risks. It may be necessary to hire consultants to determine which EMR is best for a practice and to assist with it’s implementation. As the government increases its quest for quality, documentation will be a vital part of medical practice. As they say, if it isn’t written, it didn’t happen.
All physicians should become aware of the quality markers being developed for their specialties and actively incorporate them into their daily work. This leads to the practice having in place proper procedures for handling lab results, referrals, informed consent, and patient followup. Physicians need to be sure their staff is properly trained in all these facets, and that communication with patients is done respectfully, efficiently, and in a pleasant manner.
For many years physicians have practiced with minimal regard for the business aspects of their work and have concentrated on taking care of their patients. While this was a noble method in the past, it has resulted in our becoming frustrated with the increasing costs, paperwork, referrals, and contractual controls of managed care. Only by paying greater attention to the business of medicine can we hope to be successful in the future.
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