Modern practices need a trusted team of resources who are not W2 employees of your company, but can provide needed knowledge and information and action in a timely, cost-effective manner.
Practice management consultant
I know, a bit self-serving to lead off with this! A capable practice consultant will provide several things that every doctor needs. This is an abbreviated list, certainly:
- Accountability. In larger scale businesses, the CEO is hired by and reports to the board of directors. This means there is built-in accountability to someone else, even by the top person in the company. Sometimes boards make mistakes and hire the wrong person or fire the right person. Even the now-sainted Steve Jobs was fired by the board of the company he co-created.
- Systems. Efficient practices are procedure and systems based. There are procedural manuals, policy handbooks and clinical rationales to govern routine cycles of action. Many practices are run by procedures that were inherited, or just evolved over time without any observation or design. Mature practices will frequently use redundant procedures or will be missing critical elements entirely.
- Self-development and managerial skills. We have a ton of training in diagnosis and management of a variety of patient problems and complaints. We have shockingly little business or managerial training. This would be marginally acceptable if a DC could easily become an employee of a large HMO or governmental health care facility, such as the VA. However, these options do not exist today, so we need to be at least mediocre in this regard!
- Planning, long range thinking. Patient care means being in the moment, not several quarters or years in the future. However, if we never plan ahead, we end up hidebound or in a reactionary mode.
- Financial health. The present system is labyrinth and difficult to navigate. However, it’s the only one we have and knowing how to bill, code and document is a crucial skill set.
A CPA’s primary job is to keep you in compliance with tax entities. A simple statement to make, but not so easy to execute. Federal tax law is absurdly complex and constantly changing. Since your tax burden is probably your largest lifetime expense, management of this part of your professional life makes a huge difference in your net income. Some necessary characteristics:
- Responsiveness to your requests
- Proactivity in setting up your payment and tax data collection systems. You should never have to scramble to find anything in January.
- Moderate approach to deductions. Lowering your adjusted gross income is fine, but if it’s too aggressive, it can lead to an audit, and may impede your ability to borrow or refinance your primary residence.
A bookkeeper’s job is to keep your routine finances reconciled and in order. Most of this can be accomplished by the doctor’s office with the use of quickbooks, but some doctors find this to be incomprehensible and too time-consuming. Outsourcing of this part of the practice then makes sense. Payroll can be outsourced to a bookkeeper, or to a stand-alone company, such as paychex or EDS. Most large commercial banks have an associated payroll service as well.
With the accelerating trend to electronic health records and “cloud” computing, this aspect becomes more and more crucial. Many offices cannot function for more than a day or 2 without active, operating IT systems. The idea scenario is that the IT professional would be onsite to get your system installed or upgraded, set up backup procedures and physically handle anything necessary. He would then have remote access to your system so any repairs or upgrades can be accomplished without his physical presence.
Your legal needs should be small, but are still present. Look for a locally based attorney that is used to dealing with firms of your size an dis conversant with contract and employment law. An attorney should create any employment agreement you have with licensed or support personnel. If you use boilerplates or a copy you borrowed from a friend, you may not have a valid document in your hand. If you are either the plaintiff or defendant in a lawsuit, you will obviously need counsel, but this is fortunately a rare occurrence.
If you use a commercial website, such as perfect patients, you do not need a separate one, as they will be supporting and upgrading the site for you. However if you provide your own content on a website, an e-mail blast, or a blog (such as this one), you will need someone to assist you. My preference on this is to find someone who does this for a living, and is not doing it on the side while working for a technology company full time. If you have a custom website, it’s crucial that the setup uses current SEO (search engine optimization) so prospective patients can find you, and has a CMS (content management system) setup. This will allow you to add, change or remove content without knowing computer-coding language.