From the Desk of Dr. Michael Perusich

The Luck of the Irish

Happy St. Patrick’s day!  The annual day of green not only brings about ideas of good cheer and fun, but it also makes me think about finances, and the “green” of success.

This is a great time of year to really be thinking about the success path that you are on with your practice and your personal life. Being the end of the first quarter, this is a good time to reflect on your goals that you set at the beginning of the year. Analyze whether you are on track or need to make some first quarter adjustments.  

It’s also a great time to analyze your cash flow.  By now, you should have a good idea as to how insurance is paying you this year.  How does it compare to last year? On which services have they decided to cut your fees?  How much of your care recommendations will patients be paying out of pocket in 2019? These are important questions that can tremendously affect your...

Time for an Update

By Dr. Michael Perusich, President Kats Consultants

Have you noticed lately that it seems that almost every business has a newly updated and current look?  From fast-food restaurants to the local dry cleaner, businesses are finding value in freshening up their look.

And it makes sense.  A new look means you are current with today’s trends, styles, and services.  The fast food restaurant may be serving the same burgers, but new paint and furniture on the inside and a fresh facade on the outside keeps them attractive to patrons.

The reason is today’s consumer finds value in having a complete experience.  They are attracted to services, vendors, and companies that look and feel current.  Take for example the food truck. These novelty vendors are sweeping the country with their new twist on fast food service.  It’s unique, it’s novel, it’s fun. And it represents a new way of doing business for the restaurant...

Michael Perusich: Hi, everybody. Mike Perusich, Patrick Hammond and David Kats with Kats Consultants. Thanks for joining us today. Guys, I thought we talked a little bit today about setting the pace in our clinics. As the doctor and owner of the practice, we really should be setting the pace, being the example leader, lead by example if you will, in the practice as the owner of the practice. How do you guys do that?

David Kats: Go ahead.

Patrick Hammond: Okay. Mine is, I get there early. I think you set the tone. If you can walk in late, you're already behind for the day. You get there early, you walk in with a positive body language, you're ready to rock and roll. You got to set that tone so your staff says, "Oh man, Dr. Hammond, he's raising up the day, right?" But if you come in and go, "Hey, what's up," low key, it's already setting the tone. You got to set the tone about high pace and be ready to go. Then when that first patient comes in you got to be all smiles, you got to...

[music]

Mike: Hi, everybody. I'm Mike Perusich, Patrick Hammond, David Kats with Kats Consultants. Thanks for listening today. David, you had a topic you wanted to talk about today.

David: Yes. One of the things that I have found in consulting, I found it quite by accident, was that if your no-show rate is high enough, your practice will plateau regardless of what size practice you have. Before the age of computers, I hate to say this, maybe when the computers were just starting, we took our client stats and we laid them out in a long row and we looked at their no-show rate. Some people had a no-show rate of nearly 50% and some people had a no-show rate of about 7%. What we found is if you went to about 13%, anybody that has a no-show rate of less than 13% was growing, and anybody that had a no-show rate of more than 13% was plateaued or possibly even going downhill.

The way you figure that out, you see how many patients were supposed to be here today, and then how many patients...

Mike: Okay. Hi, everybody. I'm Mike Perusich. Patrick Hammond and David Kats with Kats Consultants, thanks for joining us today.
David, patient communication.

David: Yes, I had a doctor I went to. He was kind of country doctor and I was in his office. In fact, I was a preceptor in his office before I graduated and somebody came in and they said "Our child has Legg-Calve-Perthes disease." and he said "Gosh, I never heard of that."
[laughter]
David: He got down--

Mike: Things not to say.

David: He got down on his knees by his file cabinet, he pulled it out, he said, "Here it is." You have to have a little bit better rapport and communication with your patients than to say "Gosh, I never heard of that before."
Mike: [chuckles]

David: It was like boy it really surprised him. "It sounded like a foreign name, Dave." I think what you have to do is when you have patient communication, you have to take everything in strides and it's basically, "I expected that." Patrick why don't you give some...

Mike Perusich: Hi, everybody. I'm Mike Perusich, Dave Kats and Patrick Hammond with Kats Consultants, what do you guys want to talk about today?

Patrick Hammond: How about we talk about multiple appointment scheduling because they may do that in their practice.

Mike: That's a really good one. You know, we do that not only with our active treatment patients but our maintenance patients as well. David, how about you?

David Kats: We don't do the maintenance patients. We don't put them on a yearly schedule, but we schedule every single person for the advanced multiple schedule. There will be people that you talk to doctors and staff that say it won't work in this area. They'll give you the reason why. They'll say, "Well, we have too many blue-collar workers and they were swing shifter. We have too many white-collar people and they fly out of the country or we have coal miners and they don't know when they're going to get out of the mine." The truth of the matter is if you own the...

[Music]

Mike: Hi everybody. I'm Mike Perusich and Patrick Hammond with Kats Consultants. Patrick, I think something we ought to talk about today is this idea of preemptive communication. Telling patients things before they think of it or before they act on it. I do that a lot and I know you do it and most experienced doctors do it. It is very important because if you feel a patient might have a disc issue. I think that's a perfect example, say, "Hey, we're going to do some treatments here, if things don't come around the way we feel they should, we may be talking about referring you out for an MRI." You are being ahead of the game but also you're assisting that patient to take the next step that's necessary.

Patrick: That's absolutely right. Referrals to other doctors. Having a good referral network and being able to confidently refer patients out, because sometimes what happens is, if you don't mention a referral possibility and a patient's not getting their pain for example under...

[music]

Mike: Hi everybody I'm Mike Perusich, Dave Kats and Patrick Hammond with Kats Cnsultants. Thanks for joining us today. I thought something we ought to really talk about is maintenance care, and the fact that maintenance care is typically not covered by insurance especially Medicare. They don't cover it at all. Most of these companies have very specific rules. Let's throw that out on the table.

Dave: One thing with maintenance is doctors think if I quit charging insurance and have the patient pay for maintenance, all my patients, all my maintenance patients are going to quit but I've seen this for 30 years and that is absolutely not true. When you convert somebody from insurance paying to once a month maintenance, they're going to stay with you in 95% of the case.

Mike: I can give you a great example of that and that's my practice. I converted my entire practice from an insurance-based practice to a cash maintenance practice, and now my patients are begging me to come in...