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Posted By Richard M. Goldfarb, MD FACS,
Monday, December 19, 2022
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Dr. William L. Goldfarb would insist that you call him Bill. It was the early 1940s when Bill, the son of Russian immigrants, graduated from Central High School in Philadelphia, Pennsylvania. As an excellent student, he matriculated directly to Temple University School of Chiropody, beginning his lifelong work in podiatry. However, like many from the Greatest Generation, Bill's education was interrupted when he joined the United States Army as a medic in Texas with several podiatry classmates. Fortunately, Bill and his comrades returned and graduated from Temple as lifelong friends. Bill opened a private practice in December 1948 in the growing suburban Philadelphia community of Bristol, Pennsylvania. He became an active member of the Pennsylvania Podiatric Medical Association ("PPMA"), later serving as its president. Bill was a visionary and zealous advocate of the podiatric community. He authored Podiatric Service Reporting Manual with Relative Value Guides, published by the PPMA in 1974, and was instrumental in having podiatric services recognized and paid for by insurance carriers. In addition, he dedicated a significant portion of his career to podiatry education. He was known for conducting an annual educational seminar, the "Hershey Seminar," to allow his colleagues and graduates to become board certified. Bill was also a dedicated husband to his wife, Lorraine, and father to his children, Richard and Shelley, who viewed their father as a genuinely larger-than-life figure. As adolescents, Bill's children fondly recall his frequent trips to Harrisburg and the day Bill's portrait was raised in the halls of the PPMA headquarters in Camp Hill. Bill's son-in-law, William S. Lynde, DPM, and grandson, Michael J. Lynde, DPM, also attended Temple University School of Podiatric Medicine, continuing Bill's legacy to this day at their private practice in Newtown, Pennsylvania. Bill's daughter became a schoolteacher, while his son, Richard M. Goldfarb, MD, FACS, became a surgeon and continues his father's dedication to the betterment and service of the medical community. He would have been so elated to see the success of his four grandsons. Richard's son is in pharmaceutical marketing and advertising, and Shelley's sons are in finance, podiatry, and an attorney. Bill's wish for incoming students would be that in addition to private study, students should be active in fostering and creating a community that facilitates open dialogue and learning from one another. Bill was the type who would have loved and embraced the technological advancements so critical to the improvement and advancement of society, science, and medicine. He would be so proud to celebrate 50 years of the Goldfarb Foundation.

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Posted By Jeffrey Lehrman,
Thursday, November 10, 2022
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Providers and their staff typically need to know where to find guidance regarding coding, coverage, medical necessity, limitations, documentation requirements, and more. Often this guidance differs based on the third-party payer. However, in many cases, this guidance is free and readily accessible online.
Medicare
Medicare is a national program, but it is administered locally by Medicare Administrative Contractors (MACs). There are seven Part B MACs in the United States. Some of the Part B MACs have large jurisdictions, including 13 states, and some have small jurisdictions, including only two states.
Providers and staff must know which Part B MAC has jurisdiction over their state. When navigating to Part B MAC's website, providers can find a list of policies. Part B MAC's Local Coverage Determinations (LCDs) can be found here. LCDs guide coverage, medical necessity, limitations, documentation requirements, and more. In many cases, an LCD is accompanied by a Local Coverage Article (LCA) that offers guidance regarding coding. Part B MACs choose to issue LCDs for certain services. Different Part B MACs issue LCDs for additional assistance. For example, one Part B MAC may have an LCD for ulcer debridement, while another may not. Perhaps even more important to understand is that two different Part B MACs' LCDs may have additional guidance. This is why it is so essential for providers to look for advice from their own Part B MAC rather than from national forums in many cases. Furthermore, providers in one Part B MAC's jurisdiction may not find the correct guidance if speaking to a colleague about coverage guidelines if that colleague practices in a state that falls under the jurisdiction of a different Part B MAC. A provider in Pennsylvania may be subject to guidelines other than a provider in New York State for certain services.
The Part B MAC with jurisdiction over Pennsylvania is Novitas Solutions. It is good practice for providers to review the list of LCDs issued by their Part B MAC. Pennsylvania providers can find a list of active Novitas LCDs here:
https://www.novitas-solutions.com/webcenter/portal/MedicareJL/LCD?type=active
It is also recommended that providers and their staff subscribe to the e-mail listserv of the Part B MAC, which has jurisdiction over their state. Updates to these coverage determinations are shared via these listservs. Pennsylvania providers can and staff can subscribe to the Novitas e-mail listserv here:
https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00007968
When providing Part B services to Medicare beneficiaries, guidance regarding coding, coverage, medical necessity, and documentation requirements comes from the Part B MAC, not from Medicare. Most of the time, the question, "What are the Medicare guidelines for ________" is the wrong question, and instead that question should be, "What are my MAC's guidelines for ________?" Most of the time, the question, "How frequently does Medicare allow payment for ________" is the wrong question, and instead that question should be, "How frequently does my MAC allow payment for ________?" Most of the time, the question, "Does Medicare cover ________" is the wrong question, and instead that question should be, "Does my MAC cover ________?"
DMEMACs
Just as the Part B MACs issue LCDs, the DMEMACs do the same. There are only two DMEMACs in the United States, and Pennsylvania falls under the jurisdiction of Noridian DME MAC. It is recommended that providers who prescribe and supply DME review the list of LCDs issued by their DME MAC. Pennsylvania providers can find a list of active Noridian DME LCDs here:
https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=5&contractorNumber=389%7c1&lcdStatus=all
Furthermore, it is recommended that providers and their staff who are involved with prescribing and supplying DME subscribe to the e-mail listserv of the DME MAC, which has jurisdiction over their state. Updates to these coverage determinations are shared via these listservs. Pennsylvania providers can and staff can subscribe to the Noridian DME MAC e-mail listserv here:
https://naslists.noridian.com/list/area.html;jsessionid=705DA7FB579C1D830D30F96AE8E13EF7?lui=ez723q4d&mContainer=2&mOwner=G30392x2n39372t36
Non-Medicare Payers
Non-Medicare third-party payers may also issue coverage determinations. These are often found on the website of the third-party payer. However, in some cases, third-party payers do not issue coverage determinations and instead default to the coverage guidelines of the Part B MAC policies, which have jurisdiction in the state where the services were provided. Therefore, providers should check with each third party to whom they submit claims to see what coverage policies each of their third-party payers have issued. Sometimes, the coverage guidelines for the same service or product may differ from one patient to the next, even within the same practice in the same state, if different third-party payers have other coverage guidelines for the same service.
No Coverage Policy
Sometimes, a third-party payer needs a coverage policy for a specific service. For example, none of the Part B MACs have an LCD for the service of a bunionectomy. In the absence of a coverage policy, most third-party payers, including the Part B MACs, state coverage, and frequency considerations are based on medical necessity. This includes the presence and documentation of the medical need of the service performed and the product dispensed.
Summary
Unless providers outsource this type of work, they need to know where to find the third-party payers' coverage guidelines to whom they submit claims. When it comes to Medicare beneficiaries, this means knowing who the provider's Part B MAC and DME MAC are. For non-Medicare payers may require reviewing some policies, depending on how many third-party payers the provider submits claims to. Providers can stay current with these policies by subscribing to the listserv of the third-party payer.
