Long Island Business News
Physicians Practice Efficiency
by Bernadette Starzee
February 27, 2013
Featuring: Dr. Ira Nash, Medical Director, North Shore-LIJ Physician and Ambulatory Network Services (PAANS)
Dr. Ira Nash
There’s plenty of uncertainty regarding payments and the regulatory environment, putting many physician practices into cost-cutting mode. But one thing is certain: doctors are focusing on cutbacks that won’t turn patients away.
Integrated Medical Professionals, a Melville-based urology practice group with 106 doctors and 47 locations, has put a major focus on conducting patient satisfaction surveys, collecting close to 40,000 responses.
“We are not guessing – we now know what will make patients want to come back and send their friends and family to us, which is the best indicator of patient satisfaction,” said Dr. Deepak A. Kapoor, chairman and CEO of IMP.
The results have been somewhat surprising.
“We found that non-health care parameters, such as whether it’s easy to park, weren’t as important as we thought they might be,” Kapoor said. “What’s most important is direct, face-to-face interaction with the provider.” Kapoor added that this is especially true for specialists.
“When patients come here, they have a very specific problem,” he said. “How the doctor reacted to their acute illness is much more important than how they got here.”
IMP has used its patient satisfaction surveys to consistently improve its quarter-over-quarter patient satisfaction rate.
“We have made sure our doctors know how important face-to-face time with the patient is,” Kapoor said. He added that doctors must now access and update information in electronic medical records while with patients.
“Our doctors have been trained to do what they have to do on the computer while simultaneously interacting and making eye contact with the patient,” he said.
In addition to getting the medicine right, patients increasingly expect doctors to get the human connection right, said Dr. Ira Nash, the Manhasset-based medical director for physician and ambulatory network services at the North Shore-Long Island Jewish Health System.
“A bond of trust between the provider and patient is critical to getting the medicine right,” Nash said. “For instance, the patient must feel confident enough to share critical information, and the doctor must have appropriate listening skills.”
Focusing cost-cutting on streamlining front- and back-office functions will not impact face time with the practitioner. Though it requires an initial investment, technology creates efficiencies.
ENT and Allergy Associates is implementing a kiosk through the vendor Phreesia, in which patients will receive an electronic pad when they walk in.
“Patients will type in their name and information, and they will see their co-pay and whether there’s an unpaid balance,” said Nicole Monti-Spadaccini, COO for the Tarrytown, N.Y.-based practice with more than 130 doctors. The practice, which has five locations in Long Island, recently announced an acquisition that will add two offices here by June 1.
“Having the patient do some of the work cuts down on the staff needed at the front desk.”
The practice has had a web portal in place for a year and a half. When new patients make an appointment, they receive a welcome email and are invited to fill out information online and submit it in advance. About 80,000 patients have registered to date.
“All we have to do is ask for their insurance card and photo ID when they come in,” Monti-Spadaccini said, noting the patient’s information auto-populates into the computer system, saving data entry. “It’s a little costly to set it up, but less costly than paying salary plus benefits for another employee or two.”
Patient portals can be used for multiple types of communication.
“It’s easier to route electronic messages than phone calls,” Nash said, noting patients, too, can realize increased convenience.
“If at 11 p.m., a patient realizes his prescription of Lipitor is running low, he can send an email requesting a refill,” Nash said.
Business Dynamics Ltd., which provides services to spine specialists, recommends that its clients take advantage of eFax, a technology that routes faxes to a user’s computer.
“We have instituted this, and we have gotten rid of our fax machines and the need for cartridges and fax paper,” said Barbara Cataletto, CEO of the Mineola firm.
Cataletto also recommends practices take a careful look at all vendor contracts and request competitive bids for both office and medical supplies.
“Why put money in the vendors’ pockets when you can keep it in your pocket?” she said.
ENT and Allergy Associates has saved thousands of dollars since putting a purchasing department in place.
“A doctor wanted a certain type of allergy equipment; our purchasing department found a vendor who could provide it for less,” Monti-Spadaccini said.
Small practices should consider outsourcing non-core functions, like accounting, billing and information technology, Cataletto said. IT in particular has become too complicated for smaller practices to handle in-house, she added.
“So many new things are needed, and so many old things are breaking; you need multiple skill levels,” she said, noting her firm moved its IT out-of-house and saved 40 percent versus having three IT staff members. “We’re purchasing skill levels that we never would be able to afford in-house,” she said.