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Issue Date: March 2007

Physicians Need Resources at Point of Care
There’s no doubt that physicians today are pressed for time. The New York Times recently carried a short report, “Insights: The Ticking Clock in the Doctor’s Office,” which cited a study in the journal of Health Services Research on the topic. Researchers studied video tapes of 400 visits to primary care doctors and found that patients visiting doctors have many questions but insufficient time to get answers, spend an average of 16 minutes with doctors, raised an average of six subjects per visit, and got an answer on one subject.

In the study, the physicians spent five minutes on one major subject but less than one minute on the other five, and devoted less time to secondary subjects so they could stay on schedule. Of course, rheumatologists, oncologists, allergists, pulmonologists, and physicians in other specialties have many similar challenges. Often, there are more patients to see than physicians can accommodate each day. For most physicians, “Time is always in exceedingly short supply,” as the late management consultant Peter F. Drucker once said.

Web Portals Facilitate Communication
The results of a poll published last year showed that more than half of the adults surveyed said a physician’s use and investment in technology would influence their choice of a doctor to some extent or a great deal.
The Wall Street Journal Online/ Harris Interactive Healthcare Poll published in September also showed that a significant majority of patients would like to receive e-mail appointment reminders from doctors, be able to schedule appointments via the Internet, and receive results of diagnostic tests online. In addition, a majority also said they wanted to communicate with physicians online, have access to medical information from an electronic health record, and be able to transmit information (such as blood pressure or blood glucose levels) from electronic monitoring devices.
Increasingly, health care organizations, including physician groups, are adding information tools to their practice management systems, most commonly electronic health records (EHRs) and the ability to order prescriptions electronically.

Satisfaction Surveys Can Boost Volume
A patient satisfaction survey can help physicians learn much more about their practice than they can gain from almost any other source. “It has been said that the guest sees more in an hour than the host sees in a year,” notes Susan Keane Baker, a practice management consultant in New Canaan, Conn., and an expert in the role service quality plays in physician practice management. “Patients are a wealth of information, not just about the practice, but about other health care organizations as well. Without feedback from patients, it is easy to be lulled into a feeling of complacency about how the practice is doing.” Baker is the author of Managing Patient Expectations: The Art of Finding and Keeping Loyal Patients (San Francisco: Jossey-Bass, 1998). For rheumatologists, oncologists, allergists, pulmonologists, and other physicians, a patient satisfaction survey helps measure patients’ perceptions of their practice. Physicians can use the data to implement service improvements or enhancements that will foster patient loyalty and to demonstrate to health plans and other payers the quality of patient care they deliver. Furthermore, physicians may find that the mere fact of having a good survey (which shows an interest in patients and their opinions) could cultivate an increase in patient volume. Such surveys may be even more important today than they were in the past because patients can report on physicians anonymously on Web sites that publish results without ever contacting the physicians involved.

Physicians Develop Survival Strategies
As income declines, physicians are finding new and innovative ways to continue to provide patient care and make the practice of medicine moderately profitable as well.

Some physicians are eliminating the health plan middle man by delivering care to patients who pay cash each month for easy access to their doctors. Others are using technology to improve efficiency.

FP Succeeds as a “Personal Doctor”
Interview with Michael Stein, MD, who once ran a typical primary care medical practice in Salem, N.H. This interview was conducted by Richard L. Reece, MD, Editor-in-Chief of Physician Practice Options.

Billing and Coding Strategies Crucial for Practice Success
Physicians can find it challenging to tend to practice management concerns while focusing on providing high-quality care to their patients. By spending some time each week on establishing processes to ensure careful billing, coding, and other practice management functions, however, physicians can ensure that their practices will run smoothly and successfully.

“Physicians today face a number of external pressures, including declining reimbursement, increased government regulation, an increasingly savvy patient base, and increasing costs,” says Kenneth T. Hertz, CMPE, a senior consultant with the Medical Group Management Association (MGMA) Health Care Consulting Group who has worked with many medical practices to improve their business functions. “All of these factors together are resulting in significant economic pressures on medical practices across the country. Focusing on the performance of the practice is necessary to ensure that the practice remains viable and able to serve patients into the future.”