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Practice Management

Kaneka
 
EuroMedica

Practitioners who eschew marketing and technology tactics to grow their business may find changing their mindset to “I can do this!” is easier than they think

While many practitioners are excellent doctors, they may not be the savviest businesspeople, or they just can’t find enough time to oversee the running of the practice.

“Most [doctors] do not think of themselves as businesspeople, much less marketing people,” said Karyn Wagner, creator of California-based Success Bootcamp RX (SBRX), and marketing and practice management expert. “In the past, doctors could operate with a minimal understanding of ‘the business of running a business.’ That environment has changed completely. If you work outside the world of insurance and re-imbursement, which is confusing and maze-like in and of itself, you simply must be able to attract new patients while you serve and engage your existing patients with services they value.” 

Any small business owner would be hard pressed to serve both ends of that equation, Wagner noted, let alone doctors who must devote themselves to continuing education (CE) in medical advances. “And, of course, when you’re working with a person’s health, the relationship is more intense; there’s more at stake than the average small business selling a household good or service,” she added.

Doctors now face an almost perfect storm of issues regarding business practices: incomplete training in running a business; disinclination to adopt technology; lack of awareness about technical options; and, of course, time and time management, according to Wagner. “Although curriculums in the natural practitioner space are getting better, doctors are not thoroughly trained in medical schools to manage and operate a small business. Often, they receive very abbreviated classes in running a practice, and this information is frequently out-ofdate.” 

First Steps 

One area often overlooked by practitioners is building a long-term marketing strategy, said Julia Zaslow, a California-based business and marketing consultant to the holistic health community. “Most practitioners are so busy working in their practice that they neglect to work on their practice,” she said. “By this I mean that they’re spending the vast majority of their time performing clinical and record-keeping duties with the goal of simply keeping things afloat, while ignoring the longterm business and marketing strategies that will get them ahead. This is through no fault of their own—they’ve become trapped in a model that keeps them stuck in a no-win position.” 

The key is to carve out time every week to drill down on the time and money leaks in one’s practice that are adding stress, and also focus on the big picture of where one wants their practice to be in one year, two years and five years, Zaslow offered. “Most urgent is to correct the processes that are inefficient and therefore costing money right now, but most important is to create a strategic plan to shape and steer the practice in ways that support long-term goals,” she said, adding that typical goals are greater profitability with fewer hours worked and less stress on the practitioner and his/her entire team.

What most practitioners lack, Zaslow pointed out, are clear and efficient internal processes and a solid marketing plan. “I find that many practitioners aren’t spending enough on marketing, or they’re spending their precious dollars on poorly executed marketing activities because of their lack of understanding and expertise in this area,” she said. “For example, I can’t tell you how many horrible websites I see that reflect poorly on the practitioner, doing them a great disservice. One of the first recommendations I make to my clients is to get a better website, pronto.” (Zaslow offers a free, 31- page eBook called “Your Essential Website Blueprint” that can be downloaded at www.juliazaslow.com/website). 

Another issue, according to Geoff Hogan, president and CEO of Osnium Software Inc. in Canada, creators of ClinicND practice management software, is that many practices resist investing time and money into information technology (IT) to the point that it impacts their business. “There is a general mentality that IT is strictly a cost of doing business, and many practices fail to see how IT can save them time and money while enhancing the patient experience.” 

Resources 

There’s an abundance of resources for particular issues, as well as comprehensive solutions for everything from office management to patient communication to social media marketing.

“At first, the challenge for many doctors is ‘Where do I start?’” said Dr. Holly Lucille, Natural Practitioner Editorial Advisory Board Member who has benefited from Wagner’s tutelage. “One of the most comprehensive, cost-effective programs I have encountered is the SBRX material. I appreciated it so much that I joined their advisory board to help spread the word.

“One thing we learned at SBRX is that, simple as it sounds, no two doctors and no two practices are exactly alike,” Dr. Lucille added. “That said, there are basic issues and proven solutions. A big part of any successful training involves basic education about running a business and functioning in our media- and tech-savvy environment.Seminars and especially webinars provide excellent platforms for doctors to educate themselves.” 

SBRX offers flexibility that enables doctors to participate as their own schedules allow, Wagner explained. “Consequently, using a combination of live and taped (selfstudy) modules meets the needs of many doctors. I tell any doctor who feels there isn’t time to take a webinar or seminar to seriously consider programs with self-study components. In practical terms, learning about online appointment booking and social media such as Yelp, Google Maps, Facebook and LinkedIn, pay big dividends for doctors. These are the circles in what current and prospective patients move, and it’s important to realize that social media may be the primary—if not the only— means that patients learn about doctors and their practices.” 

