Health care is acknowledged to be a highly complex business. Running a large group practice, never mind a hospital or academic medical center, presents a formidable management challenge.
Other, even relatively simple, businesses have multiple factors contributing to revenue production. Yet, in strictly business terms, the ‘means of production’ in health care delivery boils down to one single factor – physician’s/provider’s time and throughput.
Every revenue stream relates directly or correlates perfectly to physician time and effort/throughput. All system clinical revenue derives from physician time and effort. Physicians bill under their tax identification number (TIN) for direct professional services. Daily census facility revenues represent patients admitted by physicians. Ancillary revenues such as lab, pharmacy, infusions, and the full array of diagnostic tests all have orders for them signed by physicians/providers. The volume of admissions and all other hospital clinical revenue is directly proportionate to the volume of patients seen by physicians, which is based solely on the quantity and quality of time spent in patient care.
Given this truth, employed or affiliated physician time and efficiency is the organization’s most precious resource. As such, every operational structure, staffing resource decision, investment in technological enhancement, and operational process should be considered with this in mind.
All manner of noise gets in the way of focusing on this core matter. There is a historic dynamic tension between front-line physicians in the trenches and their administrative counterparts, including physician administrators. The natural variation in personal efficiency among physicians makes it difficult to sort out the value or even validity of some requests or complaints. There are myriad other stakeholders and organizational priorities competing for resources and attention. The complexity of the overall enterprise obscures the primacy of helping physicians make the most of their time.
What if, rather than seeing EHR enhancements as a few keystrokes, or ‘only’ a reduction in pajama time, this were seen as an opportunity to turn those minutes into face time, more visits, more patients cared for, and a healthier bottom line. The same thought process applies to requests for more support staff (e.g. another nurse or medical assistant) or scribes. In most instances of adding staffing, this can be tied directly to a commitment to see more patients. Calculating a cost-benefit analysis, even when only applying direct professional revenues, demonstrates that small tweaks to patient templates yield significant annual returns that justify investment in resources, technological enhancements, or process redesign. Consideration of other downstream and soft benefits, such as increased access, shorter wait times for appointments, market share only add to the impetus to proceed.
An environment in which a physician’s time is appropriately prioritized as a core organizational value will yield a continuous focus on objective decisions benefitting patients, physicians themselves, and the financial and cultural vitality of your organization.
Culbert Healthcare Solutions offers consultative services that will improve your organization’s, and its physician partner’s ability to use their time most effectively and in ways that also enhance the professional experience. Culbert consultants have many years of relevant industry experience in management, clinical operations, and IT. Our consultants work across these disciplines to provide you with the best solutions to difficult challenges. Our firm’s mission is to optimize the success of our clients and the health of their patients.