162: Streamlining the Chiropractic Practice: Efficiency Tips

Dr Michael Perusich: Okay. Dr Michael Perusich: streamlining your chiropractic business Hello, everybody. Welcome to the KC chiropold's podcast brought to you by ChiroHealth USA and Kats Consultants. I'm Dr Michael Perusich, your host and I'm joining today special co-host Dr. Alex Kallio, Alex. How we doing? Alex Kallio: I am great. How are you? Dr Michael Perusich: Fantastic, you run an incredibly efficient practice. So I thought it'd be fun to just kind of talk about some efficiency tips. and really how can we streamline our Chiropractic practices? So they run more smoothly and of course along with that comes usually more patient visits as well as higher capacity and just practice is a lot more fun when it's like that. Alex Kallio: Absolutely. I was with all our days to be, run smooth and not have any hiccups. But if you're not planning or putting some things in place, that doesn't just happen on it. So Dr Michael Perusich: Right exactly. So we have to really kind of be intentional about efficiency and there's a whole bunch of areas in the practice where we can become more efficient. So let's just kind of dive in here and just start with something and just run with it because this is kind of an A to Z conversation really, there's clinical efficiencies. There's office efficiencies. There's procedural efficiencies. They're scheduling efficiencies. Years. at least I think there's efficiencies. Alex Kallio: Yeah, yeah, supposedly there's so many avenues that you can go down with us. this is a fairly long laundry list of areas to really be mindful of and put some focus and attention to Dr Michael Perusich: so where do we want to dig in first? Alex Kallio: Yeah, that's maybe dive in where patients are walking in right at the front. … Dr Michael Perusich: I love it. Yeah. Alex Kallio: yeah, man, I mean from the time maybe even prior to that, I mean there's things from the phone call to as the patient walks in the door that can really make or break how long and how quickly you're getting people integrated into the office and through that first visit even that if you aren't starting that at the time that even before they're calling in you're setting yourself up for a headache right off the bat. Dr Michael Perusich: Right, right. That's so true. if we think about efficiency what does efficiency mean? I like to flip things around. So what's the opposite of efficiency? It's chaos and if you're patients are walking in the front door and they see nothing but chaos and everything's completely inefficient. They're gonna wonder if they're on the right place, so It really kind… Alex Kallio: Yeah. Dr Michael Perusich: Kills your first impression. So to speak if you don't at least look efficient and look non-chaotic. Alex Kallio: Absolutely, and today's day and age, I mean to really get going on efficiency. You've got to be somewhat technologically up to date, it starts with patients are they able to schedule their appointment online or are they doing it? I mean obviously plenty are still gonna call but do they have an option to do that? Are they able to get their paperwork sent to them and… Dr Michael Perusich: right Alex Kallio: fill that out digitally before they're coming in, we're still doing everything from start to finish all on paper. We're gonna look pretty inefficient and that's probably not going to look great in a patient size. So we've got to make sure right after that we're getting up to date with current Tech. Dr Michael Perusich: exactly Dr Michael Perusich: Exactly. you brought up online scheduling. That's an interesting one not too long ago as reading a statistic and don't quote me on this. I don't remember exactly what it was, but it was pretty astounding it was something like 72% of patients prefer online scheduling. I mean if that's the right number that's three quarters of your patients that are coming in want online scheduling. They want those text message appointment reminders and those kind of things and… Alex Kallio: Yeah. Dr Michael Perusich: they want to see an office that looks incredibly up to date good computer systems and has those high-tech efficiencies in the practice that actually helps not only attract patients into your clinic perhaps retain patients into your clinic. Alex Kallio: and I mean today's day and outside of really probably the medicare-aged patients. everybody else is wanting to do things on their phone. They want to be able to do that mobile. They want to be able to look up and schedule their own appointment without having to call and talk to you without having to take the time to do that. They want to text back and forth. They want to pay their bills online. There's so many things that we're doing everything from our phones these days that if you're not at least somewhat down that road, you're really missing the boat. Dr Michael Perusich: Yeah, that's so true. we're actually starting to see just the beginnings of the first. Tech efficient patients becoming Medicare age So we're starting to see even the Medicare patients are about to be. Alex Kallio: Yeah. Dr Michael Perusich: Kind of high tech so, if we haven't moved in that direction, we really need to be thinking about that. So computerized scheduling those kind of things, just really help to maintain efficient operations and help make your staff's job a whole lot easier. 