The ISKD and Me Update

Good Morning. Yesterday I wrote a blog about my personal experience with a relatively new orthopedic implant device called an ISKD. In that blog I referenced a news story that aired on Tuesday, June 29 on our local ABC affiliate WSB-TV. I want to again thank Don McClellan for doing this story. For me, this story is not about my success, but instead an opportunity to highlight this medical advancement so that others in similar circumstances might benefit from it.

I also want to thank Dr. Robert Bruce of Emory Orthopedics, and, Orthofix, the manufacturer of the ISKD implant.

I want to thank my mother, Irene, who cared from me in my early years. She is a strong woman whose courage and perseverance led me through the tough times and made me who I am today.

Lastly, thank you to my wife Donna, who supported me in this decision, and cared for me after the surgery. She turned out to be a pretty good nurse!

Here is the video that appeared on WSB-TV.

The ISKD and Me

Today, I want to share a bit about myself. While I do provide consulting services for medical practices, I am also well experienced as a patient. For those of you who know me well, you may know this story, but not perhaps the whole story.

At the ripe old age of 18 months, I underwent orthopedic surgery to correct the congenital knock knee of my left leg. Sadly, post-operatively, I developed an infection that nearly took my life, and, certainly created more problems with the leg. At the age of 13, and 15 surgeries later, we discovered that the leg was not growing at the same rate as right leg. At age 20, the left leg was 2 inches shorter than the right and I required an orthotic lift to somewhat correct the discrepancy. I wore that lift for about 35 years.

In late 2005, I became interested in lengthening the leg. Though I was doing fine at the time, I wanted to ensure I could continue to do well. I did my homework and reached out to Dr. Robert Bruce, Emory Orthopedics. I met with Dr. Bruce in early January 2006. At this consult, Dr. Bruce introduced me to the ISKD device from Orthofix. My wife and I discussed the procedure, the time element for recovery, and the "nursing" care she would have to provide. In short, we decided to move forward. My surgery was scheduled and performed on January 25, 2006.

Fast forward four and a half years. I am doing fantastic as a result of the leg lengthening procedure. Today, I am completely pain free...no more aspirin...no more Advil! In fact, my wife and I are running the Peachtree Road Race in Atlanta on July 4th.

Last week, our local NBC affiliate, 11Alive News, and ABC affiliate, WSB-TV, interviewed me and my wife about the surgery I had and my participation in the Road Race. I am personally excited about how this piece of medical technology has changed my life. I want to thank the reporters Jennifer Leslie and Don McClellan for doing the story. There are other folks in our community who could benefit from this technology and medical providers. In my simple way, I am trying to highlight my problem and the success I've had in so that others might benefit.

If you interested in spending another minute and a half, please watch this video from 11Alive.

To Google or Not to Google

How often do you "Google" your name or business? How about your competition? If not, you should. The internet continues to evolve and change the way consumers view business and often times serves as the first contact they have with your business. In my consulting business, we often suggest to business owners to do an internet search of their business to see if the results match their expectations.

My last blog focused on what to do if you see negative reviews of your business; that blog was probably a premature publication. In reality, I should have started this series with the suggestion to do the internet search. Most doctors and business owners or managers rarely do a search, but most will find that the search results are not what they expect. In most cases, the search results include a listing of consumer reviews of the business from sites like Google Reviews, ratemds.com, healthgrades.com, etc. Granted, the reviews are from patients, not medical professionals, but patients can tap into the internet media and write their review of your business.

• The first step in managing your internet presence is to do the search, and, do this search regularly.

• Second, don't take any negative reviews personal. I tend to look at negative critique as a gift - information letting me know what to improve upon.

• Thirdly, get your practice involved in social medial channels. All doctors tell me that word of mouth advertising is the best advertising, and, I agree. As such, give your patients a site they can use to spread their story about your practice.

So take this opportunity to learn about what is being said, or not said, about your practice. You might find that social media represents the most budget friendly marketing and advertising you could ever do!