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Posted By Jeannette Louise,
Monday, October 10, 2022
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Podiatrists starting a new practice or continuing to grow an existing one are accepting and seeking new patients. Marketing to attract new patients is vital. Creating a strategy to attract new patients can be nerve-wracking, especially when dedicating most work hours to patient care and office management. Marketing agencies may knock on your door, pitching campaigns that sound good. Often the costs seem steep, and you may be uncertain what works. Fortunately, you are a part of an association here to support your career by offering opportunities to network with other podiatrists and obtain relevant news! Many techniques and strategies could work for you. Here are three ways to attract new podiatry patients. 1. Create and maintain a robust digital presence. If you do not already have a website, you will want one. The website should include bios, office hours, contact information, location information, and information about conditions treated. If you are a podiatrist that does not have your practice, you can still benefit from getting an updated headshot or updating your bio online. Patients choosing a podiatrist will want to see your face and know a little about you and your qualifications before making an appointment. 2. Get involved in your community. What opportunities are there to network to get your name out there? Perhaps you could join your local chamber of commerce. Consider hosting an event and inviting potential referral partners to see your location and learn more about your services. Consider sponsoring a 5K and distributing literature about your practice. 3. Leverage the opportunity to increase referrals through existing patients and other reputable sources. Your existing patients can be your most significant source of referrals. Prospective patients often do not seek a podiatrist because they don't know about the treatment of podiatry and conditions. Existing patients aware of the conditions you treat can then refer loved ones to your practice. Ensure your office has adequate signage, brochures, and materials that incorporate all your offerings. Some podiatrists have found a strategy and a budget that works well for them! When meeting with an advertising agency, one should ask questions when you are unsure. If you don't know what questions to ask, perhaps you have a friend or mentor, such as another podiatrist or business owner, who can give you some advice! Keep working hard to get your name out there, and your practice will achieve growth, PPMA is an association dedicated to the greater good of podiatrists in Pennsylvania. To learn more, visit PPMA at www.ppma.org.
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Posted By Lynn Homisak, PRT, SOS Healthcare Management Solutions,
Monday, October 10, 2022
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Crisis! No one wants to think about a crisis. Unfortunately, it's usually, when faced with an emergency, that we stop and think about doing something about it. It's too late. According to the Boy Scouts, "Be Prepared" means "you are always in a state of readiness in mind and body to do your duty." Similarly, we in the medical profession should follow that advice and "be prepared" for unexpected crises because often, it's not IF it happens; it's when. If you think, "Oh, that can't happen here," think again. How often have you seen PM news report cars plowing through podiatry office buildings and demolishing a practice? Granted, this crisis example may be extreme, and frankly, I'm at a loss regarding how one prepares for that catastrophe. However, there ARE emergencies that we may face that are much more common. It is in these moments of potential crisis that preparedness is our friend. How prepared are you in these more likely situations: Patients in medical distress, fires, computer crashes, destructive weather, data loss from power outages, injuries and accidents, chemical spills, belligerent patients, theft, bomb scares, terrorist attacks, active shootings…pandemic outbreaks?? More specifically, have you created a Disaster Action Plan for each one? If not, when would be an excellent time to get started? I could outline some comprehensive steps to take in each of the above situations, but space would not allow it. Instead, here is an overview of measures for the more common scenarios that you should consider creating a disaster action plan for your office. By the way, making this plan to avert a crisis is an excellent and worthwhile topic for you and your staff to discuss at your next staff meeting. Please put it on the agenda. Medical distress: Have a recognizable verbal signal, "STAT," that alerts everyone in practice to be present and aware. Upon doctor's direction, follow emergency protocol (dial 911, retrieve O2, Ambu bag, emergency kit, etc., assist doctor, calm patients.) Everyone should have a distinctive role to avoid confusion, running around helplessly and wondering what to do. Fire: Remember grammar school and participating in fire drills? Why should that not apply here? Know where your fire extinguishers are, alert the fire department (911), help all patients evacuate the building and do not re-enter without an OK from the fire department. Have annual inspections, and create and post an escape plan. Injuries and accidents: What if a staffer on a stepstool falls and is injured? Or does a patient slip on a wet floor or trip to the treatment room? Make sure the person is offered outside medical attention if needed. Then take measures to prevent similar injuries. All accidents should be reported immediately to the doctor, office manager, and OSHA coordinator, and an injury claim should be filed. Chemical spills: One of your staffers are setting up for a matrixectomy when the phenol bottle tips over and spills over the counter, onto the floor, and their skin. Every office should have a spill kit with PPE and materials to avoid spread. Follow MSDS instructions for that chemical, and alert people nearby. If needed, utilize the eyewash station, properly dispose of hazardous waste, and report spills to a manager and OSHA coordinator. Belligerent patients: We tend to tolerate the destructive behaviors of some patients. However, it should not be ignored if patients demonstrate abusive – physical or verbal – personalities with the doctor, staff members, or another patient. Rather than the victim taking matters into their own hands, make it clear WHO should deal with the accused individual and then WHAT further action needs to be taken. If setting boundaries does not work and you cannot ease the situation, notify authorities and discharge this individual from the practice. In each case, it helps to "Be Prepared." Train now and be safe, not sorry. The goal is to keep you, your staff, and your patients safe. Note: I have a 9-page (double-sided) "Emergency Action Plan Template" to help you customize your specific plan. Just email me for a complimentary copy – lynn@soshms.com.

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Posted By Jan Golden, DPM,
Monday, October 10, 2022
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It is no secret that the cost of everything has significantly increased over the past two years. We see it daily when we fill up our gas tanks, go to the grocery store, go out to dinner with our families, and go on a vacation. It is evident that hotel costs doubled in rates from the previous year, and the list continues.
Inflation continues to affect not only our personal lives but also our professional lives as private practitioners/business owners. The big difference between us as private practitioners/business owners and the examples I gave you is that we cannot adjust our prices to compensate for the increased cost of supplies/equipment in our offices. For example, restaurants can increase the prices on their menus to make up for the difference in their increased cost of items/goods.
On the other hand, we can not increase our copays or reimbursements from the insurance companies because we are on a controlled fee-based schedule set by Medicare and the insurance companies. In my private office, the cost of medical supplies, office supplies, and equipment has increased significantly compared to 2020. Something has to be done! As many of you know, there is a national injectable lidocaine shortage. I read some information online about why we have difficulty finding and buying one of the most used injectable anesthetics in our practices. According to https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=88, Pfizer has lidocaine presentations on shortage due to manufacturing delays and increased demand. According to https://pipelinemedical.com/blog/why-is-lidocaine-in-shortage/ “there was an increase in the demand for anesthetics during the pandemic. Many hospitalized intubated patients required anesthesia to avoid the discomfort and pain associated with it. This increased demand, resulting in a less obvious but anticipated shortage of local anesthetics such as lidocaine.”
As we all know, what happens when there is a supply shortage and increased demand? Prices will skyrocket. I’m anticipating this is what we’ll see happen with this lidocaine shortage and the other medical supplies that have significantly increased. I also recently saw an article about our state representatives and their salaries in our local paper. One sentence captured my attention. “State representatives serve two-year terms with the salary this year set at $95,432.14 and raised annually by the inflation rate.” It got me thinking that we, as healthcare professionals, who worked through the beginning and most challenging stages of the covid pandemic, ironically, are the ones who are unable to get our reimbursements adjusted due to inflation, unlike the previous examples mentioned in this article. My goal is to help our medical professionals/business owners continue successful practices by increasing our reimbursements from Medicare and other insurance providers based on the current inflation rate. I request that our PPMA members have your accountants put together a cost of supplies report from 2020, compare it to 2022, and email it to our executive Director Michael Davis. I would also like to have the APMA pair up with the AMA and fight for our private practitioners/business owners of all medical professionals & specialists, from primary care doctors to dermatologists, neurologists, cardiologists, etc. Any recommendations or suggestions would be helpful from our PPMA members. I appreciate your support of PPMA, and we will continue to do whatever we can to keep our profession thriving and responsibly working together!

