Business of urology is more than just A/R, RVUs

Neil H. Baum, MDThe time has arrived for all urologists to become involved in the business side of their practice. It doesn’t matter the size or shape of the urologist, size of the practice, location of the practice, or employment status of the urologist; we all need to have an interest in the business aspects of our practices. 

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It wasn’t but a few decades ago that urologists had small patient volumes and large profit margins. The tide has changed in the new millennium, and now we see large volumes of patients with razor-thin profit margins. That, compounded by rising overhead costs, translates to an erosion of our bottom line. Therefore, it behooves us to become involved in the business of our practice.

Many urologists believe that the economics of health care means monitoring accounts receivable, relative value units, and reducing overhead expenses. In this first installment of a two-part article, I will discuss other business aspects that are imperative to every successful urology practice.

Be a leader

Moving forward, we will need core competencies not taught in medical school. All of us know how to diagnosis and treat urologic conditions. But do we know how to manage other physicians and staff? Leadership requires setting the example; ie, being an on-time physician and learning the art of delegating to others. Urologists should only do what can’t be done by anyone else in the practice. All else should be delegated. A medical school education is not necessary to ask about surgical history and how many cigarettes or alcoholic drinks a patient consumes.

NEXT: Patient/customer satisfaction

Patient/customer satisfaction

The word “customer” is not a dirty word and should be part of our medical lexicon. Doctors and staff must go out of their way to ensure that every patient has a positive experience at each and every interaction with the doctor and the practice. This includes the first telephone interaction between a new patient and your receptionist. A potential patient put on hold or directed through a complicated phone tree for 20-30 minutes before speaking to a human will often hang up and go elsewhere for his urologic care.

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Measuring patient satisfaction is good for business. Patient satisfaction scores are going to be used as part of the reimbursement formula for physicians. Those who have higher scores are going to receive more compensation than those with lower scores.

Manage your reputation

What is the physician's most precious possession? Patients, some might answer. Others might say education and training. But the real answer is the physician's reputation. Doctors live and die by their reputations. These reputations take years to build but are so fragile that they can crumble in a matter of seconds.

This is largely because in today's digital age, where news is instant thanks to social media, blogs, and search engines, your practice’s reputation can take a turn for the worse almost instantly. What can you do to protect yourself?

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At a minimum, physicians should monitor their practice reputation by conducting periodic searches-“Googling” their name-to identify what information about their practice is already visible online. You may find that three, four, or even 10 reviews are already posted on various review sites online. Don’t be surprised if one or two are negative.

Do not to let one disgruntled patient ruin your reputation. Take an active role and generate positive reviews to drown out any negative remarks made by an occasional patient. Protecting your valuable reputation is important for the business of your practice.

NEXT: Be transparent

Be transparent

Our patients demand the same high-quality service they would expect from any other service provider, such as a hotel, airline, dentist, or hairdresser. No one would make a reservation for a hotel without knowing the cost of the room. The same applies to any other service provider, including urologists. Therefore, we need to make our services more transparent.

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It’s no surprise that access to information about the price and quality of health care services can help patients/customers make better decisions about their care. What is surprising is how difficult it has been for patients to get this information. The truth is that patients rarely know the real cost of care until after they’ve received it. And the price-and quality-of a particular service can vary considerably by provider. What’s more, higher price does not necessarily equate with higher quality.

Today, patients/customers faced with high-deductible health plans and increasing out-of-pocket expenses demand quality and cost information. They seek answers to questions such as:

• What will my true out-of-pocket costs be?

• Where can I get the best care for my money?

• What if I can’t pay?

• If my doctor ordered this test or drug, does my insurance cover it? If the answer is no, why not?

It is good business to give patients a reasonable estimate for the cost of care.

Consider wellness as well as illness

It will be good business to think about moving from “sick care” to “well care.” As physicians, we were trained to treat medical problems and conditions. Today, the public is very interested in staying well, and it is going to be good for our business to focus on wellness as well as illness. Examples include teaching young men about testicular self exam, discussions on kidney stone prevention, the role of diet in various urologic diseases such as prostate cancer, and motivating patients to participate in smoking cessation programs, as this wellness behavior may improve their erections.

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Hopefully, you can appreciate now just how many business variables are in play in today’s urology practice. As health care continues to change and evolve, your survival will depend on changing and evolving with it. In the next installment, I will provide suggestions on improving not only your business but also the quality of your care.