Whether you are a seasoned veteran doctor or just setting up shop, one thing is certain: you didn’t spend all those years in school to do administrative and office work. That is why you have a support team. You should be the doctor—free to practice and not tied up in the details. Where do you start, what do you do, are things going the way you want and where do you go from here? It is simple; you need a "system," a system that trains you and your staff so well that you can step out of the daily trenches and really function as the doctor.
A definition of system is a well-ordered arrangement of disciplined actions to be taken. The result of a system is to allow areas of your business to operate with predictability and accountability with minimal involvement on your part. Systems can be established which benefit all areas of your business.
None of this needs to be overwhelming; just take it a step at a time. Ask your employees to help. Don’t assume that your employees automatically know what to do; communicate and let them know what you want and why! First, observe and record how your office runs on a typical day. Examine each specific step of the day and look closely at what happens. Note what you like and what you don’t like. Is there a logical and predictable sequence of events for everything from the incoming telephone call to the end of day duties?
Here’s an example of a simple task, yet a vital part of the system: The telephone call—the critical first impression of your office.
• One employee should be designated to answer the telephone first and then a second employee would answer when the first is not available, and within a specified number of rings—the domino effect.
• Each employee is to answer in exactly the same way, for example, "Good Morning, Busch Chiropractic. This is Ashley. How may I direct your call?"
• Decide which employee will always take a new patient’s telephone call, and then the next employee to take the new patient call. Establish an order of employees who can accept a new patient call. You may go as far as to decide which employees will never take a new patient call—the first impression of your office.
• Have a list of questions, so that you can consistently retrieve information that you would like to know about the new patient.
• Get control of the call and incorporate objections and the answers in your initial presentation to the new patient.
• Decide how thoroughly you wish your own incoming telephone calls to be screened.
• Create steps to properly record any telephone message, and what happens to the message. Post-It notes and scraps of paper can get lost, thrown away or buried under files. Have a message recorded on a carbonless message pad or forms which always includes date, time and who took the message.
• For existing patients, create a form titled "Patient Messages." Use an 8½ x 11 inch paper and then transfer any details about the patient. Paper is cheap! Make a copy for the doctor and place a copy in the patient’s chart. These can hold vital information that could help you in any future matters.
Here is an example of an intangible point that has a tremendous impact. Think about all of the great service you have received in your life. Perhaps it hasn’t been often. Regardless of where you were: whether it was a local diner or a five-star restaurant, if they provided great food and great service without your asking, you will remember this. You would wish to return and you would definitely recommend it to friends. Great service is what keeps people coming back, sometimes taking priority over the cost of the product or service. Quality and service is remembered long after price.
You want to be the clinic they come back to and recommend to their family, friends and neighbors. Train your people to deliver world-class customer service within the system. Tell your employees exactly the attitudes you require to be exhibited, as they are a direct reflection of you. Patients go where they are wanted and stay where they are appreciated. Attitudes of employees are based on the attitudes you create. This will create more patient referrals and recommendations to new patients. And, if you and your staff have exacting methods, procedures and scripting, the patient’s confidence will be at its highest before care even begins. This is all part of a system.
The goal is to identify and record every detail of every step of every process in your office. A procedure will be created and documented for everything from "Answering the telephones" to "What to do if …. " Every situation will have a specific action and/or response to be taken.
Your staff can learn how to create an appropriate barrier between the doctor and patient for situations that the doctor should never handle and always defer to the staff. This will eliminate the number of "got a second" and "what about this" questions from both the staff and the patient. This will make your office smooth, sophisticated and avoid outwardly awkward moments.
Here are some examples of patients’ concerns that will be overcome by the preparedness of the employees, and this is an important part of a system: You train your staff and you defer to your staff, and never outwardly become involved with the financial end and details such as the following of your patients’ care.
• Why don’t you participate in an insurance network?
• Why do I have to pay for my care?
• Why won’t you file my insurance?
• Do you discount your fees for cash payments?
• Will Medicare pay for it?
• What if it doesn’t work? Is there a guarantee?
• I want to pick up my X-rays now.
• I want an appointment today.
• I missed my appointment this morning; can I come in this afternoon?
• I don’t want X-rays taken because Dr. So-and-So never did.
• Dr. X didn’t do it that way.
You begin to create a blueprint and, once this is completed, it will be used by anyone that works for you. You record everything that you and your staff actually say and do daily. Once your processes/procedures/protocols and scripts are set, they should be recorded in training manual form. Things that will be covered are anything from the "new patient" first phone call and all the information you wish to provide to the patient and also retrieve from the patient, to the way a patient is processed, consulted, examined, reported and all the financial data. Well-trained, systematized employees will take a significant part of the work away from the doctor and establish the highest level of confidence in the patient. These employees will become a vital part of your improved stats, and will become an important role in the new patient inquiries, report of findings, patient conversion statistics, and patient success stories.
When portions of your system are documented, test the processes, rehearse and role-play. Run the business exactly as you have written it down. When you are done, don’t change a thing. Don’t allow an employee to change a thing! Remember, the employee should be able to read, learn the steps and follow them. You can ask for feedback, see if corrections need to be made, and then let go—trust your employees and trust your system.
Your staff must have the desire and discipline to follow the blueprint, but also have freedom and authority to act if there is an exception which needs to be made. Anticipate the unexpected and have generic responses in place. When this is done, there will be no doubt or hesitancy of what is the proper process and protocol of the office, and most situations will be dealt with immediately and correctly! Bear in mind, there might be periods of time when one or more support team members are absent for whatever reason. Cross-training should be a key part to your system. There should be the trained utility workers, those who know all aspects of your office tasks (scheduling, answering phones, faxing, filing, etc.) so that, even when someone is absent, your business flow is never interrupted.
Your office technology, accounting, finance, HR, technology support, administration should be part of the process. All of these departments should be defined and assigned. There are many back office duties that need to be entirely segregated from daily staff and could be economically outsourced. Delegating tasks that do not pertain to what you do as a doctor will help you become more focused and effective; although, you still need to be reported to and you must have a set of checks and balances.
Now that you have given your staff a blueprint for the system and you have clarified and communicated exactly what you expect—step away from the trenches and enjoy being the doctor with total practice freedom.
Dr. Richard E. Busch III, President and Co-founder of Freedom Awaits™, has what may be considered one the largest axial decompression/chiropractic cash clinics, Busch Chiropractic Center, in the United States, and may be reached at 1-866-662-BACK (2225) or
, or by visiting www.freedomawaits.com.