Can we actually learn something from a car dealer? OK, the repair shop, but still…..a car dealer??
An interesting article in Health Data Management recently talks about an interesting model being used by the 120 physician Crystal Run Healthcare in Middletown, NY. According to the article, the idea came about when Hal Teitelbaum, M.D., founder and managing partner at Crystal Run, wanted to buy a Hummer. After signing all the paperwork, Teitelbaum met with a service advisor who would periodically contact him when maintenance was needed on the vehicle. This caused Teitelbaum to wonder if the concept of service advisors would work in health care. Service writers are the guys who greet you, do your “intake”, presenting complaint(s), and the one who you talk to about what was done. IN Teitlebaum’s case, he was buying a Hummer, so the assign a service writer to contact him when ongoing maintenance is needed.
Some specialties, such as ophthalmology, mammography centers, and dentists, are geared towards the concept of preventive care and are set up to contact patients as needed. Most primary care practices don’t do that, and they’re missing the opportunity to provide good care and generate a profitable service. Crystal Run uses nurses as care managers. Before a patient visit, they use a quality matrix, based on the age of the patient, to ask the patient questions and determine what the upcoming examination needs to cover. In most practices, unless the patient is assertive, the clerk doesn’t know enough to ask enough questions to schedule properly, so many appointments are too short, leading to overruns and delays throughout the day. I tried to schedule time for a full physical with my internist, and the clerk just didn’t get it, and I left with no bill and no exam. Lost revenue, a lost opportunity to do real medicine, AND one very annoyed patient. I’m being nice and not naming names.
At my tender age, I’m actually past due for a battery of routine screening exams that will cost. My internist would never contact me for these tests – I’ve been healthy, and haven’t seen him in over a year. If I wasn’t assertive, it never would have happened. Think of all the patients who don’t know and don’t ask. Somw of those have lurking problems which can be treated by – you. Some will die if you don’t discover the problem, and only you can gat them screened.
OK, what does a small practice that is not going to hire RNs do? First, start training your staff about what you do. A little anatomy, and little about the problems you are looking for, a little about the prescriptions you write – the more your stsff knows, the more they can help you. Have patients fill out a “why are you here” sheet – simple questions, and you ask questions as well. There are enough guidelines about preventive services out there (see yesterday’s post), so use them as well and keep one for the patient on the chart. Pediatricians do it, why can adult doctors? Finally, use the capabilities of your practice management system. It can generate lists of patients by age group, so try sending out a letter to patients on the birthdays that correspond to addition screenings that are recommended (age 40, 50 and so on). Help your patients helps themselves, which means they will turn to you for the guidance and care.
Anyone have practice success – or failure – stories? I’ll keep your name private if you’d like. Shoot me an email at email@example.com.