Wasting surgeons' time can be a 'fatal mistake' for profitability — Dr. Jay Crawford has a solution

Orthopedic

Appointment scheduling is the key to efficient operations for independent practices, according to Jay Crawford, MD, who founded nextDoc Solutions to help facilities prioritize and assign incoming patients.

Dr. Crawford told Becker's Spine Review about the software and his experience as a surgeon-entrepreneur.

Note: Responses were lightly edited for style.

Question: Can you give a brief overview of nextDoc Solutions and how it works?  

Dr. Jay Crawford: NextDoc is a subscription software package that provides accurate, durable and auditable decision support for a practice's appointment assignment staff. It does this by capturing incoming appointment requests and referrals in a simple online form that takes a patient about 90 seconds to complete. Then, based on custom practice preferences and surgical value indicators, the nextDoc software stratifies and smart-routes each request so that groups know exactly how incoming patients should be prioritized and distributed to practice providers of all levels and service lines. The end result is that the highest-value patient encounters for each surgical specialty are always given first and immediate priority into doctors' appointment slots. It's like standing over the appointment clerk's shoulder and giving clear instructions about what to do with every appointment request, without actually having to be there.

Q: What problems does nextDoc solve specifically for independent physician groups?  

JC: Most independent groups have a huge delta between their most and least valuable encounters. Assignment of available appointment inventory left to the gestalt of hourly employees often results in misallocation of surgeons' time and expertise — a potentially fatal mistake for the profitability of the practice, if not addressed. Attempting to solve this problem by episodic counseling and defining of expectations alone generally does not work for a variety of reasons. NextDoc addresses this problem head on.

Q: What are the biggest wins you've had so far with nextDoc?  

JC: Achieving company profitability while helping clients all over the U.S. run a more profitable scheduling mechanism for over four years has been a major victory and something that very few startups ever achieve.

Q: What major industry trends does nextDoc address?  

JC: It's really two-fold. Patients want more convenient access, which we provide through an easy and practice-branded online form that can be used from any device in the marketplace (laptop, desktop, smartphone). This online form provides patient access to a surgical specialty group without an annoying phone call and a wait on hold. But the pitfall of increased access without the application of accurate business intelligence is it tends to harm profitability because surgeon time is both scarce and perishable. We help manage the correct appointment relationship between patient, appropriate timing and level of provider so that surgeon time is always optimized for productivity. Good stewardship of surgeon time is valuable to the practice and to the community because it ensures that physicians are delivering the most optimal work product at all times.

Q: What's one major obstacle you've encountered as a surgeon-entrepreneur?

JC: There are many obstacles for surgeon-entrepreneurs, but a significant obstacle for most is a deficient network. The surgeon experience throughout education, training and practice does not deliver diverse exposure to people who make good entrepreneurial teammates. No successful business can be created by a single person who keeps a surgeon's schedule. Networking with fellow entrepreneurs creates the ability and capacity to deliver a viable product with a sales mechanism and a customer service component. Without those components, the best mousetrap ever created will never make it to the home of a person with a mouse problem.

Q: What's the best piece of advice you've received as a surgeon-entrepreneur?

JC: Surgeon-entrepreneurs are not often tripped up by the difficulties of conception or execution of product creation. Because of our training and experience, we typically excel in visualization, goal-setting and work effort. Our Achilles' heel is selling the product. In his classic book, Crossing the Chasm, Geoffrey Moore explains the Technology Adoption Life Cycle and the self-selected grouping of potential customers as either innovators, early adopters, early majority, late majority or laggards. Understanding this framework, and the peculiar habits and biases of members of each group, provides an important perspective that guides the deployment of capital and time in the arenas of marketing and sales.

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