Each day I receive plenty of email from Nurse Practitioners, Physician Assistants/Associates and other clinicians who have questions about starting a practice, practice models, business development or a variety of other topics pertaining to practice operations, management and marketing.

This video (below) answers a question I received from one individual but encompasses a question I hear more and more often about starting or converting to a cash practice, also known as a direct pay practice.

While many have expressed interest in either starting a practice, focusing simply on direct pay models and avoiding insurance (and its inherent cost and headaches) or switching their already established practice to a cash basis, there are some pros and cons to this. In the final analysis it will depend on the provider and ultimately, their patient base.
Take a listen (6 minutes) and see what you think. Please be sure to leave a comment.

A misconception among many nurse practitioners, physician associates and other clinicians is that we take care of EVERYONE within our area of expertise.  Yes…but. Do you really do a good job with everyone? Do all of your clients and patients really connect with you and you with them? Are you really able to help each and every one of them?  I thought so.

While we might care for “everyone”, the truth is there are certain patients that we do better with. We seem to be able to speak to them and they actually hear us…and we hear them. These are the folks we do our best work with.

How great would it be to have a practice full of these folks…your ideal patients? In truth, it’s hard to see that happening, however, you can increase the likelihood that new patients coming to see you will fit the profile of your “ideal patient”.

In order to do this, one of the first things you need to do is to identify just who is “ideal” for you? Here are just a few of the questions you may want to ask yourself:

• What do you know about them? Who are they? How old are they? Where to they live? Do they have families? What kind of problems and concerns do they have? How do they like to solve their problems?
• Where do they hang out? What are they looking for in a health care provider? What kind of assistance would they need? Where and how to they like to access care? What’s important to them?

The answer to these questions will help you identify who your ideal patient is, the messages you want to create for them (so they can HEAR you through all the marketing noise), and deliver it to them where they will SEE it.

While it would be nirvana to have a practice full of ideal patients, chances are you may still run into folks where the two of you don’t connect well or work well together. That’s part of the work we do. But how much nicer would it be if that was not your entire day.

Take the time to identify your ideal patients and then adjust your marketing practices. I think you’ll be pleasantly surprised at how your practice will change.

Millions of people (and thousands of health care professionals)  saw this Superbowl video ad and were moved – deeply.  I know it… affected me, and everyone I’ve spoken to about it. (No, I did not watch the game). I suggest that all of us take another look, this time for the marketing lessons within. What do you see and how can that apply to your business or practice? Leave your comments below.

Most health care providers who have a clinical practice, or any type of business where they rely on clients, will need to market in order to sustain and grow that practice and business.  While knowing how to market is essential, it’s also just as valuable to know what you should not be doing when you are marketing. It goes without saying that that most common problem is just not marketing, but today let’s focus on the 5 of the most common marketing blunders I see health care providers make.

  1. Religion and Politics: It’s often been said that religion and politics don’t mix with anything. I tend to agree.  While we can all acknowledge that a persons faith does play a part in health, in most cases you are better off leaving these topics out of our marketing.  When is it appropriate? If your business is specific to a certain group based on religion/faith, and these are the specific folks you are offering your services to, then feel free. Just be aware, that you’ll potentially lose patients that have other feelings.

 2. Omitting Contact Information: Believe it or not, health care providers have created brochures – beautiful brochures –  for their practice and omitted contact information from their marketing. Always check and double check all of your marketing materials to ensure you have the proper contact information clearly displayed.

3. About you!  Health care consumers want to know about you, their health care provider. Anymore they don’t want to come into your office without knowing something about you first. Make sure you have a page on your website that tells something about you the health care provider as well as something about the practice itself (ie, health beliefs, mission, value statement, etc).

4. Drowning in brochures. When you call on another office or business to leave some of your marketing materials, be mindful of how much you are leaving behind. The office may not need/want that many and may be too shy to ask. Their patient population may not be ideal patients for your own practice. There can be any number of reasons. Be sensitive to their needs as well as your own.

5. Automation. Many practices utilize an auto attendant to answer their phone. While I understand the benefits of this for the practice (I love automation), it is also a very cold way to greet your patients at best, and at worse, can be seen as uncaring and downright hostile. The same goes with patients being place on terminal hold as if their time is not important. So while automation is important and often necessary for some practices, take care to minimize its use.