Managing Poor Internet Reviews

The internet and, in particular, social networking sites and other Web 2.0 technologies, provide ample opportunity for your customers and client to post reviews, good or bad, about your business. I once had a client tell me he let his web site expire because of fear that customer might say something bad about his practice. Other clients object to employing social network sites as legitimate marketing and advertising channels for similar fears. In both cases, these clients fail to understand that customers can post poor reviews whether or not the client is involved with these internet technologies.

There is not question that the internet in some ways is still the wild, wild west and nearly anything goes. So, how do you as a responsible business owner manage poor reviews?

• First, we must recognize that internet review sites are here to stay and customers are using them as never before. If you are not using social network sites as part of your marketing/advertising/communication efforts, you should be.
• Make internet searches for poor reviews part of you routine business management. In other words, you cannot manage what you do not know.
• Don't over react. There is no better offense than a good defense. If you encounter one bad review compared to 10 good ones, your customers can and will recognize the context.
• Just as you ask satisfied clients to refer friends and family to your practice, invite these same clients to post a review about your practice.
• If a review is clearly an exaggeration, or simply not true, contact the review sites administrator. Most review sites are very interested in providing honest and accurate reviews.
• I'll mention once again - get involved!

For more information on how to get started with social networking as part of your marketing and advertising campaign, click here.

Social Media = Budget Friendly Marketing/Advertising

I just been contracted to build another CONNECT system, an internet based marketing and advertising tool that utilizes social media outlets. Primoro, Inc. has now built 25 or 30 of these systems much to the delight of business owner. For a very low set up fee, with no on-going annual fees, I cannot think of another marketing/advertising tool more budget friendly.

Most practices use some type of marketing and advertising tool, whether it be their own website, yellow pages, in-house brochures, even a business card. For most practices, the total marketing and advertising spend should be 3-5% of net collected revenue. And as for the aforementioned tools, there are ongoing expenses due to the less-than-user-friendly nature of the tool. One example is your website. How often do you have it updated? My guess is not very often. It takes a lot of time, and perhaps money, to make the change. Yellow pages is another example. You contract for a specific ad for one year. Suppose you move, or add a new service; well you are simply stuck with what you have until the contact is renegotiated.

What if you had a marketing and advertising tool that was truly user friendly? Well, CONNECT offers this solution. Using CONNECT as your social media tool is as easy to use as writing an email. And with recent programming updates, these internet site (I like to call them "microsites" because they look and feel like mini websites), you can add as many a 10 separate pages to be used however you choose.

Take some time and consider the value social media and other Web 2.0 technologies can have on your practice. Primoro, Inc. offers one hour complimentary consultations, and, we would be happy to assist you.

404-394-0014

robert@primoroinc.com

Being Unconsciously Competent

This s favorite topic of mind. And, it has such an impact on practices customer service performance. Please take a minute to determine if you are unconsciously competent!

http://www.thecitizen.com/articles/04-27-2010/being-unconsciously-competent

Financials

This week, a friend posed a simple question, "What do you mean when you offer clients financial assistance?" Well, the answer is both simple and complex. First, let me tell you what it isn't. It is not related to personal finance, nor, is it an alternative to your accountant. Instead, financial services are related to the everyday "operations" of the practice. In short, financial services entail evaluating any number of expense ratios to aid the practice in better financial management.

For example, every business, including medical practices, has marketing and advertising expenses. Yet most practices have not real idea as to what constitutes the proper marketing and advertising expense budget. The answer lies within established benchmark values. In general, medical practices should budget 1-5% of net income for their marketing and advertising budget.

There are multiple metrics a practice can use to evaluate their current financial performance; yet looking at one metric is not advisable. My experience demonstrates that these benchmark should be viewed in the context of the practice, and, how one metric relates to another. In our marketing and advertising example, a practice could spend more or less depending on a marketing initiatives, how well known the practice is (or isn't) or the general desire of the owner. I know a doctor who insists on having the most aesthetically pleasing office in town. While he may be a little "over the top" in decor, he simply made the choice not based on financial sense, but instead, personal desire. A good consultant would not criticize this doctor's choice, but instead, simply point out the financial consequences of the decision.