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Posted By Lynn Homisak, PRT, SOS Healthcare Management Solutions,
Saturday, July 16, 2022
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It’s not my job!” Lynn Homisak, PRT, SOS Healthcare Management Solutions “It’s not my job!” What do those four little words do to YOUR insides? For me? It rivals the shrill sound of fingernails raking slowly across a blackboard. It does not matter who the recipient of this toxic phrase is – whether an employer or a co-worker – it is irritating to the senses to say the least. Sadly, it is also why many doctors are reluctant to create written job descriptions for their practice. Their concern is that assigning a fixed list of duties puts limitations on their staffs’ efforts; so (in their minds) it is better not even to have one. Well, I could not disagree more. Allow me to explain. One of my functions when I go into a medical practice is to determine if tasks are well delineated to assure each employee contributes to a seamless workflow. When I ask to see staff job descriptions, my hope is to receive well-composed, updated documented narratives for each job title that includes the salary range, educational requirements, and necessary technical and soft skillsets for that position. What I am given instead is an outdated task list or nothing at all. Why does this matter? Because it is never surprising to find that without a ‘comprehensive job description’ there exists; a redundancy of duties, system breakdown, confusion, imbalanced workload, and unqualified personnel (often not their fault). Add to that…disgruntled staff (and docs). It is at the initial hiring interview, that employees need to be informed of what the prospective job entails. This is best accomplished with a well-written job description that outlines the distinction between primary and secondary tasks, responsibilities, expected outcomes, wage expectancies, and protocol associated with the position. It is far more sensible to make applicants fully aware of job expectations BEFORE you hire them to avoid potential surprises after they have accepted the position. In many cases, this “surprise” has led to staff leaving shortly after their hire. The hiring interview provides the perfect opportunity to also discuss the workplace culture; explaining that regardless of the “job position” their role as a team member requires stepping in and helping where and when needed. Sharing your…yes, “well written job description” with them at this point provides insight. Insight for you and the applicant whether they are suitable for the position based on your needs and requirements. This document also serves as a guideline, helping new employees to familiarize themselves with criteria upon which their performance will be evaluated and preventing misunderstandings down the road. That brings us to the offensive phrase, “it’s not my job.” This destructive attitude (and make no mistake; it IS an attitude) can flow from an employee’s poor work ethic or surface later as the product of an unsupportive work environment (i.e., poor management, existing employee cliques, etc.). It has little if anything to do with a written job description. It is important, however, to clarify at the onset that the scope of their job may extend beyond the tasks listed. Adding “and any other duty required of me” as a catchall phrase at the end of each job description, makes it clear to employees that if additional duties are required, they are expected to pitch in. In other words, “it’s ALL your job.” This destroys the “it’s not my job” mentality before the mentality destroys the practice. It is an effective concept provided it is clearly pointed out, and acknowledged, preferably in writing, by each employee. Ideally, it would make more sense to hire people who demonstrate soft skills, are team and purposeful; have like-minded personalities, and view their employment as a career, not as just another “job.” This information is not always evident in their resume. That is why striking up a shared conversation with applicants is far more eye-opening in understanding their values and aspirations and determining whether they would be a good fit for the practice. Raise your hiring standards by establishing what type of people you want working for you. Do not settle. You deserve better. Don’t you deserve the best?! Poor or insubordinate employee behavior is not only unacceptable; it is destructive and any employer willing to ignore or put up with it, is responsible for creating an undesirable workplace culture. Rest assured, nothing crushes the productivity of a great employee quicker than watching their employer tolerate a bad one. If you still find that your employee succeeds in making the claim “It’s not my job” as a rational position, it is (quite simply) because they can. And at that juncture, the bigger question is…who lets them?
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Posted By By Lynn Homisak, PRT,
Wednesday, July 13, 2022
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“Staff Attitude?! Whatever!” Staff attitudes and behaviors most definitely have a direct impact on the attitudes and behaviors of our patients. In fact, studies showing over and over again that their attitude alone can play a major role in patient satisfaction, and that’s got to make you wonder just how adversely a patient is affected when exposed to a staff person who rarely smiles or one who thinks that an irritating, nail-scraping-chalkboard “whatever” response is ever appropriate! I’m sure that any malpractice insurance company would agree that an employee’s confrontational attitude is enough of a reason to turn a patient’s unanticipated surgical scar or unexpected (surprise) bill into a full-blown malpractice lawsuit; whereas, a more attentive (caring) attitude can actually help to smooth things over and prevent one from happening.
While staff cannot be expected to carry the ball alone through these types of conflict, everyone must stop and realize that (just like the doctor), their individual attention and handling of each patient is impressionable and even pivotal in “what might happen next.” In short, the attitude of your staff can make or break your practice.
Make no mistake. The attitude of the practice starts at the top…with the doctor. And you’ve heard this before…it’s not the doctor’s job to make staff happy, only to provide an environment that allows them to be happy. So, if ongoing quality patient relations and providing exceptional customer service are important to you; and taking measures to improve the overall attitude of your practice is something you want to seriously take hold of, here some suggestions to get you started:
Be very particular when hiring staff and trust your gut-instincts. If they project a warm, caring personality during the interview, most likely they will carry that through to your patients. If you see them as unfriendly, non-caring and inattentive, so, too, will your patients. Thinking that you will “just hire them temporarily” (in a pinch) until someone better comes along…or expect that their attitude will approve in time is risky. Could be their “temporary” employment can cause some long-term damage.
Once developed, do not take your employer/employee relationship for granted. Whether your staff is there for 30 days or 30 years, it should always be one that is built on mutual respect…with plenty of open communication, including making the time to listen or hear them out.
Encourage them to achieve a greater knowledge of their work and profession – through certification, association membership, educational and motivational seminars, in-house training, webinars, etc. Don’t underestimate staffs’ personal and professional growth. It is an important piece of feeling good about themselves, which in turn motivates self-esteem, job satisfaction and a positive job attitude. Stagnancy does the complete opposite.
Schedule regular employee evaluations to ensure that everyone’s needs and expectations are being met. Evaluations are needed to help staff improve and move the practice forward. Sadly, too many staff complain that they never get evaluated. Their gripe? “I just want to know how I’m doing and if I need to improve in any area.” Step up to the plate and do evaluations for your staff. Do them for the practice.
Openly and honestly discuss their salary and/or benefits on a regular basis. I suggest doing this during their annual evaluation. Make sure increases are based on a variety of qualifying factors (including job performance); not just longevity. If anyone would like to receive a copy of our Compensation and Benefits Statement to help employees understand their full compensation package…please email me at lynn@soshms.com.
Help build their self-worth through consistent doses of praise for jobs that are “well done!” Verbal appreciation (a simple “thank you”) is as good for the soul as it is music to their ears and can surely increase the quality of an individual’s work performance.
Everyone makes mistakes. Point theirs out in private; NOT public and remember that mistakes are also opportunities to learn and improve. Especially do not ridicule, admonish or embarrass them in front of your patients or their co-workers. Take into consideration that these insensitive (sometimes impulsive) actions not only point out their weaknesses to uninvolved observers, but it makes you look like a bully employer.
Make an all-out effort to include staff as part of your practice “team” with the understanding that what benefits the whole of the office ultimately benefits them individually. Listen and be open to their ideas. Doing so not only makes them feel valuable, but their ideas may actually enhance practice growth and success.
Help them brush up on their communication (and attitudinal) skills when dealing with different types of personalities by insisting they attend seminars focusing on this very important aspect of their job. You might even consider going with them, for it truly is a financial investment that benefits everyone and pays back every single day…ten times over!