The one thing that is not listed here, but permeates this short list is poor customer service. For any practice, this is one of the most important marketing concepts to keep in mind. Poor customer service will definitely get people talking about your practice, but not in a good light. So if you do nothing else for the year, remember that excellent customer service, along with excellent clinical care will get people talking about you, raving about you and your practice. And when it comes down to it, that’s the most powerful marketing of all.

Do you have marketing blunders to share? Feel free to share with us.

© 2012 Barbara C. Phillips, NP

Nurse Practitioners and other  Clinicians can no longer continue business as usual.

Our patients (clients, customers) deserve and expect much more. Gone are the days when a white coat gives one cart blanche to treat patients and staff indifferently behind the ruse of being busy. There is no doubt that you are busy. But just as you want respect from your patients, they are now expecting it from you as well.  Addressing one of the most common concerns patients make about provider offices will go a long way.

You are no doubt familiar with this complaint: “Every time I go to that office, I have to wait for hours!” I trust patients waiting in your office, wait for a much shorter time. There is much we can do to reduce wait times, but waiting is a reality for both patients and providers. It’s a fact of life that emergencies and other situations can and do happen.

So what can we do to minimize the impact of waiting? Well, it turns out there is much that can be done.

1. First – stop calling it a “Waiting Room” and rename it a reception area or something similar. Waiting Room implies that I will be waiting, no matter what. Changing the name can help reduce that perception and soften the idea that there will be a short delay before seeing the provider.
2. Make your patients comfortable. Patients have been invited into your office to see you. Think of this as your work “living room”. Make sure the reception area is comfortable for your guest. Take a seat…are the chairs comfortable? What about the room temperature? Too warm? Too cool?
3. When we are waiting (and idle) time can seem to drag on and on. However, when we are distracted or better yet engaged, time flies. Do you have a variety of reading material that is up to date? And while you are at it, is the lighting appropriate for reading? I’m not a fan of TV’s in reception areas, but perhaps you may want to consider a TV or video screen that is playing something engaging and appropriate (maybe even educational)?
4. Comfort Station. If possible, it’s nice to have a restroom available to those who are waiting as well as water or other appropriate beverages depending on your office situation.
5. Children. It can be quite irritating to a non-parent (or parent!) to listen to a child who is bored and tired. If you see children, or the family members of young children, consider having appropriate items that may keep their hands and minds engaged.

Most important, if you have patients waiting to see you, make sure they are keep up to date on any delays. Consider offering them the option to reschedule. Respect your patients and their time. It will go a long way in making them happy, satisfied patients.

What changes can you make in your reception area today?

This is literally the most common question I receive from Advanced Practice Nurses (NPs, CNMs, CNS, CRNA’s) and Physician Assistants/Associates (PAs). So this week, I thought I would create a video to answer just that question. It’s short, about 10 minutes explaining the framework I teach in practice and business startup.

Please share your own tips with your colleagues below.

You are invited to join us on a FREE webinar on Sunday 10/30/2011. Keep reading to learn more!

As a Nurse Practitioner and a Physician Assistant, you work exceedingly hard every day to make sure your patients get the best you can offer. You have been well educated as a clinician and are quite accomplished in your area of expertise.

However, one thing that NPs and PAs don’t always understand (heck, it’s not often understood by those who educate us) is that we are a “business” unto ourselves. In fact, every “revenue generating” clinician  is a “business”.

Yet business education is lacking in our schools. Makes sense – they are busy making sure we are excellent clinicians!

It’s time we, truly begin to grasp the concepts of business in healthcare. I don’t mean just the kind of healthcare business that counts it’s beans at the end of the day, but a business in which the modus operandi  is creating a culture where healthcare a  “win-win-win” for all involed.

In order to get there…we need to be more aware of business concepts, how practices work, and how we can effectively make a difference in our own practices, or the practices of others.

And this is exactly what I want to talk about this Sunday, October 30th at 5PM Pacific on a free webinar. Space is limited, so please, go here now, listen to the video and sign up for the webinar.

See you on Sunday!

As a professional, you are very aware of the need to protect your personal and professional information. But how much thought have you given to your digital identity? Are you even aware of the far reaching consequences that miss or stolen digital identity can have?

The following is a true story that was recently shared with me. Imagine that an old friend looks to see if you are on Twitter. They find you, and they see your picture. However, they are perplexed because your tweets are very much out of character, and indeed quite inappropriate for a professional. In truth, it’s not your account. It’s your name and your picture, but it’s not you. Now imagine if you will, that the person searching for you is a potential employer, business partner, post grad school acceptance committee or a disgruntled patients lawyer.  Ahh…big problem!