Knowing and understanding these metrics is the first step in financial management. If you have not done so, please consider benchmarking your financials as compared to prior years. By doing so, you can easily see trends you may choose to ameliorate.

Internal Customers; They're Your Customer

For your business owners out there, your employees are your customer. Think about it, you could not run your business without them, and, it is to your benefit to treat them with the same care as you treat your paying customers.

Internal customer service starts with business owners and managers. It is their responsibility to set the tone and culture of the business. If the tone and culture is one of treating employees well and with respect, you can bet that your employee will treat your external customers (paying customers) with similar tone. In contrast, if you treat your employees as simply workers, they in-turn will treat your external customers as just customers.

Evaluating your internal customer service "quotient" can be a simple as conducting your own SWOT (Strengths, Weaknesses, Opportunities & Threats) analysis. Though typically reserved for marketing strategy analysis, a SWOT analysis that examines customer service, internal and external customer service can be revealing. Below, is an example of an internal customer service SWOT analysis.

STRENGTHS	WEAKNESSES
· Practice includes customer service as part of their Mission Statement · Management has set the expectation · The practice utilizes staff uniforms, including a name badge · Office is clean and provides an open, inviting reception area	· Practice experience relatively high turnover, necessitating only basic CS training · Little daily management of CS activities · Retail area appears unkempt
OPPORTUNITIES	THREATS
· Annual employee evaluations do not include customer service as a measured metric · Practice does not use EMR or other CRM technology · Need for ongoing CS training	· Other area practices utilizing EMR/CRM technology · Improve staff retention

For your analysis, consider conducting an input session with your practice's management team. Remain open with all critique and refrain from defending any position you may have taken in the past. By doing so, you demonstrate one of the key elements of leadership, listening. You might be surprised at what you learn and the new direction this activity brings.

Where Have I Been?

It has been a week or two since I last issued a blog. Frankly, I've been tied up with a project for a pharmaceutical company. They asked me to create a few training manuals for their sales teams. One of the training modules concerns providing excellence in customer service. In my research, I was surprised to see so much material regarding the little discussed of internal customer service.

When we hear the term customer service, most of us think about the service we provide to our customers or clients. Internal customer service is the recognition that our employees are customers of the owner and management, and the employees are customers of each other. This recognition is important because the better customer service we provide our team members, we improve our external customer service, business efficiency which leads to greater profitability.

Simple steps to improve your internal customer service include:

• Communicate, Communicate, Communicate - be proactive in communicating with co-workers about your expectations of them and them of you.

• Management must build a sense of teamwork - Likewise, staff members must understand how their actions, or inactions, affect their co-workers ability to complete their tasks.

• Eliminate work silos - the medical practice is a business and should operate as a cohesive team.

• Managers, treat your employees like customers. Providing your employees excellence in customer service fosters excellence in external customer service.

• Create a rewards system in your office. Rewards can be as simple as a monthly award all the the way to cask bonuses. Make sure you set the expectation and reward the observed activity.

ISKD and Peachtree Road Race

I have been involved in healthcare my entire life. As an adult, I've worked for hospitals, pharmaceutical companies and now operate my own healthcare consulting firm, Primoro, Inc.

Many of you may not know of my association with healthcare as a child and as recently as four years ago. At the age of about three, I contracted a bone infection that most of my doctors believed damaged the growth plates on my left leg bones. During puberty as my right leg grew, my left side simply lagged behind. By the age of twenty my left leg was 2+ inches short as compared to the right. After wearing a two inch orthotic lift on my left shoe for 38 years, I decided to undergo a limb lengthening procedure with a fairly new orthopedic device called an intramedullary skeletal kinetic distractor, ISKD for short. Dr. Robert Bruce of Emory Orthopedics performed my surgery in January 2006. The surgery was successful and what a change the surgery had on my life.

Today I am pleased to tell you that I am registered to do this year's Peachtree Road Race on July 4th. In fact, after learning about my story, the AJC elected to do an article that appears in today's paper. Frankly, I never thought I would ever be written up in the sports section!