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Posted By Kimberlee Hobizal, DPM, MHA, FACFAS,
Friday, May 20, 2022
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Increasing Office Efficiency The top five tips you need to know for running your office correctly As a physician, you have many responsibilities, from patient care to business management. A well-run practice provides peace of mind, increased revenue, and happier patients. However, finding that path to a smoothly operating and efficient office is not easy. This article will provide tips that I have found helpful and pertinent to a productive office space. These tips include a thoughtful blend of embracing new age technology coupled with reasonable ole bedside manner, quality of care, and improved patient experience. 1. Online Scheduling - as a mother of three, it is often difficult to have a free minute to make a phone call, much less finagle through work and school schedules to find a mutual time and date while talking to an office team member on the other line. Having online Scheduling is helpful to the patient. It lessens the load on your administrative team, allowing those team members to focus on physically present patients in the office. Of course, patients can still call the office to ask essential questions, but this will decrease calls and scheduling errors. 2. Provide online email and text reminders - this will drastically reduce the number of missed appointments and no-shows. Further, if a patient needs to cancel, you can easily have a link sent for a reappointment reminder. 3. Modernize new patient paperwork and X-ray appointments - providing the patient an online platform to complete new patient paperwork or sending this via mail weeks in advance allows the patient to complete these questions at home while reviewing medications, all at their leisure. I have also found it helpful to schedule patients 15 minutes early for an “X-ray” appointment before their appointment time. This strategy allows the physician to remain on schedule as closely as possible. 4. Better your break room - what keeps the office running? Staff! Workplace burnout is both bad for your employees and your profit margins. Providing a welcoming environment offers your staff a small getaway from patient demands and a relaxing place to eat lunch or unwind. This update can be as minor as a sofa and a single brewer coffee machine. Your staff and their well-being will be an investment in your practice. 5. Cross-train employees - this proves to be a “well worth it” practice that will pay off long term. It does require an initial investment and learning curves, but a well-trained employee will be able to fill in when a coworker calls off sick, and another is on vacation. Investing in training and development shows your practice values the culture of flexibility and teamwork. Delegating your office manager the task of ensuring each employee cross-train a colleague over time (possibly at slow times like midsummer/Christmas) to cover duties increases appreciation of each important office role that allows the office to run smoothly. These tips will provide the physician with the path to a more efficient and productive practice coupled with a thriving work environment. Furthermore, including staff in monthly meetings and valuing team feedback is equally successful in encouraging better practice management and better patient care. Remember, anything that is worth chasing takes time and enthusiastic support. Working toward the goal of efficiency will provide stamina to propel forward in this ever-changing field we call health care.
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Posted By Jeannette Louise,
Wednesday, May 11, 2022
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I am reminded of Robert Fulghum's "All I need to know I learned in Kindergarten," whose core life principles can (and should) be practiced daily. You know, share everything, play fair, do not hit people, put things back where you found them, clean up your mess, do not take things that are not yours, say you are sorry when you hurt somebody. But life's lessons do not stop there. With knowledge and experience as teachers, we can learn something new every day. Or at least we should! Sometimes the best management lessons are found when we least expect them and in the most specific and unpredictable settings. Simplicity is where the true genius lies. Let me explain. What I learned from going to my hairdresser: Some people do not belong in the receptionist's chair. As I sat in my stylist's chair, it was painful to my management consultant's ears to overhear how the receptionist answered her phone. Her welcome opening was hardly welcoming. There was no greeting, no inflection in her voice, and her response to what I suspected was a request for an appointment became a missed opportunity. "No, there are no openings." Period. No offer to look ahead in the schedule, no recommendation to accommodate this customer, no thank you for calling! Barely a goodbye. Does the owner even know that her "style" is turning customers away? As the assigned receptionist of a beauty salon OR a doctor's office, they are the "Director of First Impressions"; good manners and a pleasant, polite, engaging, helpful personality should be mandatory. Their attitude can make or break a business (or a practice). Some off-hours training is crucial, where role-playing and appropriately overseeing phone calls and turning them into appointments can be taught. Sadly, it is not. - A confident professional can work and talk at the same time.
I have been to some hairstylists who think that they need to stop working to have a conversation with their customers. This standstill approach to hair cutting involves stepping away from the customer's head, poised with scissors and comb in hand, to tell (or listen to) a story. Being a good listener is one thing, but, no joke, it turns a one-hour appointment into two. Similar complaints have been made against podiatrists who wield a scalpel or nail clipper until they finish their conversation. Little wonder that patient schedules sometimes run behind. What I learned from going to my dentist: - A patient's fear and trepidation can be minimized, and adherence optimized.
Introducing scary needles and instruments or not fully understanding WHY a procedure is necessary can be a frightening experience for a patient. However, the dentist (or doctor) who takes the time to explain what will be done thoroughly communicates what one can expect to feel during and after the procedure can put the patient more at ease. What is more, patients seem more willing to adhere to associated recommendations when they understand the consequences of non-compliance. What I learned from going with my mother to her doctor: - Doctors need to manage their time with their patients.
Patients love when doctors take an interest in them and engage in personal stories and conversations. Patients DO NOT love when they become prisoners of these personal stories and discussions for over an hour. OMG, in this case, TWO hours! Many patients will walk out if they are kept waiting due to mismanaged time. Building customer relations does not mean talking incessantly. It means mutual respect and knowing how and when to draw the line between enjoyable conversation and long-winded rambling. Oh yes and staying on schedule is a big plus. What I learned from going to a restaurant: - Hiring people who love what they do pays off.
A restaurant experience has so much to do with the served food. It is also about the people who serve the food—employees who love what they do exceptionally reflect strongly on the business. Excellent, efficient service combined with good-natured personalities are substantiated reasons for customers to return and refer friends and family. What I learned from being a management consultant: - If you do not change anything, nothing will change.
I applaud doctors who want their practice and staff to be more efficient, productive, and consistent in their standard protocols. They acknowledge that a pair of outside eyes can offer new perspectives and ideas, help create an on-board team mentality, and often recognize what is working well. Yet, when it comes to implementing recommended changes, there exists a reluctance. Usually, the desire for immediate outcomes dominates the recommendation to slowly eat the elephant, one bite at a time, turning efficient changes into a time-consuming and overwhelming project and landing them right back to where they started. Elephants aside, Dr. Albert Einstein responds: "If you always do what you always did, you'll always get what you always got."

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Posted By Jeannette Louise,
Thursday, April 14, 2022
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PPMA wants to provide every opportunity to communicate with our members. This includes providing a strong presence on social media to share relevant information, as well as support and engage with our membership. Currently, PPMA has accounts on the following social media channels: Facebook Instagram LinkedIn TikTok Snap Chat
PPMA regularly updates Facebook, Instagram, and LinkedIn accounts. We regularly respond to comments, as well as share relevant content that is of use to our members. That is not enough for us! We want to help increase YOUR digital footprint! You may be asking how can PPMA help improve our digital footprint? By Liking or Following our pages we will then be able to locate YOUR social media channels, follow your brand, and share any applicable content with OUR followers. When your brand’s social media posts are shared, the algorithms show your posts to more followers, which results in increased reach. It is important for PPMA to support our members as well as educate them in areas in which they could improve their business which include social media and marketing for their business. Private Message If you have content that you think our members would be interested in kindly private message us on YOUR preferred social media channel!