It’s not always a matter of deliberate stolen identification, but mis-identification is far more common. Do you know, for example, how many Barbara Phillips’ are out there? I share my name with other NPs, physicians, real estate agents and more. Chances are it’s not much different for you. This is why it’s so important for you to claim and then protect your digital identity.

Here are five steps you can take now:

1.  Search. Log on to Google (your favorite browser) and search for yourself.  What do find? How many people have your name? Do they have accounts of Google, Facebook, Twitter, LinkedIn?
2. Create a Google profile. Include a professional picture and some professional information. There is no need to share personal information.
3. Purchase you name as a domain name. For example I have www.barbaracphillips.com. If you can put up a website or blog, or even just a one page with a snapshot of you as a professional. If that seems too difficult at this point, get the name anyway and just hold on to it. Domain names @ www.1and1.com or www.godaddy.com run less than $10.00 per yr.
4. Claim your name and create profiles on LinkedIn, Twitter, Google Plus and Facebook. There are literally dozens of other SM sites, and you may want to create a presence there as well, but at least do the big 4.
5. Create a Google Alert for your name.  You will be notified every time goggle finds your name mentioned on the internet. You can set it up to be notified daily, weekly or monthly.

While this can seem to be a lot of work, and may even be overwhelming, it’s really important that you take the time and begin to work on this step by step. Doing so will help protect you digital identify and your digital reputation.

(c) Barbara C Phillips, NP, 2011

I am frequently asked “what kind of business can I have”? While there are several forms of business, most NPs and PAs choose a clinical practice. And while most chose primary care, more are choosing a niche or specialty practice. One such niche is urinary incontinence (UI) care.

A continence practice is a fantastic opportunity for the advanced practice clinician. There are three very important factors for this type of business. First, there is a huge need; second there are few clinicians involved and finally, the evaluation, management and procedures are reimbursable.

A flexible, scalable model

What is nice about this type of practice is that it can be set up to work within office (yours or someone’s), a long term care facility and even within the home using a house call model. It can be full time or part time. And for those that already have a primary care practice, this is a great add-on service that can help build your practice revenues.

For those that like to work with a patient for a specified length of time, have them get better, and only see them back for “tune-ups”, an incontinence practice is ideal.

This business model is also scalable. You can start of doing it all yourself and as the business grows (if that is your plan), you can add additional providers and staff in order to accommodate your growing business.

Reimbursement

Medicare and most insurance companies will reimburse for assessments and procedures that are done in an incontinence practice. This will include your initial assessment, urodynamic testing (simple or advanced), microscopy, ultrasound, laboratory testing (both send-out and point of care), patient counseling, pelvic floor rehabilitation and more depending on how you set up your practice.

Often, tools that patients might use are hard to find and this can be an additional source of revenue. You can offer hard to find items to your patients in your office or through your website.

A Day in the Practice

As with any practice, your day will vary depending on location (office vs long term care facility for example) and other factors, however the basics are the same. Your job will include (but is not limited to):

• Evaluation of incontinence for pelvic floor dysfunction, overactive bladder or other issues that may be causing or contributing to UI. You will likely perform simple cystometrography as part of your workup.
• Counseling patients regarding behavioral modification, prevention and treatment of constipation, diet modification, fluid management as well as exercise they can perform.
• Treatment of the cause with medications and pelvic floor rehabilitation and electrical stimulation as indicated.

Getting Started

Like any business, you have perform the necessary analysis and evaluation to determine if this is the correct business for you. You’ll need to learn how to get reimbursed and how to maximize those reimbursements as well as know what it takes to operate a business. And of course getting started and finding your patients and referral sources (ie, the marketing) is key.*

Continence is a state that all people strive for. When it’s not present, it affects an individual physically, emotionally, financially and socially. This is an area that clinicians can make a huge difference in the lives of their patients. The need is great, the need is now.

For more information on building a business and building a continence practice, Helen Carcio, NP @ The Health & Continence Institute (HCI) offers an opportunity for the entrepreneurially minded NP to establish a lucrative continence care program of excellence.  She offers course intensive courses a few times per year and it’s a training well worth going to.

© 2011 Barbara C Phillips, NP

Ready to learn how to start your nurse practitioner owned business and practice? The NPBO™ Practice Startup System Program begins it’s summer session on July 12, 2011. Lots of folks have had questions…here are the answers.

Visit http://www.NPBOStarterKit.com