Myths and Facts about Practice Management

John Guiliana, DPM, MS”
Collaborative Practice Solutions


What are some common practice management myths we’re hearing about in podiatric care? I’ve listed them below and dispelled them with solid facts. Don’t let yourself get hung up on any hype or confusion. Learn the facts and stand firm on them as you’re moving forward into the new year – 2017!

Myth #1: The primary objective of “practice management” is merely about making more money

FACT: The side effect and consequence of good practice management is more money. But the primary objective is to deliver high-quality podiatric care in a cost-effective, patient-satisfied manner. This is achieved by utilizing evidence-based clinical protocols, exceptional physician- patient communication skills, and exemplary customer service.

Medical StaffMyth #2:  Medical staff needs to be monitored and kept “in check” at all times.

FACT: Numerous studies (including a large study performed by McGregor at MIT) completely debunk this myth. To the contrary, employees perform best when they are provided with the details of a good outcome, and empowered to make the decisions on how to achieve that outcome using their own skills, talents, and intuitions. While periodic feedback is required, micromanagement is counterproductive to good outcomes.

Myth #3: The customer is always right.

FACT: The customer is NOT always right! But good conflict resolution skills, which leads to positive relationships, involves far more than deciding who is right and who is wrong. It involves negotiation through which the customer feels like they have achieved something rather than nothing. Language must be “interest-based,” meaning that the customer has to see what’s in it for them and not just what’s in it for you!

“The doctor is too busy to speak to you right now” is 100% positional-based.

“The doctor wants to be sure there is time to thoroughly discuss and answer all of your questions… so what would be a good time for him/her to reach you” is 100% interest-based.

Myth #4: Multitasking is always a positive attribute

FACT: Many studies have demonstrated how multitasking might actually violate principles of good time management. Each time a “focus” is changed, many minutes of refocus is required, thereby wasting valuable minutes each hour. Multitasking is not always beneficial.

Myth #5: It’s difficult to understand my practice’s weaknesses

FACT: There are many consulting companies (including my own) which have an enormous amount of aggregated podiatric data that can be used to benchmark your practice against others. Most electronic health record software has the ability to report this data in a very efficient manner. Knowledge is power! Determining your weaknesses is the first step. Fixing them is even more important and might need to be outsourced to experts, much like you outsource accounting, IT, etc. Remember my business philosophy: “If you need something, you pay for it whether you buy it or not!”

Myth #6: The status quo is good enough

FACT: Status quo, and an inability to adapt to an ever-changing environment, will be your demise. You cannot be an ostrich in changing times. You must be a chameleon and embrace change. Successful practitioners will begin to enthusiastically approach change as a “game.” Gamesmanship can help your practice thrive!

Myth #7:  MACRA will destroy my practice!

FACT: As our nation evolves from a fee-for-service reimbursement method to one based on “value,” the reporting of data becomes an integral part of determining a provider’s unique fee schedule.

The whole topic is complicated and has many doctors worried, but it isn’t the end of the world, or even the end of private practice. MACRA is a unique business decision for you, and needs to be treated as such. 100% compliance in every possible area may not benefit you as much as it will cost you, given your current staff, your work flow, and so on.

Fortunately, meaningful use and PQRS are no longer “all or none” components of the program. You can be partially compliant. You have to figure out your unique “cost/compliance balance” to determine what you need to do to maximize the MACRA benefits (or minimize its penalties) for your individual practice. Mitigating damages to your composite score (which is based on your compliance) also helps limit the damage to your online reputation, since these composite scores are going to be posted on the new CMS website known as Physician Compare.

At next weekend’s AAPPM Fall Practice Management Symposium in San Antonio, conference attendees will get a chance to learn a lot more about running their practices effectively, efficiently, and profitably. John Guiliana, DPM, MS will also be offering free, 30 minute 1-on-1 consultations to talk about your specific practice more in depth. We hope to see you there!