The point of this story is to highlight the accomplishments of this country's our healthcare system, the providers, the research companies. It is blessing that the spirit that exists in our United States allow for such advancements that does so much for those in need. I am an example of the ingenuity of the system our republic provides. For those of you who I know, and those of you I don't, Thank You!

Customer Relationship Management

Recently, I've been working with a pharmaceutical company in development of some consultative tools their sales team can use with customers. One topic the company asks I comment on is customer relationship management (CRM). CRM is broadly defined as strategies designed to manage a company's interaction with customers and prospective customers. Typically these strategies involve the use of computer software organize and automate the various business functions such as sales activities, marketing of products, customer service and other support.

CRM in itself is very interesting to me as most organizations view the CRM strategy from a company centered point of view. That is to say, a company will use these strategies only to the extent the system is beneficial to the company. For me, that seems backward.

As I have written many times, I have never seen a case where excellence in customer service was bad for business. Likewise, I've never seen any computer software deliver excellence in customer service. Excellence in customer service is always delivered by PEOPLE!

Now I do not discount the value of technology helping house customer data, making it easily accessible to those who need and the ability to mine data to help a company understand their customer better. But in the end, your business cannot depend on computer systems to deliver the service your customers expect. In today's technology driven business world, too few companies really train their people in customer service.

I am reminded of the customer service story I found as part of my research. A well dressed lady visited the local Nordstrom's shoe department. She jokingly asked saleslady, "I bet you won't sell me one shoe. As you can see I have only one leg." Well the lady lost the bet. This story exists because of Nordstrom's commitment to developing a customer oriented customer service policy. It should be no surprise that Nordstrom continues to be very successful clothing retailer.

Using technology to help you gather and maintain customer information, but remember to invest in the people who interact with your business's customer.

A Customer Service Story

Primoro, Inc and PrimoroVet provide a full range of business consulting services for the medical community. As many of you know, a key focus of our organizations centers on assisting medical providers in establishing customer service standards within their practices'. By improving customer service, businesses tend to retain current customers, enhance "word of mouth" referrals, and produce better bottom line results. As I have stated before, I cannot think of a case where good customer service was bad for business.

Today, I would like to share a personal customer service story about our local auto repair shop. The car in question is a European make (Volvo) and as you might expect, not the cheapest in general maintenance costs. This visit included oil and filters, tire rotation, etc. In specific, the cabin air filter was to be changed at a cost of about $90. As the technician inspected the existing filter, he determined that the existing filter did not need to be changed, thus saving me the $90. As you might expect, I enjoyed the savings, but more importantly, I appreciated this professional's evaluation and ultimate recommendation.

I cite this as top notch customer service. Rather than trying to sell me something I really did not need, this repair shop focused on what was best for the customer. In addition, my observations of the staff, the shop's cleanliness and the overall experience are all results of the owner's vision of what a repair shop should be, and, his leadership to execute his vision.

Excellence in customer service is no accident. Make excellence in customer service part of your vision and lead you team in executing your vision.

P.S. In case you are wondering, my repair shop is AllSpeed Auto Works.

Much Has Been Said About Social Networking - Read This!

Primoro, Inc., is actively engaged in promoting the use of social networking tools, a.k.a. Web 2.0 technologies, in medical practices. As you might suspect, many physicians are reticent about betting involved for fear that patients may use such a tool as a vehicle to disparage their doctor.

While that possibility exists physicians must recognize that there are many internet sites designed to provide patients the ability to "rate" their doctor. I've looked at these sites and there are patients out there who proverbially "throw their doctor under the bus." So what is a physician to do?

Oddly enough, I came across this blog through social networking. Follow this link and take a look at it. I believe you will find the information compelling enough to get involved in social networking.

For answers to your questions and an easy as writing an email social networking tool, call Primoro, Inc. @ 404-394-0014.

Primoro, Inc. Supports Fayette Care Clinic

Primoro, Inc. is proud to be a supporter of this year's Fayette Care Clinic's "Dancing With The Stars" event. This is Fayette Care Clinic's annual spring fund-raising event that benefits the medically uninsured of Fayette County, Georgia. An open invitation is posted on their website.

