A Holistic Guide to Practice Management

Picture this for a moment: the phone’s ringing, your receptionist is trying to print an invoice, you’ve run out of coffee (again!), your appointment book seems to have something spilt on it and you can’t actually see who you will be seeing next, and your last client just didn’t arrive for their session. And who knows when the last time was that someone cleaned the windows of your reception room.

Sound familiar? You’re not alone. Practice owners around the world are running on fumes, trying to see clients and keep up-to-date with a never-ending list of administrative to-do’s. Small business owners have burnout rates of around 77%, and it’s estimated to be much higher for healthcare practice owners if you consider the significantly higher rates of physician burnout compared to the rest of the population. In reality, the day-to-day demands of keeping your practice running make it very challenging to see clients (healthcare provider hat) while running the practice at the same time (business owner hat).

If you’re thinking to yourself, “practice management, what is practice management, and what on earth does that have to do with me?” We’re here to let you in on a secret. Proactive practice management, if you can get it right, is going to completely change the way that your practice runs. You’re going to free up time and mental space, and it’s going to have a massive impact on your bottom line.

In this article we’ll start with a quick look at ‘what is practice management?’, and then (and this is where it gets exciting), we’ll cover the four steps to follow if you want to improve productivity in your practice by taking a holistic, pragmatic approach.

What is practice management?

Before we take a look at the four steps to holistic practice management, let’s take a quick look at what we mean by the term ‘practice management’.

In essence, running a practice happens in 3 key areas:

Front office – appointment scheduling, welcoming clients, as well as checking eligibility and authorisations.
Clinical – the client session.
Back office – invoicing and payments, referrals, marketing, HR (and much, much more!)

There are a couple of dozen processes and protocols for each area, and each may involve different employees. As a practice owner, there’s a good chance that you’re trying to do more of #2 but often are stuck in vital (and innumerable) tasks that fall into the third category. And, because you’re putting out fires all day every day, it’s hard to think of how you could move from days that are heavy on the #3 tasks, and light on seeing clients.

So, if you’re going to move from mostly #3’s to mostly 2’s, you’re either going to have to do some serious outsourcing, improve your multi-tasking, or (and this is what’s going to make the most difference) improve the management of your practice.

A holistic approach is one that looks at all aspects of the practice from when the client books, to their arrival, seeing their healthcare provider, the payment process after, and then building and maintaining a relationship using online channels. And it’s a lot for one person to be responsible for. That’s why we’ve developed this handy 4-step process that will take you from drowning in detail to an organised, efficient strategy that covers all aspects of your practice.

Step 1 – Get Your Practice in Order

I love the saying:

“A new broom sweeps clean.”

But the truth is, you don’t need someone to come in and tell you how to run your practice, you just need to get proactive. Across the world, minimalism and decluttering are taking even the most disordered and cluttered homes by storm, and there’s no reason that this shouldn’t spill over into our professional lives as well.

This is the most overwhelming step, especially if your practice is mostly offline (with physical appointment diaries, piles of paper everywhere, physical copies of your patient records and the list goes on). If that sounds like you, you’re going to need to sketch out each area of your practice and develop a detailed process for each. Then you need to find ways to make those everyday tasks (such as appointment scheduling, invoicing, and taking treatment notes) simpler and easier to manage.

Some ideas:

Get rid of old client folders (if possible). Your country will have legislation related to the length of time that you need to keep client information. Check what that limit is, and shred the rest.
Digitise your treatment notes, this can be as simple as a bulk upload using practice management software that will give you a full digital copy of each client’s records, so you don’t need to store them anymore.
Throw out your appointment books and start making appointments using electronic diaries (and while you’re at it, allow clients to book appointments for themselves with an online booking system).
Do a drive to collect all outstanding payments, if necessary, get a professional company to help with this.
Start writing up processes for the most important daily tasks – such as onboarding a new client or setup templates for taking treatment notes so that it becomes efficient and standardised within the practice. You can use Zanda’s Practice Operations Manual which includes over 100 pre-written policy and procedure templates that can quickly and easily be adapted for your practice.
While you’re cleaning up, give your practice a fresh coat of paint, do a thorough clean of each room in the practice, clean the windows, buy some new magazines (and throw out those ones from 2012), and buy some fun scatter cushions to brighten up the waiting room.

Step 2 – Get the right support for your practice

If we came into your practice and asked why you have professional, qualified staff providing services to your clients, you’d know exactly what to say. Your clients are the lifeblood of your practice, and you’d go to huge lengths to ensure that they have an excellent experience. So, why don’t you extend the same courtesy to your practice? How can your business grow and thrive, if it’s not getting the best possible care?

Top tips for building a support framework that will nurture your practice:

Implement practice management software

Remember all those piles of paperwork that you sorted out in Step 1, well this is how you’re going to prevent your practice returning to the same place a year from now. Times have changed, and you need to roll with them. Keeping post-its with important reminders, a physical appointment book, and handwritten client notes is just not going to give your clients the best experience.

Practice management software takes all of those distractions out of your day-to-day practice management. And a side benefit is that it’s all in the cloud so you have access to everything, from appointments to client notes, and even accounts receivable at the click of a button, wherever you are in the world.

Here are a few ways that practice management software can support your practice:

Appointment management;
Automated email and SMS reminders;
Invoicing and payments;
Treatment notes;
Telehealth video calls;
Client management;
Online booking;
Reporting;
Integrations with other accounting and marketing software.