00:05:00 Alex Kallio: No, absolutely what it starts with, many of the EHR systems, some will have that as options that you can just incorporate directly from that same company maybe you're integrating and outside third party to do texting or do some of those things. There's so many different options and features. It kind of depends a little bit of what works best with them, your particular practice style and certainly area but those options That's What patients are looking for and you mentioned from a staff time standpoint. my gosh, I mean you and I have been in practice long enough that I remember the days of staff calling, 70 80 people to remind them of their appointments, tomorrow amount of time that took Was insane and… Dr Michael Perusich: Yeah was nuts. Alex Kallio: d. I mean you get that set up on a text reminder. It's entirely automated your staff spends. No time doing that. Dr Michael Perusich: It exactly. Alex Kallio: It's incredibly efficient. Dr Michael Perusich: It's incredibly efficient. So, those are just a few little tidbits that you can use to help, really maximize your efficiency for that new patient event for any of your patients that need to be scheduled for your staff. that whole front desk automation process is amazing. And another one is when you have a new patient coming in. Do you have a kiosk where they can come in and register where they can come in and maybe fill out their paperwork or sign their consent or… Alex Kallio: Yep. Dr Michael Perusich: whatever it might be, those little tools Remove a lot of barriers from the front desk and make your front desk a whole lot more efficient. Alex Kallio: and in our office, that the new patient can go on and fill their paperwork out online through our website, but once they're scheduled our system automatically sends them a link for that paperwork too so that they have access to it multiple points. They can fill it out online submit it back digitally. It's all done. And then yes when they get in we have a check-in kiosk they can fill out their symptomatic, pain levels and things and that's uploading directly to first into the note for subjective. You're taking that off of your plate and minimizing your time off the bat on that as well. There's so many layers that can happen just off of those systems that cover, things both on the front end from the Staffing standpoint as well as to the clinical end and the doctors stand. Dr Michael Perusich: Absolutely, that is so true. And another efficiency in practice is having a ChiroHealth USA is doing some amazing things to help practices. Fight the financial component of care and explanation of the finances for patients. So we're going to hear a quick word from our sponsor when we come back we're gonna keep talking about efficiency tips that we can integrate into our practices to make us much more fluid with our practices. All right. We'll be right back. SPONSOR BREAK Dr Michael Perusich: Hi everybody, welcome back to the KC CHIROpulse podcast brought to you by Kats Consultants and ChiroHealth USA Today. Alex and I are talking about streamlining your chiropractic business and really just kind of bantering some efficiency tips around here today. So we started talking about Alex we started talking about EHR systems and trying to improve efficiency. I know on some realm that's kind of a little bit of a misnomer because on our side of the ledger sometimes our EHR systems. Don't feel all that efficient. And here's the but - built into your EHR system is all your electronic billing your patient charting your appointment reminders your point your appointment scheduling systems. Alex Kallio: double Dr Michael Perusich: All these great tools are built in and I'm telling you docs even from a note-taking standpoint if you will spend the time. To set your system To put in those can statements and those kind of things that you like to have in your node or need to have in your note. I call them CUA statements if you take the time to set all that up. Your system is going to be that much more efficient. So I know Alex you have EHR system in your practice and… Alex Kallio: No. Dr Michael Perusich: we don't have to talk about Brands but here but let's talk a little bit about some things that we can do to make that process more efficient. Alex Kallio: Yeah, I mean you kind of mentioned getting into your can statements or things and that's gonna be somewhat tailored to I mean, whether from technique or maybe soft tissue things for instance, we do a lot of dry needling. So we have a button right in there that for first encounter dry needling we cook it and it populates all of the legal stuff that we need to have in there that the patient is signed there, they're consent form that they've been reviewed with they've consented that they know the whole Spiel through that populates and… 00:10:00 Dr Michael Perusich: Sure. Alex Kallio: then for any subsequent visit we have another button that we click that and it populates that that was covered on a prior Vision you put in but I don't have to type it out to think about it. It's just click the button and… Dr Michael Perusich: right Alex Kallio: that can be through everything from your report of findings, gone over the informed consent. Do you click your Alex Kallio: But you have to spend a little bit of time to put those in and most systems will come with some things kind of integrated but you've got a tailor to your practice style to the techniques and the types of pigments that you're doing and just take that moment to set it up and again from we go to the billing aspect of Medicare and maintenance and those things and have your scan statements put in to be able to transition those things but a little bit of time what saves you immense time later sitting in a room when you're backed up and busy and you're not trying to type out, all those kinds of things. Dr Michael Perusich: So true the more you can customize your system the better and one of the things that helped me kind of customize our system was periodically actually a couple times a week. I would print notes off and actually read them and how did they read and I would always think of things. I should add this in there and I go back in and I tweak it and it kept tweaking it until literally my notes were three or four clicks and we're done. and… Alex Kallio: Yeah, yeah, absolutely. Dr Michael Perusich: then