There are many physicians and dentists in our area that donate their time and expertise to aide and support medically uninsured citizens of Fayette County. In addition Fayette Care Clinic is supported by companies in our area with services and supplies. This year, Primoro, Inc. is providing a CONNECT system to the highest bidder during the live auction. Of course, the proceeds go to further support the Fayette Care Clinic mission.

You too can get involved by simply making a cash donation, or better yet, attending this year's gala! For $100 per person you receive sumptuous edibles, incomparable entertainment and all the dancing your legs can stand!

"Dancing With The Stars" is on March 13, 2010 at the Glendalough Manor in Tyrone, Georgia. The reception starts at 7:00pm with dinner and dancing starting at 8:00. I hope you will consider attending! I can think of no better way to spend $100 and have so much fun, AND support such a worthy cause.

You can see more details and an invitation on the Fayette Care Clinic's website, just follow this link.

This was reported by the Medical Group Management Association (MGMA) on Monday, Feb. 22, 201o.

Weekly Health Care Reform Update

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21.2 percent cut to take effect March 1

Barring last-minute action by Congress, the 21.2 percent cut to Medicare physician payments will take effect next Monday, March 1. Despite previous indications that the Senate was considering an amendment to an anticipated job-creation bill to avert the cut, no clear legislative pathway for relief has yet been defined. Medical Group Management Association (MGMA) has reiterated to the Senate leadership the importance of permanently repealing the sustainable growth rate (SGR) formula at this time. All MGMA members and their practices' staff are urged to join physician organizations in repeatedly expressing the importance of addressing this issue to their senators. You can contact your senators via the MGMA Advocacy Center or by calling the American Medical Association Grassroots Hotline, 800.833.6354.

On Thursday morning, the president will convene a bipartisan summit with congressional leadership to discuss efforts to achieve consensus on broad healthcare reform legislation. The White House has released proposed legislation in anticipation of this meeting. These discussions will be streamed online.

Social Networking Enables Patient Referrals

Recently a physician told me that the best advertising was "word of mouth" referrals. I cannot argue with that. Now, imagine if you could harness and accelerate the power of word of mouth. Web 2.0 technologies allow just that.

Your patients are using social network site like Twitter and Facebook to stay in touch with friends and family. They comment on nearly every aspect of their lives, including their health. If you are part of that conversation, you harness the most targeted marketing and messaging opportunity today.

Should you continue to have doubts, Google "social networking" some time. The internet is filled with information and companies that help businesses, like yours, establish and create a social network presence on the internet. It is really not a matter of should be participate, but when will you participate. Patients are using social networks every day. Every day you are not involved is an opportunity wasted.

Why Wouldn't You?

I cannot help but wonder why more medical practices aren't using social networks as part of their marketing and advertising campaigns. New Web 2.0 technologies, e.g., blogs, social network sites, video, etc. afford medical practices unprecedented opportunities to expand the reach into their respective communities without on-going expense.

Many companies, including Primoro, Inc., offer options for getting connected to the popular social network sites like Twitter, Facebook and LinkedIn. And yes, it is true that you can actually connect to these sites for free. But, instead of writing to each of these sites, what if there was a way to write you message once, then have it sent throughout all of your network sites with the click of a single button? Primoro, Inc.'s product CONNECT does just that. You compose your message once and with the click of one button, your message is distributed through your network automatically!

Combine this time saver with customized backgrounds to complement your existing website, and on board analytics, you now have a robust marketing tool. And for any of you doubters as to the value of getting your practice connected to the social networks, take a look at this article from the MGMA.

Primoro, Inc.

