It's all about your livelihood

By Mary Ann Porucznik

Practice management symposium focuses on the bottom line

“The AAOS aims to have a positive impact on the quality of practice life,” said Joseph D. Zuckerman, MD, in his opening remarks at Tuesday’s Practice Management Symposium for Practicing Ortho¬≠paedists. “No other effort could have a greater impact on more members.”

As part of that effort, David Teuscher, MD, course chairman, focused on topics that would improve operational efficiencies and maximize revenues, regardless of a practice’s organizational structure or size—beginning with practice metrics and concluding with marketing strategies. So that attendees could learn from others’ experiences, actual case studies were used to illustrate not only what works, but also what doesn’t work.

Practice metrics

Using data from the Medical Group Management Association’s 2008 Cost Survey for Orthopaedic Practices and the American Association of Orthopaedic Executive’s 2007 Orthopaedic Practice Benchmarking Survey (both based on 2007 data), William R. Creevy, MD, reviewed various metrics that practices could use to measure their performance against their peers. He also reviewed physician-specific metrics such as the number of surgical cases, clinic utilization, throughput time, and clinics cancelled.

“We keep track of how many times a physician cancels a clinic with less than 60 days notice,” he said. “Last-minute cancellations create a lot of work for others in the office, so we don’t want to see them happen too often.” He also pointed out the value of a “secret shopper” to test staff responses to phone calls and questions.

Cost-cutting strategies

Audience participation added value to the session on “Practical ways to lower your overhead.” As possible solutions to issues such as increasing medical liabilty costs, increasing supply costs, and increasing employee benefit costs were presented, faculty and audience members shared their personal experiences, underscoring the importance of the shared learning.

“Premiums for my employee healthcare plan were rising at 20 percent annually,” said Thomas Grogan, MD. “I sat down with my employees and gave them several options, from accepting a higher deductible and copayments to switching plans and benefit levels. They made the decision to assume more responsibility themselves.”

Redesigning your office may not sound like a cost-cutting measure, but according to Dick Haines, of Medical Design International, an architectural and design firm, it could lead to improved productivity and patient flow that enables the practice to generate additional income. Through a series of case studies, he showed how practices could maximize the space and services they offer.

A medical recession?

According to Karen Zupko, of KarenZupko & Associates, Inc., 2009 may not be a very good year—even for physicians. “As the value of retirement portfolios collapses, many doctors will change their retirement plans and continue to work. That may mean less hiring of new physician associates,” she explained.

More importantly, she predicted that patient visit volumes will drop, a practice’s payor income mix will change dramatically, and ancillary income will also fall. She offered several suggested action steps for practices to implement.

Ms. Zupko later returned to the podium to offer advice on marketing an orthopaedic practice. “Marketing mistakes can not only be expensive and ineffective, they can also damage your practice’s reputation,” she noted.

One of the first steps, she said, would be to “get your Ps in order”—place, price, product/

service, people, and promotion. She also encouraged the audience to differentiate their practices from competitors and to leverage the power of the Internet by taking advantage of social networking sites such as Facebook and YouTube.

Additional presenters during the symposium included Craig Mahoney, MD; Aleksandar Curcin, MD, MBA; Michael Kleinpeter, EdD, MHSA; Michael Freehill, MD; Claire Pettrone, JD; and David Lovett, JD, of the AAOS office of government relations.

Mary Ann Porucznik is managing editor of AAOS Now. She can be reached at