1. Take a multidisciplinary approach to building the practice. In addition to bringing spine surgeons to your practice, hire family practice physicians, anesthesiologists, physiatrists and physician assistants to diversify the range of services at the practice. “No one specialty has all the answers on how to best handle a situation,” says Thomas Schuler, MD, a spine surgeon, founder of Virginia Spine Institute. “Having the different specialists integrated in the practice together and meeting weekly, we can ensure the best care is offered to each individual patient.” Dr. Schuler is the spinal specialist for the Washington Redskins and says that if one of the players needs medical attention, the problem can be diagnosed and the player can begin pain management and rehabilitation the same day. “It’s our ability to immediately perform comprehensive treatment of our patients that makes us so successful,” he says.
It’s also easier to keep track of the patient if all of their care occurs in the same place. “If you are referring to an outside practice for these services, patients can sometimes become lost in loop holes and physicians might hold onto a patient longer than they should,” says Dr. Schuler. “When everyone works together in a coordinated care system, it enables the proper care to be given by the most appropriate doctor. By being integrated under one roof in the same facility, we can ensure that patients get what they need and are not captured inappropriately in any one specialty.” This collaborative approach is both time and cost efficient because the different specialists don’t spend time with inappropriate patients. If a patient comes in to see a surgeon when he or she really needs pain management, the surgeon can take the patient to a rehabilitation specialist the same day. Also essential is that the different specialists can collaborate to produce the most synergistic treatment for each patient.
2. Consider expanding for easier access. If a large portion of the patients at the practice are traveling long distances or from another state to receive care, the practice should consider constructing another location to accommodate those patients, says Faris Ghani, COO of Advanced Spine Technologies in Cincinnati. While patients will travel across the state and into new states for treatment, it becomes difficult for them to return for check-ups and receive additional guidance from the practice surgeons and staff. Building a new location closer to that group of patients makes it more convenient for the patients to make several trips to the practice for check-ups, surgery and rehabilitation.
3. Become familiar with referring physicians. Too often surgeons become overly focused on procedures and forget to be friendly toward their referral sources, according to Paul Slosar, MD, an orthopedic spine surgeon with SpineCare Medical Group in San Francisco. He avoids this pitfall by remembering the importance of a letter. Since he sees patients who often travel more than 100 miles to visit his practice, Dr. Slosar doesn’t always know their primary physicians. In those cases, he writes them a letter and introduces himself, sharing information about his practice and sometimes including booklets or literature. He also reaches out to them — himself. “A lot of times, surgeons delegate responsibility for everything,” he says. If Dr. Slosar does know a physician, a simple note, phone call or e-mail thanking them for the referral maintains a connection that results in additional referrals.
4. Market your practice creatively. When Bruce McCormack, MD, a neurosurgeon and spine specialist who practices in San Francisco, was the new guy on the market and relatively unknown, he needed to market himself in different ways to attract physicians who would refer patients to him.
“I began sending out flyers and giving continuing medical education talks at hospitals around the Bay Area — I’ve been to every hospital in Northern California,” he says. “Sometimes nothing comes of them, but if you get just one referring doctor out of the audience, that’s great. I actively marketed my practice outside of the city, but as time went by I received more referrals from within the city.”
He says the first three or four years after he left the university there weren’t many referrals. But as his name recognition and reputation have grown, those efforts produced referral streams. “That was key to building a successful practice,” he says.
5. Save money by reducing employee hours. One way to aide efficiency is to reduce work hours, says Penny Forbes, practice administrator at Sierra Regional Spine Institute in Reno. We observed that during the time between 3:00 p.m. and 5:00 pm on Friday afternoons, our employees were extremely non-productive. Many employees would ask to leave early on Friday as well. So we decided to send everyone home early on Fridays, which forced the employees to be more efficient the balance of the week. The same work is being done, with two hours less a week than before. Thus, we cut our payroll expense (by approximately $30,000 per year) while maintaining work flow.
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