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Posted By Jeannette Louise,
Wednesday, March 23, 2022
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Darco provides foot and ankle products to various markets, including podiatrists. This includes post-operative shoes, walking boots, products designed to help patients suffering from plantar fasciitis, wound care offloading products, and ankle bracing products. Darco headquarters are here in Huntington, WV. Darco’s products provide a healing platform for patients as they adjust from the acute phase to rehab, and finally back to their normal footwear. FOUNDER STORY The provider has been serving the podiatric community since 1985! Darco was founded by a podiatrist by the name of Darrel Darby, DPM. Dr. Darby was a graduate of the Ohio School of Podiatric Medicine. He was president of APMA in 1976. Dr. Darby created the first modern-day post-op shoe after seeing many patients being given various kinds of shoes to use when recovering from surgery or foot trauma. He listened to patients’ complaints about being uncomfortable. Like many small business owners, he started the company out of his home garage. Darco’s first run of the shoe was successful. His efforts eventually led to Darco becoming the largest manufacturer and distributor of foot and ankle products in the world! Dr. Darby’s solutions have a reputation for innovation and high quality. This has led the company to expansions that include an international presence. International locations include Suffolk, UK, Raisting, Germany, Shang Hai, China, and Darwad, India. PHILANTHROPY Dr. Darby was a big advocate for podiatric education and as such, Darco has donated over $500,000 to the podiatry schools for scholarships! DOING BUSINESS DURING THE PANDEMIC Podiatrists interested in learning more can contact us by phone or email. We often set up a Zoom session to help podiatrists learn about our products and answer any questions they may have. We also can provide product training for the application and use of our products via Zoom. All companies have been impacted by COVID-19. Representatives from Darco are not able to attend as many professional conferences. The in-person interactions with clinicians or our distributors have been replaced with virtual sessions held via conference calls or Zoom sessions. The transportation issues experienced at many United States ports have delayed product shipments resulting in a lean inventory at times. The increased transportation and raw material costs have impacted our business resulting in us raising prices to keep up with the increased costs. Darco accepts direct calls from patients regularly that need advice on what shoe to use for recovery or what size product to get. Most patients are not familiar with these types of products. The employees take pride in servicing the customers explaining the ins and outs so that the patient is satisfied. GOING THE EXTRA MILE There have been instances in which a patient may be facing financial hardship and Darco has sent products at no charge just to do good and it has resulted in a positive experience for both the patient and the employee. SERVICING CUSTOMERS Darco does not sell directly to clinicians. Darco works with a well-established network of distributors who sell to clinicians and various health care facilities.

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Posted By Jeannette Louise,
Wednesday, March 23, 2022
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BEWARE DEA Scam Four members have received telephone calls from persons claiming to be from the DEA. We feel that the callers are trying to "phish" for the member's DEA number. The caller has the member's PID and may have their state license number. They appear to be asking about a large drug discovery in Texas, or other state. PLEASE do not interact with these callers. Have them place their requests in writing and forward them to you. That will terminate the conversation and the scam. You can then forward notice of the call to the DEA DO NOT HAND OUT INFORMATION ON THE TELEPHONE

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Posted By By Lynn Homisak, PRT,
Friday, March 11, 2022
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Expressing Gratitude – A Step in the Right Direction By Lynn Homisak, PRT Whatever happened to gratitude in our world? Sadly, our country has always known inequality; but it's become worse, and as a nation, we are more divided than ever. Have we forgotten, amid our differences, how to be kind, civil, or tolerant of each other? Has it come to the point that we don't even want to share the planet with someone who doesn't share our views? Is "thankful" something we only feel obligated to think about once a year in November? Does everything we do have to end up with the finger gesture from the car or a scornful comment to someone without a face-covering during a crisis? What is it that stokes the mean spirit in us, to the point in which destroying the lives of fellow citizens by any means possible has become just another day? Someone, quick! Please get me a pair of much-needed rose-colored glasses to see the good in people again. I know it's there! It may be that I am too much an optimist, but I think we need a boost in compassion and a little more understanding; show a little more gratitude towards each other. I've been feeling this way for a while. It became clear to me the other day as I sat in the reception area of my doctor's office, awaiting my appointment. I happened to overhear a patient expressing her gratitude to my doctor as she left the office. She pointed out how appreciative she was of the care she received that day. My eavesdropping on their conversation was unavoidable as this very vocal patient was within earshot of where I was seated. Her comments were flattering and mainly focused on her experience with the medical assistant. "Karen was so great," she said. "She took excellent care of me, made sure I was comfortable, and kept poking her head in the room while I waited to let me know how much longer you would be and to make sure I was comfortable. You might not realize it, but little things like that make a difference to us patients. I hope you recognize what a good nurse she is and thank her for being so caring." I smiled publicly and cheered silently! I always love hearing some good employee feedback. The doctor's response, however, was not what I expected. Nor was it, in my opinion, professional. A simple acknowledgment was all this patient looking for. Instead, what she (and everyone else in the reception room) heard was, "Well, I don't have to thank my staff for being nice to my patients. That's their job. That's what they get paid for. If they weren't (nice), however, they would surely hear about it from me!" As a patient, witnessing this unfortunate scenario allowed me my interpretation. He would undoubtedly point out to his staff all unsatisfactory conduct and silently ignore their generally excellent behavior. Are these qualities of a successful practice? My viewpoint might be better explained by sharing Sam's story. Sam was a little league baseball coach. From the dugout, he heard one of his players complain to another. "Coach only sees what he wants to...he only sees the times I miss the ball!" The coach turned to his player and assured him that coaches do see everything! "Then why, Coach, do I only hear it when I do something bad or outstanding. What about all the stuff I regularly contribute that helped make ours a winning team? Don't you ever notice the little thing we do? Don't they matter too?" The coach still argued that he saw everything but shamefully admitted that the "expected" things are sometimes just taken for granted. He thanked the young player for bringing this to his attention. He needed to hear it. From that point on, he vowed to be more aware and recognize his players, even at the "un" expected times. Similarly, the patient I described made a point of sharing her experience, and it was something the doctor needed to hear. It is not uncommon for doctors to be unaware of daily activities while busy treating patients. After all, they can't be everywhere all the time. However, as managing physicians, they need to be aware of staff responsibilities; the inadequate, the exceptional, and everything in between. Where to start? For one, it would be helpful if doctors did self-awareness checks and occasionally noticed what may appear routine activity, yet vital to the efficiency of the practice. When they do, let staff know that these everyday tasks are appreciated. Show well-deserved gratitude to the staff. Not only because "it's their job," but because it will lead to repeat behavior, higher morale, job satisfaction, and if that wasn't enough…greater productivity. Two, start a new habit of beginning or ending staff meetings by saying nice things. It helps by balancing gripes or complaints that may arise in our practices with positivity every day. Managers can go around the room and suggest each employee verbalize some gratuitous words of encouragement about a co-worker, their manager, or doctor, even a brief uplifting patient story. Go for the smile! Receiving compliments at the beginning of a meeting can help break the ice and encourage participation, leading to new, more constructive ideas. If you choose to do so at the end of the meeting, everyone leaves on a high note, feeling a positive boost. And three, it would help to make gratitude a routine occurrence. You will see a change in staff attitudes simply by saying thank you. Not just a contrite, "let's get this out of the way, thanks," but a sincere "thank you" for a specific act of service. Employees can tell the difference between a nondescript pat on the back vs. a true expression of gratitude. Expressing gratitude is something you can do every day. Do it three times every day. It doesn't cost a thing! Indeed, an ambitious doctor who can express gratitude to staff is purposeful. Employees are not exempt from this exercise. Gratitude works both ways. Put your heads together and start the ball rolling by making simple changes to create a more gratitude-contributing climate. Your internal efforts may not change the way people treat each other outside of the practice, but if we all aim a little higher, we just might set a great example. That would indeed be a step in the right direction!

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Posted By Jeannette Louise,
Thursday, January 27, 2022
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Diabetes Management Marketing Materials - Diabetes Awareness Infographic (PDF)
- Diabetes Awareness African Americans (PDF)
- Diabetes Awareness COVID (PDF)
- Diabetes Awareness Health Disparities (PDF)
- Diabetes Awareness Intro (PDF)
- Diabetes Awareness Undertreatment (PDF)
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Posted By Jeannette Louise,
Tuesday, January 25, 2022
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Homisak, PRT Some of you may recall a very dated (1965) TV commercial “Mother, please! I’d rather do it myself!” The message of course was to get relief from a particular aspirin, rather than suffer the headache-induced stress brought about by (in this case), an interfering mother. Undoubtedly, many of us are “I’d rather do it myself” people, and while our intent is not to grouch on those around us, there is a refusal or resistance to change our ways. Enter Effective delegation. The answer to the “DIY” cry!
