In this article, CEO Michael Cox, PhD, and Jeffrey Wigton, director of operations for Central Maine Orthopedics (CMO) in Auburn, Maine, share five ways orthopedics practices can grow and how these techniques have worked for their practice.
1. Grow your community presence. Often the best opportunities for growth lie outside the front door of your office. Practices should make sure they are in contact with not only orthopedists, but other physicians in the community.
For example, CMO employees often host lunch meetings and visit with primary care physician offices in the area. “This gives everyone a chance to meet, and we can educate potential referring physicians about our services,” Dr. Cox says.
Aside from physicians, practices should become actively involved within their communities. Dr. Cox sits on the board of directors of his area’s Chamber of Commerce, for example. CMO has also supported local events, such as the Dempsey Challenge, an event hosted by hometown celebrity Patrick Dempsey and Central Maine Medical Center to raise money for a local Dempsey Cancer Center. In addition, CMO has also created a benevolent foundation supporting local agencies involved with health and human services. This has helped to increase the practice’s visibility and to make the practice a household name in the community.
Mr. Wigton also suggests having orthopedists reach out to different media outlets in your community. “Our surgeons recently did an ‘infomercial’ about orthopedic surgery that aired on local television. We received 10 referrals as soon as it aired and received another five the next morning,” he says.
2. Reach out to secondary markets. While maintaining a good presence within your primary market is important, practices in smaller regions may find it difficult to expand within their current areas. Dr. Cox suggests looking to nearby areas where you can market your services.
“The Lewiston/Auburn area, where our practice is located, doesn’t have any big cities, but it is a business hub. We have a significant presence in our community and have invested the time and personnel in reaching out to surrounding areas,” Dr. Cox says.
CMO began by working with critical care hospitals in their secondary markets by providing orthopedic services on-site in the hospitals’ specialty clinics expanding CMO’s market reach.
3. Improve patient satisfaction. Word-of-mouth advertising is one of the biggest sources of new patient referrals. Patients who have sought treatment at your practice are more likely to tell friends and relatives about a poor experience than a good one, so it should be the practice’s goal to maximize the positive patient experiences.
Mr. Wigton says CMO has worked on this area for the last two years. “We’ve attempted to engage staff at every level and have employed a workgroup model that has re-examined all aspects of the patient’s experience,” he says. “Using the results of patient satisfaction surveys and patient comments we have elicited the expertise of all staff members in redesigning critical work processes.”
Some of the areas that can affect how patients view your practice are wait times, communication back to patients when they call with questions and physician communication in the examination room, according to Dr. Cox.
An important step in this process, according to Mr. Wigton, is to take the time to give every staff member the chance to contribute and kick around ideas to improve patient care. “We have tried to engage them and get them to truly thinking about service. This has made the staff more sensitive to patient care issues and has resulted in less of a top-down structure to handling these issues,” he says.
To address patient satisfaction from the standpoint of the patient-physician interaction CMO staff members, facilitated by the American Academy of Orthopaedic Surgeons, underwent a two day seminar focused on the way physicians communicate with their patients. “We really needed to focus on improving our communication with patients, and the goal of the retreat was to show the impact this had on how people feel about our practice,” Dr. Cox says. “Patients are our customers, and we needed to create a user-friendly environment.”
According to Dr. Cox and Mr. Wigton, focusing on this one area has had a major impact on the practice. “We’ve had a big response from patients and their families that we’ve made changes for the better,” Dr. Cox says. “We turned the control of these process back over to the employees, and they’ve been able to make improvements. We are located in a smaller town, so word-of-mouth referrals are important, and we are sensitive to that.”
4. Implement a strong IT system. A solid information technology system can represent a significant capital cost for an orthopedics practice, but it can make operations run more smoothly so that your practice is ready to handle more patients and standardize processes to keep your practice healthy.
CMO started this process by replacing aging computer hardware and reconstructing the entire IT infrastructure, according to Mr. Wigton. “We had the option of completely changing the model or reproducing the system we currently had in place,” he says. “We had several servers that were at the end of life and took the opportunity to upgrade our system to a virtual environment. This has given us the flexibility to add applications that otherwise would have been much more expensive due to the associated hardware costs”.
As part of the new IT system, CMO was able to implement an in-house Exchange server which distribute email to all levels of the organization for the first time but also enabled shared calendars and other Outlook functionality which has since been extended to Blackberry phones. “Communication among all members of the organization has been taken to a new level,” Dr. Cox says.
Installing a virtual server environment has facilitated the adoption of other technology within the facility. For example, CMO was able to update their X-ray equipment from a traditional film system to a DR system with a significantly reduced central hardware expense through the ability to create a new virtual server on the existing server, rather than purchasing a new stand-alone server.
Training is important to securing the success of your practice’s investment in IT. Staff members should be comfortable with interfaces and using the system to input information. CMO established training programs for all of the operational systems for its staff as most were not well-versed in technology. CMO used a formal course structure and brought in an instructor to teach basics on desktops and software, including Office and the Sharepoint software.
The practice also partnered with an IT company that gives employees access to a direct line so they can call a systems specialist if they encounter any problems. Investing time and money in training has allowed Central Maine to truly embrace the new system and use it to improve processes. At our practice, it is becoming part of the culture and has been a big move forward for us,” Dr. Cox says.
5. Enter into partnerships with local hospitals. Some smaller orthopedic groups have chosen to seek employment under local hospital systems. While some larger groups may be reluctant to seek employment with their local hospitals, the opportunity exists to align the practice and the hospital through an affiliation. This approach has been found to be beneficial for both the hospital and the orthopedic group.
CMO created such affiliations with both nearby health systems, St. Mary’s Regional Medical Center and Central Maine Medical Center. The CMO group has managed to maintain its autonomy, while helping both hospitals’ orthopedic program. For example, Dr. Cox serves as executive director at the Central Maine Medical Center’s Orthopaedic Institute of Central Maine, a hospital within a hospital.
“Central Maine Medical Center wanted to improve its image, its orthopedic profile, and improve the continuum of care for orthopedic patients,” Dr. Cox says. “We had talked about the concept of an orthopedic institute in the past, and both our practice and hospital saw it as a good opportunity for our surgeons and patients, and an opportunity for CMO and the hospital to align their mission, goals and philosophy.”
The affiliation has allowed the practice to leverage some of the hospital’s resources to better market orthopedics and improve patient care, according to Mr. Wigton. “We’ve been able to do more outreach than we could have done without our affiliation with both of the local health systems,” he says.