404-394-0014

Heathcare Reform In Another Form

Recent activity out of Washington may lead some of us to believe that Healthcare Reform and its impact on physicians, if passed, is in the distant future. Today, I learned the new Jobs Bill the President is pushing has tons of pork in it. One item is the impact on physicians accepting Medicare patients. Off as it may seem, one of the methods proposed to help pay for the Jobs Bill is a 20% reimbursement cut in Medicare payments to physicians. It seems that Congress and the President is hell-bent on cutting fees to physicians. And, if this Jobs Bill is passed this year, and it looks like it will, the reimbursement cuts will also happen this year. If I know Washington, somehow, they will make the cuts retroactive if they can.

So, what is your action? Physicians costs to provide care continue to rise, thus the only way to make up for the proposed cuts is to either:

• Cut you overhead, if possible, and that might mean people,
• Increase your patient capacity, thus stretching your fixed costs,
• Or dropping Medicare patients altogether.

In short, physicians are in a real dilemma. Depending on your specialty, you may choose any of the above. But have you done your due diligence in information gathering to make the best decision? Consider these actions:

• What plans make up the majority of your patient appointment slots?
• Which plans offer higher reimbursement, relative to Medicare?
• Which plans are quick to reimburse after you submit the claim?
• When are your current plans up for renegotiation or renewal?
• Does your patient demography allow you to no longer see patients in one plan while seeing more patients in another?

Answers to these questions can help you decide how to move forward with the business of you practice.

For more information or help, please feel free to contact Primoro, Inc.

What A Difference A Few Days Make

Just after the Massachusetts election of Scott Brown to the Senate, Speaker of House, Nancy Pelosi, commented that she did not have the votes in Congress to pass a Healthcare Reform bill. Fast forward 2 days, and the Speaker commented that she and the Congress were moving forward with Healthcare Reform. Well which is it? I suspect that the Democrat controlled Congress will pass some form of Healthcare Reform. So what does that mean for us?

Well, sadly most practices opened on January 2, 2010 with business as usual. While any reform is probably several years off, this reminds me of the good old RVRBS days. For those of you who are too young to have been affected, RVRBS represented Medicare's strategy to get control, that is to say reduce, reimbursement physicians received from Medicare patients. This occurred in my early days as a consultant. Our team introduced to physicians strategies to prepare for the scheduled annual reimbursement cuts. As such, physicians were prepared with information and could make strategic changes in their practices to manage the reimbursement reductions.

So the question remains. What do we do now? Without the benefit of passed legislation we can study, it seems prudent that physicians take a hard look at their business processes to ensure they maximize their budgets and get as much efficiency out of their employees as possible. Taking stock in own time budget is crucial. The old says, "Time is Money," is no more true than it is today. Improving your efficiency is just good business.

• Have you created a strategic plan for your office?
• If you have a strategic plan, when was the last time it was updated?
• Are your employees committed to your Vision and Mission Statements?
• Are your Vision and Mission Statements still relevant?

Now is the time, while the healthcare business environments remains intact, is the time to make adjustments. Consider making the changes necessary to take advantage of the current environment and prepare for the next.

The True Cost of A Doctor Appointment

The medical service your patient receives is only part of the patient's overall visit experience. Patients use many metrics to "score" the customer service, AND, the overall value they receive.

Value is the result of three components: Price, Access and Quality. Price goes beyond the cost of the professional services. If one considers the time element incurred by patients, the overall cost rises.

Consider the average patient:

• First they have to take time away from work in transportation time, 30-45 minutes one-way,
• Second, most patients find themselves waiting too long in the waiting room, then the exam room, before actually seeing their doctor, 45-90 minutes,
• Next comes the check-out process that may include making a follow-up appointment, 15 minutes,
• Lastly, their commute back to work, 30-45 minutes.

All totaled, and in the best case scenario, the patient loses 2 hours at work. Depending on their hourly wage, the cost to the patient is certainly more than the professional fee they pay to the practice.

Being sensitive to the patient's time is an under-appreciated aspect of customer service and the overall value patient's perceive when they see their doctor. Creating a patient oriented attitude in your office, including expectations to run on time are key elements to providing customer service your patients will appreciate.

Providing exceptional customer service is always good for business!

Is HealthCare Reform Dead?