To clarify – delegation is not just about unloading tasks because you don’t want to do them or because they are too difficult or boring. It is about carefully selecting, empowering, and trusting capable individuals to take on specific tasks. Then transferring the decision-making responsibilities to the assignee in such a way that they are granted full ownership of it. It’s intention? To help reclaim your time, reduce your stress, and increase efficiency and productivity – all of which can lead to added practice value. While there are tremendous advantages to delegating, the push-back (or barriers) by naysayers are not far behind. Of course for some, it’s nothing more than benign habit (“I’ve always done it myself”), an unwillingness to change, or fearing a loss of control. Others believe “I’m the best; no one else can do it like I can!” And include the standard refrain, “it’s easier just to do it myself.” Many doctors, by their own admission, have found it particularly difficult assigning hands-on tasks to their staff. Perhaps because they feel a duty and obligation to their patients, or a combination of reasons listed. Additionally, there is the fear they could risk malpractice. Others that might consider delegating do not want to take (or claim not to have) the time to train. My favorite though, is the worry of patient disapproval. (“Patients expect ME to treat them, not my staff.”) I don’t doubt that a handful of patients may prefer the doctor’s attention; however, the ability to convince them ultimately rests on how the doctor presents. If a physician is confident that his or her well-trained staff are capable of performing a particular task, it follows that patients will too. Few would question a dental assistant prepping for a root canal. In fact, you would be surprised if the dentist was the one who cleaned your teeth. Every successful endeavor has a form of this hierarchy. The auto shop has ‘Bud” the seasoned mechanic who takes on engine repairs and assigns ‘Jimmy’, the young new hire, oil changes and flat tires. The Executive or Head Chef manages the kitchen while sous chefs, line cooks, and prep chefs work many jobs to prepare restaurant meals. The bank president rarely if ever works the teller position. Brad Pitt has a stunt double; and as good as he may be, you will never see Tom Brady kick a field goal. To be clear, some resistance is valid because not everything can (or should) be delegated. There are indeed limits and stepping over that line is unacceptable. However, no one is suggesting that staff perform bunion surgery, suture-close capsules, administer injections, or deep wound debridement, all which of course, would define unprofessional, even unlawful conduct. There are tasks, however, that can be considered suitable. Conscientiously select those jobs that can be directly trained/learned and are personally comfortable for you to let go (administrative or patient hands-on). Once staff have become capable and confident in their performance and can prove that they are able to handle more, they’ll need one-on-one instruction and guidance. For example, show them and explain how to prep a patient for a procedure, apply pads post-palliative, acquire preliminary patient history, assist in surgical procedures, and with adequate training and supervision are achieved, take orthotic impressions. Being able to delegate such tasks allows for simultaneous revenue streams. While you are giving an injection, they can productively apply and instruct a patient in proper night splint use. Proper delegation requires three critical steps: - Choose the right person when delegating assigned tasks. Expect some initial mistakes, remembering that mistakes (recognizing and correcting them) are part of learning and development. Keeping in mind, that too much leniency or mistakes unchallenged will result in YOU re-doing the work - accomplishing nothing.
- Be sure to clarify and manage (not micromanage) the job. Detail the reasons why and how something needs to be done and insist on quality as an end result. Remember, people are not mind-readers, so unless you successfully communicate your expectations, they cannot possibly understand how best to meet them. If you are vague, they are left to their own interpretation and that is a set-up to fail. Then review and supervise their progress.
- Provide Incentive; praise, and reward the action – especially for a job well done. Everyone likes to feel their work and efforts are appreciated. Spell out what in particular they are being commended for by saying, “Sue, the patient history you took today was very thorough…made my work much easier!” Rewards (not for simply doing the task – but excelling at it) are a great morale builder. In fact, self-confidence, appreciation and rewarding good behavior often results in repeated good behavior.
If the barriers that prevent us from letting go are self-induced, so too are the remedies that can allow us to reverse course and welcome the help of others. Just think of it. Reduced demands of your time. Increased efficiency and productivity. Additional revenue opportunities. A more fulfilled, confident, reputable and devoted staff. Less stress; less headaches. All because of the decision to put that “do it yourself syndrome” to rest. And without the use of any OTC medicine. Plop, plop, fizz, fizz – Oh what a relief it is!
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Posted By PPMA,
Friday, August 27, 2021
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Improving your practice and providing the best care to your patients is priority. But not knowing your strengths or opportunities for improvement can hold you back from making progress. Sending satisfaction surveys is a simple way to recieve insight directly from your patients that will help you evolve in your practice. Fear of hearing potential complaints may prevent you from sending satisfaction surveys to patients, but the potential for understanding your strengths and learning steps to improve easily outweighs these heistations. In another PPMA members-only article titled " Conduct Patient Satisfaction Surveys? You Really Should!", Lynn Homisak, PRT, CHC, SOS Healthcare Management Solutions, LLC states, "The function of a patient satisfaction survey is to help keep a finger on the pulse of the practice and determine what it is that makes your practice stand above the competition, or not." Creating a customer satisfaction survey can be as simple or as complex as you want and depends on how you plan to utilize the results. Software options for creating surveys: Basic Response FormGoogle Forms and Microsoft Forms are great options for creating a simple feedback form. These tools are free to use when you create a Google or Microsoft account. Each platform provides a few question types to use (checkboxes, dropdowns, input, etc) and the system is drag-and-drop, making it easy to quickly put together a survey. Responses can be viewed individually or downloaded in a spreadsheet. Feature Loaded FormIf you are looking for more dynamic features, you may consider Survey Monkey, TypeForm, or another platform. Systems like these incorporate features like question logic, options for HIPAA compliancy, multi-lingual surveys, receive file uploads, accept payments, and more. These platforms are much more complex and offer loads of variety for robust forms, but can require a subscription. Integrated FormDepending if you use an email management software like Constant Contact or MailChimp, you may already have access to a form builder. What's nice about this option is that your database is already connected. All response data can be saved in the same space and you can easily send out the form to different user segments. For example, you may want to send a form to all your patients who live in a certain zip code or to those who have been patients for 5+ years. As long as your database has this information available, you're already set to go! Plus, you can even use forms as a lead generator to add people to your mailing list. For example, you may create a survey regarding what types of foot pain people have experienced in the last year and share it on social media. If an email address is required (and a disclaimer is provided), these people could me added to your email list and you would be able to start an email sequence with them to learn more about their foot pain.
What can surveys be used for? - Satisfaction surveys after a visit (think star-rating)
- Yearly check-ins with patients
- Guaging interest for further learning (Provide a checklist of topics to see what your audience may want to learn about. Use the responses to write blog and social media posts)
- Learn how you can adapt to meet your patient's needs (Ask how your office can serve them better. It could be as simple as offering appointments one hour later on Wednesdays or the ability to request an appointment online.)
Tips for creating surveys - Keep surveys to 5 questions or less
- Use different question types (multiple choice, drop down, rating, input, etc)
- Make sure you provide an immediate thank you message
- Consider offering an incentive for filling out the survey (if appropriate)
- Follow up within 24-48 hours regarding any responses that require attention or clarification
How are you using surveys to connect with your patients? Share your story with us through a Facebook message!