the next patient three or four clicks and you're done three or four clicks and you're done you can even do that with your exam, we all have a tendency to kind of do the same Orthopedic exams. For example, if you have a set of Orthopedics exams that you traditionally do for a low back patient. have a button that says low back exam click it populates all your tests and everything and then I have to do is say what's positive. What's not Alex Kallio: Absolutely. Yeah makes it an incredibly easy to do and the flip that's the same to the Staffing gun for the billing for statement printing, those scheduling a time every month to print statements and you following your systems procedures for that blocks that time out. So that staff isn't trying to do that. Willie Nelly and in the middle of patient time or we forgot to get statements out this month. when were we supposed to do that? We just kind of did it when we had time, that kind of thing if we can get somewhat precise with when you're doing those billing procedures when you're doing statements when you're doing collection type things block your schedule for those activities and set that out. So everybody knows when it's done how much time is a lot of for it and you kind of clear up some of those kind of things too. Dr Michael Perusich: Yeah, and here's another tip when it comes to EHR and just managing your patient records. Keep up with them. You… Alex Kallio: Yeah. Dr Michael Perusich: hear a lot of docs waiting until the end of the day to do their notes. that could be a lot of notes, if you see 50 people a day and let's just make the number simple. Let's say you see 50 people a day and you work So you see five people an hour. Okay reasonable. Is it to do At the top of every hour or is it easier to do 50 notes at the end of the day? Just do them as you go and… Alex Kallio: Yeah. Dr Michael Perusich: I realize that if you've got a Pik or a complicated case or something like that it may take a little bit longer. But just keep up with them. I see a lot of doctors. especially Pi notes putting them put them aside for weeks or waiting till the case closes. Okay, you really can't do that. you're not supposed to do that. You have a window of time that you're supposed to get your notes done, but don't wait just figure out a way to create enough white space in your day to be able to keep up with them and it'll be much easier small bites. Alex Kallio: No, which maybe is a good segue into scheduling efficiency, from when it comes to setting up your day for success and that mode and trying to make sure you have that capacity rule kind of that 80/20, rule we typically talk about of having ideally trying to have 20% of that schedule open, Dr Michael Perusich: Yeah. Alex Kallio: as docs we tend to look at it. I want my schedule 100% full but if you're always in a capacity, Then you don't have time to get things done and you don't have time to fit more patience in either. Dr Michael Perusich: Right, right and there are ways and so some of you are probably thinking that'll reduce. My Revenue. If I do that that I'm gonna cut you off right there because there are ways to still maximize your revenue and that's totally another podcast,… Alex Kallio: another discussion. Dr Michael Perusich: but Yeah, Exactly. I think too one of the things that helps kind of make your practice highly efficient is really paying attention to your stats as well. if you're just lumbering along and you're not looking at your statistical measures your key performance indicators if you will. Then you may not be as efficient as you think you are. for example, how many patients are dropping out how successful was your recent advertising or marketing program, looking at those kind of things. Really can help you create some great efficiencies in your practice. another one is not just dropouts but missed appointments. why are people missing appointments? Is it because we stopped the 00:15:00 Dr Michael Perusich: reminder system or something or something happened to it. So if you're not paying attention, you might not realize that the reminders system stopped working for some reason so really pay close attention to those things because when you pay attention to kpis. That's what helps you measure your progress towards your goals. So that's incredibly important. Alex Kallio: Absolutely. This is important as measuring your normal statistics and watching your collections and services and all those types of things, obviously those are important to track but your kpi indicators are definitely more of how are all the other things working. are you retaining those patients? Dr Michael Perusich: right Alex Kallio: Not just are you getting them in the door the first time? Dr Michael Perusich: Right, and of course here at cats Consultants, we do a 33 Point statistical analysis trending analyzes plus relativity analysis on our client stats every month. So we really dig deep and see where those efficiencies are and where they aren't and can very quickly help Really put that efficiency back into their practice. Alex Kallio: Absolutely, and that would say, if you don't have any idea what we're talking about, you probably should call us. up Dr Michael Perusich: Right, if you're not tracking your stats, give us a call. Let's talk about that, another area is and this is one that nobody likes to talk about but it's compliance, we have a lot of things that we have to stay in compliant with compliance with there's Medicare rules. There's HIPAA. There's no surprises act. There's making sure patients sign in informed consent every year, or however often you need them to there's data security. I mean, there's all these Layers of compliance that we have to manage and how good are we at managing those things? Alex Kallio: Yeah, yeah, and we have things in place too that clients and doctors can set those things up just by following