It has certainly been in interesting political week! With Scott Brown's from Massachusetts election to the U.S. Senate, many a political pundit, both right and left, is guessing what comes next. Speaker of the House Nancy Pelosi says there are not enough votes in the House to pass the Senate's bill. Cap and Trade legislation appears to be questionable. And, President Obama focused his attention to banking regulation reform, much to the displeasure of Wall Street; the markets dropped about 5% in just three days. So what does all this mean for the physician-owner?

While Washington politicians scramble for cover, physicians may be feeling a sigh of relief. I, too, feel somewhat relieved, but I do believe reform in one form or another is in our future, both as a country, a small business owner and for the practicing physician.

The best defense to the changing political and business environment is to have solid business processes in place within your practice. Ensuring your business is fiscally sound, fully trained and competent staffs, as well as a patient outreach program should be your focus for 2010. When healthcare reform occurs, and I believe we will see some type of reform, proactively managing your business always makes good sense.

While we are still in early 2010, consider taking actions to improve your profitability now. Some of these actions are:

• Schedule a financial review meeting with your office manager/administrator,
• Develop a working budget for your practice,
• Develop training events for your staff; clinical, customer service, business process,
• Create a patient communication outreach program. Review you current marketing, advertising and communication plans. Consider revamping your internet presence.

Mr. Rosser has been a featured speaker for a variety medical societies and organizations. He received his Bachelor of Science degree in life sciences from North Carolina State University in Raleigh, North Carolina and has completed numerous management and industry courses offered at University of California, Irvine, and the American Management Association. He is an active member of the Medical Group Management Association and is an Advisory Board Member of the Association of Dermatology Administrators and Managers. Mr. Rosser received the Consultant of the Year, the highest recognition award, from Allergan.

An Interesting CONNECT Week

I have blogged several times about Primoro, Inc.'s CONNECT offering and this week was no exception. Primoro, Inc. installed CONNECT systems for two of Fayette County's non-profit organizations, Fayette Care Clinic, Inc. and Fayette Youth Protection Homes, Inc.*. Fayette Care Clinic provides medical care for the working poor in our county and Fayette Youth Protection Homes provides shelter for neglected and abused children. Both organizations provide needed services, have many volunteers and needed a way to more effectively and inexpensively communicate activities, programs and fund-raising events for their organization.

CONNECT represents a wonderful opportunity for businesses to use new internet technology, commonly called WEB 2.0, to house, host and create an outreach through the internet. Using tools such as blogs, video and social networking sites (e.g., Twitter and Facebook) provides businesses the affordable and nearly instant communication they are looking for. And best of all, once connected, your businesses can, and do, use these tools at no ongoing costs. Some businesses choose to use for-fee services to help maintain the system, usually a monthly fee that runs about $99 per month. In any case, using these technologies should be part of your annual advertising and marketing budget.

Ten years ago, a business could barely get by without a web presence. Today, having just a website is just not enough. Consider getting involved with what internet technologies can help you maintain and grow your customer base.

* The CONNECT systems were donated by Primoro, Inc.

Employee Work Performance Evaluations

Do you conduct employee work performance evaluations (WPEs)? If you don't, you should. For those of you who do conduct WPEs, when do you conduct these evaluations; on the employees hire date anniversary, or do you conduct WPEs for all of your employees at the same time each year?

Conducting employee WPEs is a crucial component to staff management, AND, serves as a building block for overall practice performance enhancement. In short, if your employees are not evaluated, they tend to perform at "meets expectation" levels or below. If they are evaluated as compared to their job description, and as compared to other employees, you create the sense of urgency for them to create and maintain the level of performance your patients expect.

Conducting employee reviews at the employee's hire date anniversary is used by many medical offices. While this represents a better option as compared to not doing one at all, most medical practices would benefit from conducting WPEs for all employees at the same point in time. The

rational is both practical and has sound financial considerations.

From a practical perspective, conducting annual WPEs for all employees a the same time insures no employee is overlooked in the process. It also ensures all employees are evaluated over the same time frame. Lastly, as the evaluation date should be publicized, your employees are never caught off guard and can participate in the overall evaluation process.