Have professionals on speed dial

You’re a healthcare practice owner, not a bookkeeper, and tax advisor rolled into one. While it’s good to know the basics, it’s much more effective if you can get on with the business of growing your practice, and leave the more specialist roles to a small trusted team of advisors. You won’t need them all the time, but just knowing who to call in an emergency (or even if you just have a question) can really reduce your mental load. You’re juggling so many different balls, and it helps to know that there are others watching to check that none of them drops.

Here’s who you should have on speed dial:

A bookkeeper who has experience with healthcare practices.
A tax advisor who can help with submitting returns at the end of the fiscal year.
A legal advisor, to look over your client contracts and waivers.
A web designer, so much of the modern-day health practice happens online, and for that, you need a website that’s updated regularly (and they can refer you on to an online ads specialist or an SEO expert if needed).
A mentor, someone who has run a successful practice for many years who will be able to weigh in with ideas and advice when you find yourself in a sticky or uncomfortable situation.

Step 3 – Manage Change Within the Practice

If you’re implementing processes that are going to modernise your practice, you need to make sure that everyone is on board. After all, what is practice management if not for getting the best out of your team. A holistic approach to practice management means that you’re committed to ensuring that everyone knows and understands their role in the practice, over and above any procedural changes that you put in place.

Top tips for making sure that everyone in the practice is on board:

For people to buy into new ways of doing things, they need to be empowered. This can take many different forms, but for a healthcare practice, these four are non-negotiable:

The quickest way to get your team members to buy in is if you make them part of the process. You could host regular sessions about your vision for the practice, and ask for feedback and suggestions. This is a powerful way to get new (and often better) ways of doing things, as well as ensuring that everyone is on the same page. Conversely, if you’re not going to take the time to bring everyone in on your plans, you’re probably going to get a lot of outright resistance, and more than a little passive resistance as your team is not interested in a vision that they have had no part of forming.

Technical training

All employees need to have time to get comfortable with any new systems or technology that gets implemented in the practice. This has two important benefits:

Your staff are going to be more productive if they understand what they are supposed to do, and when they’re supposed to do it. It might take a bit more time up-front, but you’ll begin to reap the rewards almost immediately.
The systems are actually going to work; if your staff can see how to use the software, and how much easier it is making their jobs which means they’re going to keep using them. By skilling up your team, the money that you’ve invested in building a system is actually going to turn into a solution that’s effective in the long-term.

Ongoing skills training

If you ask anyone who has been running a healthcare practice for a while, they’ll be quick to tell you that your value lies in your staff. They’re the ones that will keep your clients coming back over and over again, and they’re the ones who you need to rely on in good times and bad.

There’s no question that ongoing skills training is essential to the holistic management of a practice. It is a time commitment, but the dividends are huge. Regular skills development and improvement can be done internally, where a different staff member researches and covers a specific treatment or service, then presents it back to the team for discussion during your weekly staff meeting. Even if it’s 20 minutes a week, those small, incremental improvements are going to have far-reaching impacts including:

Higher-skilled staff, which is going to result in higher levels of client satisfaction.
Increased loyalty, so they’re going to stick around and you will save on hiring and training new employees.
Improved teamwork, regular learning sessions mean that your team will learn to go to each other for help.

Mentoring

This is often difficult to prioritise, and it can seem less important than other pressing to-dos. But it follows on from skills training and vision sharing – you need practical ways to show your team members that you care about each of them as a person, not just as a healthcare provider.

Schedule catch-ups as often as is realistic; it might only be 30 minutes every three months but make a regular commitment and stick to it.
Have a couple of points to cover, but make sure that you leave enough time to find out where they’re struggling and how you can support them.
Make a list of a few insightful questions, that way you can kick start a conversation that will be meaningful for you and your mentee.

Step 4 – Improve Productivity

With a pragmatic approach that looks at all the different aspects of what makes up your practice, from management to processes, outsourced software, and people-based support, you’ve definitely got your work cut out for you. Because guess what? It’s not a once-off task.

Improving your practice management is an iterative process, and you’re going to need to keep coming back to make small changes and refinements. This could be something simple, like an easier procedure for taking on new clients if your current process is unnecessarily long and time-consuming. Or it may be something a bit more daunting, like learning how to incorporate Telehealth services into your product offering.

Once you’ve implemented a practice management software you’re also going to want to look at employee productivity, staff satisfaction levels, referral rates and more to keep making small improvements to the productivity of each employee (mostly yours) and the productivity of the practice as a whole. This is going to be a whole lot easier if you’ve gone ahead and chosen a good practice management software in Step 2 as you’ll have the data you need at your fingertips.

We love hearing success stories about how seemingly small changes can make a big difference to a practice manager’s ability to grow their practice. This can be anything from switching to taking appointment and treatment notes electronically or conducting client sessions remotely instead of in-person via Telehealth, but the resulting jump in productivity is often completely unexpected.

That’s why it’s important to take a holistic approach, looking at the different aspects of practice management, then putting our 4-step plan into action. By doing this, you get an overview of all the different processes that are happening within the practice, and you can pinpoint weak areas that need improvement. But just knowing what is practice management and its different components, can give you the new mindset you need to effectively manage your clinic.

Finally, this is a gentle reminder that you’re probably not going to get it all right the first time around. It’s a progressive approach to improving practice productivity and even though it might feel like one step forward, two steps back some days, in the long-run you’re going to reap the financial (and mental) benefits of having a streamlined, ship-shape practice. Don’t get paralysed by everything that needs to be done and the pressure to get it all perfect. Rather, concentrate on making small improvements and changes so that when you look back a year from now, you’ll be amazed at how all those little steps have added up to real progress.