Health care for all!

I started my business practice 25 years ago specializing in medical practice management. I understood before most that a medical practice is like any other business. I taught my clients that providing great customer service would make a difference in their practice. It costs very little to improve service and the returns were great.

I also learned that it is incredibly difficult to make money in a medical practice or hospital. If you’re in the health care field, you know the obstacles to profitability. Overhead is huge. Insurance costs are outrageous. Billing insurance companies and government programs is extremely complicated and labor intensive. The practitioner’s hours are long and the stress beyond the pale.

In 1979 I had clients who made $100,00 per year. They drove nice cars and had nice homes. The average person thought doctors made too much money then. Many people still think that today. Few people have spent a day in the doctor’s little cluttered back room office. I’d do that sometimes because it might take a full day for us to complete a 1 hour meeting. The doctor would come back to talk with me whenever he had a minute. Sometimes we’d talk while he updated a chart or wrote out prescriptions. They liked having someone who “understood” spend the day in their office. I wasn’t selling anything. I was there to work on a project or advise on an office procedure. People have seen those cramped little offices piled with files waiting for review. What they haven’t seen is the human being doing a very tough job.

On one of these days, my client came back to his office and sat down looking very anguished. “I’m now going to tell the parents of a six-year-old that their daughter is not going live much longer. There’s nothing I can do.” That job doesn’t pay enough.

Those were the early days of cost cutting for Medicare and insurance companies. They cut cost by simply deciding to pay only a percentage of the bill. If the doctor wanted to accept insurance payments, he had to agree to their fee schedule. Medicare was worse. Many claims were simply denied. Paperwork was voluminous. It was common to collect 50 cents for every dollar billed. And those were the good old days.

There is a lot of talk about universal health care during this election cycle. I doubt the winning candidate will achieve that, but we’ll take another big step in that direction. The politicians will control the cost by mandating the billable fees per procedure. It’s getting tighter all the time. If you are in medicine, you already know this.

So, how do you survive? Hospitals and doctor’s offices must refocus on the business of medicine. Customer service is vital if a medical facility is to thrive. Team effort and total cooperation of all staff will determine the level of success. This is going to require a complete change in the culture of the medical community. Early adopters of this strategy will do very well. They will be properly positioned as the politicians apply the pressure to reduce cost.

If you are involved in any area of medicine, you are feeling the pinch now. Will you survive the squeeze?

Chris Reich, Author of TeachU’s Business Talk Blog
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