From a financial perspective, the physician-owner can avoid "wage creep." Wage creep occurs when the employee receives a merit increase where no basis exists, and, the percentage or dollar increase decision is made in a vacuum. Conducting annual evaluations for all employees at the same point in time each year provides comparisons to other employee performance. Further, I always recommend the medical practice conduct these reviews in February, or early March. Why? Well, first, early in the year sets the stage for employee performance improvement. Secondly, you should have your prior year's financial results to help you determine what percentage increase in wages is reasonable as compared to the practice's financial performance.

Conducting WPEs is an owner's opportunity to reward an employee's performance. It is also a time that you can help your struggling employees with their development. It is a key management responsibility and one that should not be taken lightly.

As a reminder, Primoro, Inc. offers clients comprehensive management consultation, including job descriptions and employee work performance evaluations strategies.

Job Descriptions 2010 Update

With the new year here, it is a good time to update your job descriptions and start preparation for your staff annual reviews.

Relevant and current job descriptions are the basis for developing employee accountability and the foundation for all aspects of employee evaluations, e.g., promotions, dismissals, etc. Having good job descriptions just make good business sense. Steps to designing, writing or updating job descriptions can be a time consuming chore for your office manager. There are some good job descriptions available to medical providers through various vendors, but they can be expensive. One internet vendor is charging upwards of $400 for a CD of various medical office job descriptions.

Steps to creating relevant job descriptions are:

• Careful consideration to the actual job function requirements, and not necessarily what your employee does.
• Establish 3-4 key measurement areas and the activities required in each of these areas.
• Determine the relative importance of each measurement area and assign a percentage weighting to that area, e.g., Medical Assisting, 80% weight.
• Gather input from employees to the functions performed each day. If an employee reports a function they perform, but is not truly their responsibility, reassign that function to the proper job description.
• Once you job descriptions are complete, make sure you employees review their own job description and sign off that they have read and understand their daily job function.

Primoro, Inc. provides its clients with complimentary job descriptions as part of the comprehensive consultation process. In addition, Primoro, Inc. works with medical practices on establishing employee annual review processes that meet the needs of individual clients. Should you have questions about job descriptions, or are interested in implementing a formalized employee annual review process, please give Primoro, Inc. a call.

Welcome to 2K10!

Well, 2009 is past and 2010 is here. I for one am looking forward to a very good year filled with challenges and successes. Year 2009 ended with the US Senate passing their version of healthcare reform. Now, the two houses of government are set to merge both the Senate and House of Representatives versions of healthcare reform into one singular piece of legislation. The final outcome is yet to be determined. In any case, you the physician-owner is challenged with providing medical care in an environment of uncertainty.

It is safe to assume that physicians, hospitals and other healthcare related outlets will bear to brunt of reform. Whether that brunt is reimbursement related, or, new regulations complete with inordinate paperwork, the physician-owner must be efficient. Taking advantage of services that can help you with that endeavor is paramount in light of this upcoming legislative change.

Sadly, since most of the healthcare reform changes, aside from taxation, will be several years off, most providers will begin 2010 with a "business as usual" attitude. The successful practices will instead start planning and implementing business practices that maximize their opportunities for success in future years. Here are few things to keep in mind as you plan your business activities in 2010:

1. How efficient is your practice in serving your existing patient base, including your capacity to see patients, your staff's capacity and your physical space?
2. Have you conducted a SWOT (Strengths, Weaknesses, Opportunities & Threats) analysis for your practice?
3. Have you established your strategic plan for the upcoming 5 year period?
4. Have you updated your Vision and Mission Statements?
5. Does your staff live up to the Vision Statement and execute your Mission Statement?
6. Have you started evaluating 2009 financial performance? If not, get the final P&L and Balance Sheet statements before the end of January!
7. Schedule a meeting with your advisors, legal, accounting, marketing, and other consultants. Conduct your own strategic planning session with all key practice stakeholders.
8. Lastly, spend some time alone thinking about your long range goals, personal and professional.

Wishing you a very successful and fulfilling New Year!