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Posted By PPMA,
Thursday, August 26, 2021
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Written by Lynn Homisak, SOS Healthcare Management Solutions, LLC
I’ll admit. I commiserate with doctors (employers/parents/coaches/teachers) or any leader when they hear the words, “It’s not my job” after asking why an assigned task was neglected or incomplete. To be fair however, I have similar compassion for staff when they hear, “That won’t work here!” after offering a new suggestion for improvement. Both sound like nails screeching on a chalkboard or a fork grating across a china plate! Eeeccchhh! Both expressions are toxic from auditory, motivational and common sense perspectives. Instead of the traditional face crunch every time we hear these words, we would do much better to understand why they are said and how to prevent hearing them ever again.
It’s usually implied (if not stated) that job descriptions are the culprits of the phrase “It’s not my job”; however, it is generally the product of an unsupportive work environment or an employee’s poor work ethic. If the employee is not team-oriented, does not align with the practice culture or sees their employment as just a “j-o-b” as opposed to a career, every job-related thing they do is a struggle.
Similarly, if the employee has a decent work ethic at the onset but turns bitter once on board, it’s likely due to an uncooperative culture. For example, maybe they were getting a disproportionate number of extra jobs dumped in their laps that prevented them from getting their primary tasks done – while other co-workers seemed to always get a pass. Perhaps they were continuously assigned tasks that they were not properly trained in, or not within their skillset or comfort range. Finally, bad performance could simply be the result of bad management. How can you avoid all of this? Three simple guidelines: hire for personality, build a positive work environment and manage staff the way you’d like to be managed.
In order to address the mind numbing, “That won’t work here!” comment, we have to talk about change and why that typical first reaction to a new idea is to resist it. Truth is, many times it is simply the WAY people are approached, rather than the change itself that causes resistance. Let’s say a practice sends the staff to a conference where they are exposed to many new efficiency strategies. When they return, staff are eager to implement the new stuff they learned so they enthusiastically approach their doctor with several pages of things they “need” to do differently. Unfortunately, the doctor was not there and doesn’t share their enthusiasm and in fact, feels a little threatened by change. As a result he/she pulls back and without even hearing what’s involved or knowing the potential outcome, the automatic response is “That won’t work here!” Ouch. Talk about an energy killer!
If the approach was less overwhelming; if the staff presented just one or two top ideas; and if they had laid out what was involved along with the potential outcomes…the doctor would be able to process it much easier and resistance levels would drop significantly. When offering up a new idea, avoid going in like gangbusters. Instead, take a more reasonable approach:
“Doctor, thanks for sending us to the conference. There’s one thing we learned there that we are eager to share with you and feel it would benefit the practice. (State the idea and the benefits) I’ve done some research and the costs to make the change are minimal-to-none. (Present anticipated costs, if any) Basically, here’s what would be involved. (Outline x,y,z actions needed) Susan (or whoever will be responsible) has already offered to do (x and y) to get things started and I’ll tackle (z). If we try it for about 2-3 weeks, we’ll have a good indication of whether or not it will work for us (Point out that it takes approximately 21 days for any change to take effect.) I’m pretty confident this will make our practice more efficient, however, if it doesn’t work to your satisfaction, we’ll agree to go back to doing things the way we did before.”
By the way, this strategy works in reverse too; e.g., if the doctor plans to implement new policy and needs staff to be on board.
If you are absolutely, positively 100% satisfied your office is flawless, perfectly fine-tuned, and couldn’t be better… there is no need to make changes and you have already spent too much time reading here. If however, you want to continue improving your practice, well then, change needs to be part of that process. Whether the doctor initiates some new ideas or the staff does…for the sake of progress, have an open mind, lose the de-motivational “It won’t work here” and consider an “Ok, let’s try” response. You won’t be sorry.
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Posted By PPMA,
Tuesday, July 27, 2021
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Written by Lynn Homisak, SOS Healthcare Management Solutions, LLC Originally shared in the July/August 2021 PPMA Newsletter
Are you a micromanager? Answer yes to any of these?... - Feel like you are the only one who can do things right and therefore must DO everything yourself;
- Refuse to delegate or share responsibil-ity for the above-mentioned reason;
- Constantly point out to employees things they have done wrong but ignore or fail to compliment what they do right;
- Do not trust that employees can accom-plish their work on their own, without you observing their every move;
- Feel a need to babysit employees;
- Do not make time to participate in employee training, guidance, and support; yet get annoyed when certain, expected outcomes are not achieved;
- Put little trust in their ability to prop-erly accomplish tasks;
- Believe your employees “just don’t get it” and never will;
- Make yourself unavailable when staff have questions; or are bothered when asked;
- Feel it necessary to be informed and take control of every detail of every situation;
- Feel your voice is the only one that matters in what should be a productive “dialogue” with staff during meetings or performance reviews;
- Feel completely exhausted, drowning in work, AND bordering on burnout at the end of the day;
- Have difficulty prioritizing critical vs. routine tasks (everything is critical in your eyes);
- Must approve every action – big or small;
- Expect perfection rather than excel-lence (you consider errors a sign of incompetence);
- Wonder why your staff is not motivated;
- Have an inordinate amount of employee turnover;
- Focus too much on undesirable results and too little on strategies to reorganize and improve;
- Feel reluctant to accept new ideas because change is hard or “This is the way we’ve always done it.”
...then, read on! Truth is that micromanaging stems from several things. For example, dealing with one negligent employee can lead an employer to think ALL employees need constant watching and none can be trusted. Or it could be the result of an employer’s innate desire for perfection; something they think only THEY can achieve. Finally, some employers may have difficulty understand-ing where that line is between good and bad management because while possibly busi-ness trained and clinically proficient, they never received proper guidance to manage. Some micromanagers acknowledge their controlling behaviors; others dismiss it as part of doing business. If you have responded “yes” to many of the checks above but refuse to “come clean” …hold on to your ivory tower, because you have the makings of a micromanager! This article is not intended to target anyone in particular; however, as the saying goes… “If the shoe fits…” The best part… it is never too late to turn things around.
WELCOME TO THE MICROMANAGER’S 10 STEP PROGRAM: 1. Delegate some tasks to staff that will help you gain more confidence in them. After doing so, take a step back, let it go and see what they are capable of. Guidance and instruction are necessary and always appreciated; breathing down their necks is not. Neither is babysitting them. Initially, expected outcomes may not be consistent with your standards, but allow them to start small, discuss ways to improve, and build your trust through their accomplishments. 2. Employees really CAN undertake essential tasks without your involvement if given the chance to prove themselves. They may even surprise you! Refrain from requiring your approval for every little decision. Give praise freely. Allow the necessary space for employees to present and solve problems on their own without your input.
3. It is important to have a handle on the business side of the practice. And it is important to request and review regular reports to keep informed. Rather than concen-trate on every little, microscopic detail, look instead for progress made and the big picture outcome. Discuss potential modifications and encourage suggestions to improve. 4. Try not to make mountains out of molehill errors. Mistakes are not only expected; they are an excellent and necessary source of learning.
5. Do not be afraid to place others in charge of certain tasks (i.e., running the staff meeting). Assigning them responsibility helps build their strong character and gives you the opportunity to develop confidence in their abilities.
6. Stop insisting that doing everything yourself will save time. Teaching staff how and why tasks are done a certain way will allow you to spend YOUR valuable time being the doctor. As you should.
7. Refrain from second guessing every decision or action your staff takes and recognize that YOUR way is not the only RIGHT way to do something. Think of it this way. 4 + 4 = 8, but so does 3 + 5. Do not shut out alternate pathways that may prove more productive and efficient.
8. Seek out thoughts and participation from staff. If given the chance, their observance of patient flow and activities firsthand offers unique, front line ideas towards the advancement and growth of the practice.
9. It is not necessary to stay on top of your employees. Part of their commitment, enthusiasm and motivation comes from having challenges, as well as the space and freedom to be a creative and an inclusive member of the team.
