Do You Know Your Practice Management Metrics

Too Many Variables

How can Dr. Ben effectively put his information and ideas into his chiropractic practice?

Ben closed his office door gently and pulled his chair up to the desk. He pulled his wife’s crayon-made chart from his pocket and smoothed it out on the desktop. Carmen knew a lot about business, he thought. He had to admit that he found that part of his job challenging, but he was also confident that he’d be able to take control of this aspect of the practice now that he had some direction.

With medical information, he could look at a few pieces of data and see what was going on — or what else he needed to know to find the answers to his questions. If he needed additional information, he knew where to look for it. And generally speaking, the patients’ charts had the data he needed in the places where he expected it to be. His own experience with that data made it instantly meaningful.

It didn’t seem to work that way with practice management. So Carmen had grabbed one of their son’s crayons and drawn him a chart. Ben chuckled.

Ben copied the chart into a spreadsheet and hit “print.” He heard “Dr. Ben?” at his door and just had time to put away the original chart before Pam entered. “Dr. Ben, we have another last-minute cancellation.”

Pam handed Ben the patient folder. “She’s done this before, hasn’t she?” he asked, checking the file.

“She does it pretty regularly,” Pam admitted. “She always says something about work, but I wonder whether maybe she just finds herself short before the appointment comes up, and makes excuses so she won’t have to pay.”

“Do we have other patients who work at the same place she does? Do we have the same kinds of problems with them?”

“That’s a good question. I’ll check on that. I hate to have to charge her if it’s work-related and she can’t help it.”

“If we take that position, though,” Ben pointed out, “we’d never charge anybody for cancelling, even though we have a sign out there explaining the policy. Everybody probably has a reason they think is important.”

“I know, but if the cancellations are caused by financial problems, then charging…” Pam continued, but Ben had stopped listening.

“This is paralysis by analysis,” he interrupted.

“What?”

“I mean, we’re looking at so many possibilities and so many hypotheticals that we’re never going to be able to make a firm decision. If cancellations are enough of a problem to us that we have a policy, we ought to follow that policy. She could go to her boss and explain that she’ll lose that $35 fee if she cancels, and then it would be in the boss’s court. Or if it’s financial, she could level with us and we could work out a payment plan for her. All those things about her life are just muddying up the waters for us.”

Pam nodded. “You’re right.”

“Or if our data shows that cancellations don’t really make any difference to the bottom line, then we could get rid of that policy. But let’s narrow this in to the most basic information we need for the decisions, instead of broadening it out to include all the possibilities we can imagine.”

Pam left looking satisfied, but Ben remained in the office, lost in thought. It sounded good when he said that, but the truth was, he didn’t know what no-shows cost him and whether they needed to be firm or not. He didn’t even know how often this particular patient had made a last-minute cancellation or not shown up for an appointment, and Pam simply had a feeling about it, not hard facts. This was definitely a case in which having fast access to the KPIs would improve decision-making at his chiropractic practice.

In fact, if he or Pam could spend a little time sorting these things out, they would probably make it up by having fewer conversations agonizing over decisions of that kind and second-guessing their earlier decisions.

Ben looked at his spreadsheet. Why couldn’t someone from the office staff pencil in the current figures every week and calculate a running total? Then when questions arose, they could take a quick look at the spreadsheet and find exactly the information they needed.

Pam wouldn’t like it, he was sure, but it seemed like just the right solution.

Disclaimer: For HIPAA compliance, all characters appearing in this post are fictitious. Any resemblance to actual persons or actual events is purely coincidental.

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