Practice Management

At the American Academy of Ophthalmic Executives (AAOE) meeting, Derek A. Preece, MBA, from the BSM Consulting Group, Orem, UT, talked about the importance of understanding exactly what benchmarks are and how to use them effectively during his presentation, "Using benchmarks to improve your practice."

A new incentive is being offered under Medicare for physicians who choose to prescribe electronically, or e-prescribe. At the American Academy of Ophthalmic Executives (AAOE) meeting, a panel of academy representatives and members presented, "Introduction to e-prescribing: Improving the safety and efficiency of medication management."

Ophthalmic practice administrators know that keeping physicians happy is crucial to the practice's overall success. And the best way to do that is by making sure their incomes are continually growing.

Depending on your location, your specialty, and the size of your practice, insurers may actually want to keep you happy, especially if you threaten to walk away from a bad deal. If nothing else, negotiations may reveal that lowball reimbursement for a particular code is nothing more than an inadvertent mistake that most insurers are willing to correct.

Physician groups are adopting tougher collection tactics, largely in response to tough times. What compounds their problem of skimpy third-party reimbursements and rising overhead is having to depend on patients for a bigger portion of their revenue stream-a result of the rising number of uninsured and the growth of high-deductible health plans.

Losing even one patient to another local practice is one too many. To achieve and maintain an edge in the LASIK market, you've got to stay on top of your competitors with research and analysis, and regularly evaluate where you fit in terms of image and consumer perception.

Organized medicine's "victory" resulted in postponing harsh reductions in payments to physicians for Centers for Medicare and Medicaid Services.

Updating your Web site-not just once, but frequently-offers an excellent opportunity to boost your practice's business by developing new patient relationships using the Internet.

Ophthalmic practice administrators often find heavy demands on their time and attention and so, like many managers, risk losing sight of what's important in the rest of their lives. But while it isn't possible to avoid the stresses and strains that accompany the job, there are ways administrators can maintain or restore a sense of balance in their lives.

Reimbursements for ophthalmic practices are steadily declining while costs are going ever higher, leaving practices scrambling as never before to find new sources of revenue and ways of cutting costs. But unless these goals are approached wisely they can lead to stress among both staff and doctor.

Current Procedural Terminology (CPT) is updated regularly, often in response to difficulties reported by practitioners. Practices that fail to keep up with the changes experience negative consequences on revenue and compliance. Staying familiar with changes in CPT can be very useful, and potentially quite rewarding.

Changing demographics in the United States will require ophthalmology practices to adopt strategies to deliver care to large numbers of diabetic and elderly patients. Possible steps could include more effective use of support staff and increasingly efficient practice patterns.

The best practices learn how to hire, train, and retain the best staff, manage patient and staff issues and physician relationships according to Ian Maltzman the administrator for Fromer Eye Centers in New York City. Because Fromer Eye Centers has a very complex organizational structure, including a president, administrator, and a chief operating officer, Maltzman has had to find ways to manage the complex structure.

New administrators at an ophthalmic practice should start by learning every non-medical aspect of the practice, including finances, computer maintenance, patient satisfaction components, and staff requirements and rewards systems.

The typical difficult patient can ruin a perfectly good day at your practice if you let them. By not taking it personally and keeping your cool you can successfully deal with this type of patient without adding stress and frustration for you or the patient.

Practices can increase their efficiency by performing surgery in only one location, having multiple operating rooms (ORs) and an efficient preoperative area available, using anesthesia blocks preoperatively instead of topical anesthesia in the OR, choosing a safe and reliable phaco technique that minimizes surgical time, and hiring well-trained staff members.

It is just as important to create a supportive and friendly atmosphere in a negotiation so that continuous relationships can form, as well as a good reputation. Here are ten Commandments for carrying out a negotiation in the ophthalmology practice.

An ophthalmic practice must create an environment in which employees are engaged with their work and are motivated to perform it well. Such an environment can be achieved by obtaining information about employee strengths, weaknesses, and goals and tying these to the practice goals.

The particulars of partnership agreements often vary depending on the circumstances and culture of a practice, in almost all cases they cover four subjects: practice buy-ins, division of net income, governance issues, and buy-outs. The three elements, which a person is essentially buying, are a practice's tangible assets, accounts receivable, and goodwill.

The leaders of two professional ophthalmology organizations discuss ways to hire top talent and retain them. Included in their tips are over-looked sources for potential employees such as national chains, the importance of job descriptions and what to include in them, and training.

With the flattening of the LASIK market comes the need to diversify and one procedure in particular to accomplish this is cataract surgery with an IOL implant.

Change in the practice setting can affect acquired skill sets, physician expectations and, perhaps most significantly, delivery of patient care. Major sources of change in ophthalmic practices include: technology, personnel, compensation, workload, patient mix, and payers.

People, whether they are the patients, co-workers, or just a stranger re-affirm why some people are still in the field of patient care. They give the opportunity to "care."

There is an inherent tension between the appeal of maintaining a successful, secure business and the desire to expand the business. According to Dr. McDonnell it is much more common for practices and departments to wait too long before beginning the process of adding excellent people to build upon a successful and vibrant operation.

Monovision offers a safe and an effective option while multifocals are a high risk strategy, Dr Graham D. Barrett controversially told delegates during a session that discussed whether surgeons should introduce multifocal IOLs (MFIOLs) into their practice.

David Bailey, president of international operations at Staar Surgical, makers of the Visian ICL & TICL, says ICL technology allows surgeons to differentiate themselves in the slowing LASIK marketplace.

Marketing at the practice level offers a less expensive and easier way to increase patient volume. Creating a memorable patient experience by showing the practice's superiority over others, starting at the consultation, as well as addressing concerns and fears at the beginning, will help retain patients and increase references.

The efficiency of an ambulatory surgery center can be accomplished by aligning leadership, having congruent goals of leadership, the placement of a consistent pattern for analysis of processes, problems, and situations in the surgery center, and a courageous leader on the frontline. Finally, and probably the most significant-recognition that quality produces quality.