things, off of the cast procedures. There's outside parties that you can also, pay to walk you through and establish those things some within the Chiropractic profession. one of cath Partners Kathy Mills Chang, they typically have a very good compliance type program as well. But we can do those kinds of things as well and some of how much Hands-On or hands off doctors want to be with setting up those types of plans. But it could be either way whichever works the best for an individual. Dr Michael Perusich: Yeah, And if you don't keep up with your compliance, just pick something Insurance compliance, if you're not compliant with your treatment plans your diagnosing and your building structure and those kind of things, the last thing you want is Blue Cross to come in and do an audit because that's gonna totally make you inefficient, because they're gonna come in they're gonna ask for five or six records and See what they don't like and now they're going to ask for 20 then they ask for 40 and next thing, they're not going on your front door. Alex Kallio: Yeah. Dr Michael Perusich: So we want to make sure that we avoid throwing up that red flag of potential Audits and can potential compliance issues and compliance issues go far reaching, for example Here's one that we ran into the other day. You have to make sure that staff that's leaving your practice knows that their Compliance that their hip agreement that they have with you for Phi continues on forever after they leave. We had a disgruntled employee who threatened to disclose patient information on Facebook after she left because she thought she wasn't under the HIPAA regulations. you need to make sure staff knows that before they leave and put it in writing form. So, those little things you help make you efficient because now you're protecting your reputation out in the community. so Alex Kallio: Absolutely. Dr Michael Perusich: there are so many different my mind's just all over the place thinking about all the places where you can be efficient, patient communication strategies is another how efficient are you for example at delivering a report of findings. Is it understandable for patients? Do we give them an opportunity to ask questions or Be engaged in the communication process or do we just spend 45 minutes giving them a Spinal Care class? that Alex Kallio: Yeah, are you still showing the video from 15 years ago? Yeah, the procedures and… 00:20:00 Dr Michael Perusich: Alex Kallio: the recommendations on these things have changed immensely in the last several years,… Dr Michael Perusich: immensely dramatically Alex Kallio: especially but the days of doing a lot of that extra stuff and time-consuming stuff. We're just gone, patients aren't gonna sit for that anymore. Dr Michael Perusich: right Alex Kallio: Today's consumer is very short attention span, much more on a time constraint and we've got to get better in our communication to kind of match and give them their needs kind of meet them at their level. Dr Michael Perusich: Absolutely, we've got to test that message along the way and make sure the patients keeping up with what we're talking about that they understand that they're engaged in that they see that we're trying to help them solve a need that's incredibly important. and then you're staff needs to match communication with you, if the doctors telling the patient, hey at home until we get your pain under control and once you to ice 20 minutes on 20 minutes off and at the front desk, they say that your front desk person tells the patient. maybe just take a hot shower or something before you go to bed at night. I mean that's totally contrary to what you may have said it's a simplified example, but it's totally contrary to what you as the doctor may have said and that confuses the patient. So now all of a sudden the patient is so confused that they might even drop Dr Michael Perusich: Care, so now your whole new patient intake process trying to get that new patient onboarded has just been completely blown out of the water and… Alex Kallio: Yeah. Dr Michael Perusich: that's a totally inefficient process. So we have to have those coordinating communication strategies in the practice. Alex Kallio: Absolutely, but you can't imagine no mind being all over the place. There's just so many areas that efficiency can be impacted within the clinic and my gosh we could sit and do a podcast for probably hours just a stop like yeah,… Dr Michael Perusich: three days Alex Kallio: just there's so many Avenues in the clinic that it goes down that it's really good to get some help with it, be able to have somebody walk through, with your office and with your staff to take a look at it rather than just trying to do it on your own. Dr Michael Perusich: exactly exactly, and if you feel like you're practicing is not as efficient as it could be or there are areas. You want to work on check us out at KatsConsultants.com - jump on one of our calendars and let's do a breakthrough call. Let's talk about your practice. We do that for free we do that because we want to give back and help doctors have incredible amazing, efficient and profitable practices. So on our website, we've got lots of different downloads. You can connect with some of our seminars our blogs and be sure to subscribe to the podcast as well. Make sure you're listening to this every single week. We put out new information every week. So I also want to thank our sponsors of course Kats Consultants as well as ChiroHealth USA. So check it both of those out and Alex. Thank you so much for being on here today. It's always fun. Let's do this again. And let's talk about some more efficiency tips next time. We do a podcast together. Alex Kallio: Absolutely glad to be on I'm looking forward to it again. Dr Michael Perusich: All right. Everybody have an awesome day. We'll see you next time. Meeting ended after 00:23:13 👋