Along that line, familiarity with SEO (search engine optimization) is vital, not only to learn some basic, easily implemented techniques, but to assess the army of firms approaching doctors (and small business in general) with often lavish promises of SEO success, Wagner said. “Lastly, it pays for a doctor to know a few key practice management technologies, such as Google Apps for Business, HIPAA (Health Insurance and Accountability Act) compliant emails and cloud storage,” she added.

Osnium’s Hogan agreed: “The resources and strategies available to natural practitioners to help build their practices and have them run more smoothly include low/zero cost services, such as Google Apps for Domains (gmail for your business), internet-based fax and social networking (Facebook and Twitter). We recommend that doctors use a practice management package designed specifically for natural practitioners. This will allow you to integrate scheduling and electronic medical records with the rest of your practice.” 

Time & Money 

IT spending varies depending on the size and needs of the practice, but Hogan provided a range practitioners can anticipate: anywhere from $250 a month for a solo practitioner with no front desk staff, to $1,000 a month for a large, multi-discipline practice.“The one-time setup cost of IT for a new practice varies as many practitioners already own computers and cell phones. [A safe rule of thumb] is to expect 10 times your monthly cost [for those tools] as a one-time IT setup cost.” 

To make the best use of technology, the practitioner or a staff member needs to lead each project to make sure it is completed quickly and properly, he added. “You do not necessarily need to hire front desk staff as long as you understand duties, such as billing and appointment scheduling, will fall to you.We recommend solo practitioners set up patient self-scheduling to reduce the amount of time they spend returning patient calls.” For marketing costs, Wagner cautions that it may be too early to pin down definitive industry standards and comparables for medical practices. 

“For many small businesses, there are accepted levels of annual sales and marketing costs—sometimes as little as one percent or less, sometimes into double digits for retail operations,” she explained.“But on the other hand, according to Bloomberg.com, eight out of 10 entrepreneurs who start businesses fail within the first 18 months; a whopping 80 percent crash and burn. That’s a huge cost for doctors.Its a staggering statistic that should be sobering for all of us.

“This is still a work in progress, as branding in the medical environment is a relatively new reality,” she continued. “Still, there are solid, informative online courses available for less than the cost of a weekend CE session.A doctor can realize rewards and save time, especially if there are self-study modules.In the longer run, doctors must be prepared to assign a percentage of SG&A (selling, general and administrative expense) to marketing.” 

Trained with the right basic marketing and branding skills, a doctor can accomplish an amazing amount in a relatively short period of time, Wagner stressed. “After working with many doctors and surveying the new landscape, and running SBRX as we have, I am comfortable saying that every doctor should allocate three to four hours per week to marketing,” she said. “This time allocation would include business development in the form of creating new services; for example, a weight-loss program to serve patient needs. The remaining percentage of time would be allocated to overall marketing, including outreach to current patients and use of social media to attract new patients.” 

Laws & Ethics 

It is important that practitioners understand their licensing board’s requirements for patient confidentiality and record keeping.“Of course, doctors must understand and implement all HIPAA guidelines. That’s basic,” Wagner said.

“I believe one of the reasons that not only doctors, but many professionals in general, avoid marketing is the sense that such salesmanship is somehow inherently unethical— in short, akin to selling used cars,” she added. “Obviously, that’s not the case.Doctors, like everyone else, make buying decisions based upon an understanding of the firm with which they’re dealing. That’s the essence of a brand—a collection of attributes. But more than that, a brand is the outcome of a history of successful relationships with multiple buyers.” 

Evaluating Success 

A definition of success can have multiple answers from many different viewpoints, but for practitioners seeking to improve their practice management, it is worth pinning down.

Zaslow said she believes success is determined by three criteria: financial profitability; the client or patient’s level of satisfaction; and the practitioner and their team’s level of satisfaction. “If only one or two of these are met, success is not complete. When all three are high, the business is secure and everyone wins.” 

As for successfully implemented IT, Hogan said it should be unobtrusive and allow the practice to run smoothly without demanding attention of staff. “The best IT environments are ones that no one notices.” 

And running a practice that enables a doctor to support their life (and family, too) while paying off student loans is the most fundamental measure, according to Wagner.“Beyond that, each will have personal benchmarks for success. In some ways, the sky is the limit. Yet many natural practitioners are struggling in their practices and some may not ‘make’ it. Being a doctor is not easy; being a doctor, marketer and small business person is a challenge to be sure.” 

