One thing that’s always the same in health care is the constant state of change in the industry. New techniques, procedures, research, procedure and diagnosis codes, payer policy guidelines, etc.—it’s always in flux.
The chiropractic and multidiscipline specialties are certainly not exceptions to the rule. Regardless of your practice type, the procedures you render, or the products you offer, you are going to find that change is inevitable. When by choice, change is welcome, exciting, and easier to prepare for, but unexpected and uninvited change catches you by surprise and contributes to frustration and uncertainty in your practice, with the ripple effect of coding, billing, collections (patient and payers), and communication obstacles (patients, teammates, and payers).
Let’s look at just a few common occurrences:
• New procedures implemented into your practice that you have discovered are not well payable or payable at all by third-party payers.
• Increase of limits on patient coverage or capitated plan policies that restricted your expected cash flow.
• Discovery that your state doesn’t permit payment plans or programs offered by your practice in the manner that you offer them.
• Change in your local demographics resulting in more insurance patients or self-pay patients (without insurance) coming through your door.
• Billing-related problems resulting in rejections, denials, and accumulating aged accounts receivables.
• New business opening nearby that may have competitive products or services.
• A change in team members, which may somewhat alter the dynamic of your practice and how certain tasks are accomplished.
• The realization that, while you’ve continued in practice with the same systems year after year because, “well, that’s what we’ve always done,” but now this approach is not as effective or profitable as it once was.
And the list goes on...
For each of those items listed, as well as other obstacles, there is a manageable and beneficial response and, in many cases, a productive solution—perhaps one even better for you and your practice than you might expect. Resisting or avoiding the reality of any of these elements increases provider vulnerability from various avenues. Bending or breaking the rules (federal, state, payer, etc.) is not really a viable option either—after all, you want to operate in the best position to be paid properly for what you do and to keep that money once it’s been paid (by you patients and payers).
So, what is the answer to the ongoing changes taking place in our industry and our practices? Adaptation.
Note that adaptation doesn’t mean surrender and acceptance. It means you’re recognizing and understanding the details of your current situation, identifying the challenge(s) that you now face, and taking immediate action steps to plan, prepare, and adapt moving forward.
Keep in mind that this doesn’t mean you have to agree with the situation; you can certainly be proactive in other ways to make changes that could improve your current scenario. However, you also shouldn’t hold yourself and your practice hostage by resisting the necessary steps of adaptation. By doing so, you could be effectively sabotaging your business, yourself, and your team. The same applies to any team member in your practice who may be unwilling to make necessary changes to better perform in their role or who perhaps resists providing information or giving/accepting assistance that could be helpful to the team or practice.
You may be familiar with the book Who Moved My Cheese by Dr. Spencer Johnson. That short story presents a profound message that is invaluable to us in our practices. The story is about four characters who had settled in comfortably and developed daily routines surrounding a station of cheese they had discovered. Day after day, the characters would travel from their homes to the cheese, always with the expectation that the cheese would always be there, just exactly as it had been the day before. One day, they arrived to discover the cheese was completely gone.
"So, what is the answer to the ongoing changes taking place in our industry and our practices? Adaptation."
While each of these characters was in shock at the empty cheese station before them, two of the characters immediately understood that change was necessary. They promptly left their comfort zone in search of new cheese.
A third character became angry and bitter. Upset that his cheese was gone, he continued to go back to the cheese station each day, expecting that it had returned exactly as it once was, but each new day, there was no cheese, so his anger and frustration increased. When it was suggested that he go in search of new cheese, he became more frustrated and more adamant that he was not going anywhere, but rather he would insist that the cheese must be immediately replaced, exactly as it had been before. Even as he became weak, tired, and hungry, his perspective didn’t waiver.
A fourth character was upset and confused for a period. He continued each day to come to an empty cheese station, wondering what happened to the cheese and why. Over time, when he was weak, hungry, and afraid, he concluded that the cheese would not reappear as it had before at that cheese station. He decided that if he were to survive and prosper, he would have to search for new cheese. He pondered his past and realized that he should have seen that the cheese was getting old and lesser in supply. He pondered his future and envisioned new cheese and opportunities that may be before him. The story goes on to describe the uncertainties, adventure, building of confidence, and eventual prosperity that this character had in his journey. It shares the steps he took to adapt to his circumstance and his discovery of a new cheese station with more and even better cheese.
The underlying message in this story is that many changes that take place can be recognized quickly if we don’t become too stuck in our routines and expectations, and by keeping a finger on the pulse of our businesses. Next, when inevitable changes do occur, we can minimize our suffering and strife by taking the reins more quickly, choosing our path forward, making plans, and executing the necessary steps. Ultimately, while we may not always be in control of change and its effects on our practices, we do control our response to it. The benefits to businesses and ourselves could be far better than we realize if we are proactive in “searching for new cheese” with strategized adaptation.
So, what are our best action steps to move toward efficiency and prosperity in your practice?
1. Acknowledge challenges or changes within your practice’s efficiency and profitability.
2. Take the reins (it’s up to you!) in moving toward “new cheese.” This could mean evaluating and gathering information with your team and delegating action steps forward. It also could mean reaching out for information and guidance from trusted individuals and organizations, such as Sidecar (www.sidecaredge.com).
Build confidence in your practice and your team. Enjoy the journey!
Often, when deciding to create change or strategically adapt to change that has occurred and impacted your practice, it can help to reach out for information and guidance. Why learn by trial and error when you don’t have to? The entire Sidecar (www.sidecaredge.com) team is equipped with tools and experience and is ready to join you and your team in making your practice as efficient and profitable as possible!
About the Author
Brandy Brimhall CPC, CMCO, CCCPC, CPCO, CPMA has served chiropractic since 1999. She holds multiple certifications in the areas of coding, compliance, and auditing. She has a passion for serving practices by helping them obtain information, understand rules and regulations and streamline their practice systems.
