TMA’s practice checkup
TMA Practice Consulting can help you perform a comprehensive diagnostic review of your medical practice. The assessment includes an analysis of ac- counts receivable; billing and collections processes; patient flow; internal controls; managed care processes; medical record systems; practice management software; overhead; human resources and person- nel issues; and clinical staff operations. TMA Practice Consulting services are
available for a fee. For more informa- tion, contact TMA Practice Consulting at (800) 523-8776 or email practice .
consulting@texmed.org
comes back as requested, then my no-show rate is lower, and that makes money,” he said. There is a modest cost associated with evaluating patient satisfaction, Dr. Fullerton added, but it’s a worthwhile one. “A small expense measuring patient satisfaction can prevent po- tential Medicare penalties. That’s cheap.” ABCD Pediatrics uses a patient satisfaction tool provided by
MGMA, which is based on the Agency for Healthcare Research and Quality’s Consumer Assessment of Healthcare Providers and Systems survey. The tool, used by Medicare, is quickly becoming the industry standard. Find this and other patient experience resources on TMA’s website at
www.texmed.org/ patientsafety.
ABCD sends out surveys often, for example, any time a new
professionalism, appointment availability, and quality of care, among other things. (See “Happy Patients Mean Healthy Prac- tices,” page 20.) More than half said they used surveys to eval- uate and improve practice operations and educate staff and physicians about behavior. About 10 percent of the practices said the survey results factored into physician compensation, according to MGMA.
TMA Council on Health Care Quality member Cliff Fuller-
ton, MD, is not surprised by the findings. “It is becoming more important, and patients are expecting more. Patients are at- tracted to places that have better service, and those will be more successful.”
While patient satisfaction is most associated with the qual-
ity of care delivered, and rightly so, it can also be an indicator of a healthy bottom line, he added. “Quality pays.” If patients are satisfied, physicians are likely to be more satisfied knowing they are doing a good job; staff turnover is lower; and patients who trust their physicians and staff are more likely to follow instructions, which lessens the practice’s workload. And patients who are satisfied with their care are more trusting of their physicians’ recommendations, which can help improve quality and productivity. “If I only have to recom- mend to a patient once to take a particular medication for his or her cholesterol, versus 20 times, then I have saved myself and my staff a lot of time, which can allow us to manage more patients. If a patient with diabetes has a good experience and
22 TEXAS MEDICINE February 2014
provider comes on board and periodically to assess all of the practice’s physicians. The surveys also target the administra- tive side of the practice, like the front desk and insurance de- partment, even the quality of the restroom. The physicians and the staff get the feedback, both the negative and the posi- tive, and “we use those tools to help make improvements,” Ms. Waltemath said. “That’s how your practice grows. If you have unhappy patients, they are not going to refer others to you.” The practice also uses many of the meaningful use features of its certified EHR, recognizing that patient satisfaction will soon become part of those and other measures, she says. “Doc- tors will soon be graded on this. It’s going to become more important to practices than in the past.” Stephenville Clinic pulled together a patient satisfaction tool that looks at care delivery, wait times, and physician- and staff-friendliness. The practice recently conducted a study of patients’ transit time through an entire office visit to find out where it could improve, including how long it takes to sign in, to get roomed by a nurse, to wait for and then visit with a physician, and then to get dismissed. None of the practices Texas Medicine interviewed saw pa- tient satisfaction factoring into physician payments or com- pensation. But it does factor into the bottom line, Dr. McMil- lion says. “Patients nowadays have a choice of where to go, so if you provide good service, and they really believe you care about them, they will choose to come to you and others in your group, and that’s a big part of a practice’s success.”
Preserving independence
Such strategies not only help practices stay financially com- petitive, but also help them stay independent. “That’s the goal,” Dr. Arnold said. Meeting that goal also involves looking to the future. For example, ABCD Pediatrics is exploring what steps it can take to become a medical home. Similarly, Thomas Spann’s financial stability has helped
it recruit new physicians and also band with other practices to form an independent practice association and to pursue participation in a local accountable care organization while remaining autonomous. Being further removed from an urban center, however, Ste- phenville Clinic does not have the option of joining an ac- countable care-type organization, making its financial viability
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