In regard to technology and marketing, many doctors underestimate themselves, Wagner concluded. “That same curiosity that drives so many to continually study and learn about cures (natural and ancient), can be harnessed to understanding basic tech, social media and business practices. But one must get help where they know they need it. Again and again at SBRX we have doctors exclaim, ‘This is easier than I thought! I can do this!’”

FOR MORE INFORMATION

Osnium Software Inc., (888) 676-4861,www.osnium.com

Doctors Supplement Store, (877) 846-7122, www.doctorssupplementstore.com

Holly Lucille ND, RN, (323) 658-9151,www.drhollylucille.com

Success Bootcamp Rx, (510) 681-7003,www.successbootcamprx.com

Julia Zaslow, (415) 326-4322, www.juliazaslow.com

Tech Support

Natural practitioners need to be cautious about assuming that a particular technology or software application will solve all of their practice management problems.

Julia Zaslow, a business consultant to the holistic health community, said practitioners may find that what is needed most often is simply time to sit down and think strategically about their business, and the advice of a practice management and marketing expert who can help them craft a plan that works for their unique practice.

According to Zaslow, every practice can benefit from:

• An attractive website with blog functionality, preferably built on the WordPress platform for flexibility and scalability. “While WordPress software is free, you will need to pay for a skilled graphic designer and web developer to create something that looks great and works well, plus a copywriter for effective and engaging copy.”

• An e-mail marketing service such as Constant Contact, iContact or MailChimp.“There are many good email marketing services to choose from, but no matter which one is used, the point is to keep in touch regularly with your prospects and client/patient base. You want to provide them with useful content and nurture the relationship on an ongoing basis. This is called relationship marketing and every practice should be doing it.”

• Scheduling software that allows for automated scheduling of consultations and appointments. This is particularly useful for solo practitioners who may not have office staff, Zaslow noted. “There are many options to choose from (simply Google ‘scheduling software’), but key features to look for are the ability for clients/patients to modify or cancel appointments, with restrictions set by the practitioner (i.e., they cannot modify or cancel less then 48 hours in advance), and automatic e-mail and/or text reminders to prevent no-shows.”

• Applications that help a practitioner save time and stay organized. “Some of my favorites are password management software such as 1Password to keep logins safe and organized, and applications that allow for easy tracking of notes and research such as Evernote.”

• Quickbooks online accounting software and a great bookkeeper who can work on-site, as well as remotely.

• Marketing training such as Zaslow’s free Holistic Practice Secrets webinar (www.holisticpracticesecrets.com) and the Z School Marketing Mastery course (www.zschoolmarketingmastery.com).

Supplement Sales Support

For practitioners selling nutritional supplements out of their office, what might begin as a small, simple function can grow into a frustrating challenge.“Responsibility for managing sales and inventory may have changed hands a few times within the office, and the practitioner may not realize how big the job has become or that the person doing it is either under-qualified, juggling too much or both,” said Dave Preis, vice president of marketing with Missouri-based Doctors Supplement Store.

“In the process, the practitioner can lose sight of the actual costs of this retail function, which include credit card processing fees, product expiration, employee wages, in-bound shipping, missed price increases, lost sales, financing fees, shrinkage and storage space,” he added.

Practitioners must ensure that inventory is being tracked and price changes are being applied, even if this is simply done in a spreadsheet. It is also important to track actual sales, so ordering is commensurate with sales volume, and enticing volume discounts are only taken when there is a high degree of certainty that the products will sell.

Alternatively, practitioners can consider outsourcing their supplement sales function to a full-service, turnkey solution such as Doctors Supplement Store.

Financial Investment & Staffing 

The cost of maintaining sufficient inventory can be surprisingly high, Preis explained. “This is cash that is tied up and cannot be used for marketing, equipment or other office needs. While particularly burdensome for new practices, even growing practices can experience cash flow problems as inventory growth consumes what would have been profit from sales.” 

While selling supplements seems straightforward at first, it can quickly become very time intensive. Preis suggested it should be assigned to a dedicated, capable and trusted staff member who can handle inventory management, customer service, supplier management and accounting tasks.

In addition, practitioners should consult an attorney to be familiar with the laws of their state regarding supplement sales out of their office, Preis noted. “They should also be transparent with patients if they are profiting from sales and let patients know that they may have additional options when it comes to their purchase.”