10. Take a good hard look at your style of management and whether it directly impacts the frequent staff turnover or low employee morale. Many times, an anonymous employee survey can offer constructive criticism and define specific areas of unintentional neglect.
In the end, the best way to determine if you ARE a micro-manager involves a bit of self-analysis and honesty. Just ask yourself, “Would I enjoy or want to work for someone like me?” If your answer is an unequivocal “yes”, you pass. Carry on. If not, a good recovery program involves taking a “One Step at a Time” approach to reach a desired goal and ‘engage in what is right’. You can do it!

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Posted By PPMA,
Friday, July 23, 2021
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By Lynn Homisak, PRT, CHC, SOS Healthcare Management Solutions, LLC Originally published in the Mar/Apr 2021 PPMA Newsletter
“Practice management” encompasses a variety of organizational skills that help to, well, manage your practice. That includes managing your finances, employees, standards of operation, and time. Regarding time, if I had a nickel for every instance someone said to me, “There are just not enough hours in my day,” I’d be uber rich on nickels. That said, I believe introducing my five proven time management methods (below) will help open some eyes in the office on how to be more time-conscious. Then, if one or two or all of them could become routine, who knows? They just might, in time, even eliminate some unwanted headaches, and crazy-talk here, make your practice work for you. In fact, I KNOW they will! 1) Plan and Prioritize. It helps to have effective tools to keep you and your day on task. In other words, plan your work and work your plan. Start by keeping a neat work area. You can work a lot faster when everything is in its proper place. Second, create a list of “things to do” and put it on paper so you can visualize it. Any of these simple approaches will work:
- Jot down random tasks as you think of them and in no particular order;
- Organize your task list according to categories, i.e., outgoing phone calls, errands, correspondence, projects, misc., etc. Then, tackle by group;
- Differentiate urgent tasks from non-urgent and important from not important, focusing on the urgent and important ones first; and finally,
- Partition your work day into hourly slots and fill each time-frame with tasks you want to accomplish. Of course,
- Checking off tasks on ANY “to do” list means you have, in fact, “done” them. Revel in your productivity!
2) Structure your day for best achievements. Don’t ignore your internal clock. That means working in coordination with your own energy levels by scheduling more activities and work during your energized time and less during those lazy times. It is proven that during your prime, energized time, your batteries are charged, your brain is ON, and your focus is good. But when you are in slow mode and dragging, so too does your brain. By the way, doctors should also consider taking this approach when creating their patient schedule. Late riser? Start late, work late. Early riser? Well, you get it. The start of your day, whenever that is, is your most productive. Be sure to start on time! Not doing so is the #1 reason we fall behind schedule. Don’t forget to use automation when available; it’s there to make your life easier. Take advantage of it.
3) Do not Procrastinate. Nike® had the right idea, “Just do it!” However, for 20 percent of our population who are chronic procrastinators, that is easier said than done. Something or someone holds them back from starting and/or completing what they set out to do. We all know you can’t fix something if you don’t know what that something is holding you back. If that sounds familiar, try a little introspection. Ask yourself why by finishing this statement, “I’m avoiding this task because …” Your response might provide all the insight you need to forge on. If certain projects feel overwhelming, start small. Small action is still action. You’re on your way.
4) Don’t Multitask, Delegate. There is a part of us that thinks we can effectively multitask. And for some things we actually can because we’ve developed a “we can do this in our sleep” mentality that enables us to accomplish menial, routine, mindless tasks, like walking and talking at the same time. But the term “multitasking” was created for computers, not humans.
Our brains are not wired to multitask. In fact, our IQ is lowered by as much as 10 points, and we are said to be 50 percent LESS effective and accurate when we try to juggle two or more things at the same time. When we do, we spend more time correcting errors, redoing work, and overlooking important steps. It leads to less focus, less productivity, and far more stress. Experts agree. In order to do a job well, we must concentrate on one thing at a time. Start it. Finish it. Begin the next task. Now, if you find you have too much on your plate, rather than trying to take it all on yourself, ask for help. Remember, though, you do not delegate a task because it is too difficult or boring, you do so because someone else (a staffer or co-worker) possesses the proper skills and is perfectly capable to pitch in. Another reason is to help them learn and expand their responsibilities. That’s the essence of teamwork. After all, Nick Foles did not win the 2018 Super Bowl, the Philadelphia Eagles TEAM won the Super Bowl!
5) Eliminate Distractions and Time-Wasters. Determine where you are wasting your minutes that lead to wasted hours. Is it the phones, emails, unlimited social time with patients or co-workers, unnecessary paperwork, or not being able to make prompt decisions? Identify them, then slowly weed them out and voila! Suddenly, there will be more room for productive ones. Maybe it’s because I’m entering the “Autumn” of my life (Medicare enrollment will do that to you!), but I don’t have to tell you that each minute we are given is a valuable commodity. Until we value our time, we fail to care how we spend it. Isn’t it about time we started caring?

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Posted By PPMA,
Friday, July 23, 2021
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Written By Lynn Homisak, PRT, CHC, SOS Healthcare Management Solutions, LLC Originally published in the Nov/Dec 2019 PPMA Newsletter
Do you conduct patient satisfaction surveys? They can be a little scary, I know, hearing potential patient complaints, especially if they are left waiting in the reception area for longer than expected. Yet, that is exactly the reason WHY you should do them. If there is a customer service problem, you need to know about it, and you need to fix it. Remember, if they don’t tell you, they are very likely going to tell 10–12 other people. Negative chatter spreads fast, and it’s never pretty! Here’s the reality. The function of a patient satisfaction survey is to help keep a finger on the pulse of the practice and determine what it is that makes your practice stand above the competition, or not. They are effective in providing key insights into your patients’ thoughts, which is important because meeting their needs is an ongoing priority. They help define why patients keep coming back, why they suddenly leave. Additionally, they serve as a gauge to monitor what operational systems are working to the advantage of the practice, and conversely what improvements need to be made.
Best Survey: Short, Anonymous, Onsite As far as the best type of survey, some offices prefer issuing a short three-question survey that patients can fill out at the discharge desk. Others, an online survey that they can complete at home. Personally, I’ve always liked a third option. The short, anonymous patient survey done onsite. Yes, having the patient fill one out while they are there in your office effectively captures their real-time impressions based on their experience and the type of care they received. Anonymous surveys always tend to yield more honest evaluations. And like it or not, that’s what you want. Putting it on your website is always good to accommodate those patients who are willing to offer feedback at their convenience, but it should not be your only approach. Not many patients actually make a point of following through, even though they say they will. You will get a much higher rate of participation overall in-person—they’re a captive audience, very few will refuse to fill one out—than you would with an Internet version.
One Page/One Side Survey My suggestion is keep it short but not too short (one page, one side); as I have found this to be most effective. Asking your patient to quickly circle three (3) very general questions and then hand it back to the person who asked them to fill it out is by far the most simplified and uninformative version of patient feedback. However, it rarely pinpoints necessary change. That being said, for an intermittent, ongoing shot in the arm, “The Super Short (3-question) Survey” can still be available on the counter year round.
One Full Month Annually It is beneficial for your practice to initiate annual surveys for one full month out of the year, to get a realistic assessment. I like doing them in March, sort of a “Spring Cleaning” effort towards change. Questions asked should cover several critical areas, e.g., appointment, facility, staff, and doctor. You’ll also want to provide a closed receptacle; consider getting a big old-fashioned single slot mailbox complete with a flag and a lock to place on the discharge counter. This allows them to return their survey, again anonymously, before leaving the office. You’d be surprised at how many patients are anxious to “drop” their survey into the mailbox!
So, do conduct your survey! And, please don’t ignore your patient’s comments. Any complaint they may have is one worth addressing. You asked, now make it a point to follow through.
Get tips on creating a patient survey in this article!

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