New year, new concerns: How to set medical practice goals for 2012

A column about keeping your practice in good health

By — Posted Dec. 5, 2011.

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What is your practice going to accomplish next year?

Experts say setting goals for the coming year that do not fall by the wayside like many New Year's resolutions is increasingly important to help medical practices stay focused and in business, what with all the changes being wrought by health system reform.

"We're in a very dynamic time in health care, but it's not a stable time," said Manuel Lowenhaupt, MD, a partner in Accenture's health provider practice in Boston. "Practices need to recognize that their ability to flex and change and focus is much more important than it has been in the past."

And December is not too late to set goals for 2012. "It's never too late," Dr. Lowenhaupt said.

People who work with medical practices say the first step in goal setting is to identify aspirations that are large and overarching. Experts advise that any list of goals include ones that are both realistic to achieve within the next year and ones that are more long-term. There is no specific number a practice should have, although too long a list can become unwieldy.

"You need to have goals to build a strategy and manage a successful business, but if you have more than 10 goals that you hope to implement, it can become unmanageable," said Jason Hwang, MD, executive director of health care with the Innosight Institute, a think tank in Mountain View, Calif., that focuses on innovation and business.

Goals should be in line with the needs and priorities of the practice.

"Each individual practice is going to have their own mission or vision as well as their own financial or operational goals, and they should be tied into where you want to bring your business," said David MacDonald, president and CEO of health care consultancy Aegle Advisors in Marion, Mass. "You need to know what the practice's challenges are."

For example, is the practice so busy that patients are frustrated with long wait times? Are phone calls from patients not returned in a timely manner, or not at all? Are new physicians or staffers needed to maintain a level of care and keep patients coming back, as appropriate? Are employees disengaged from their jobs? Even if the practice is financially successful, ignoring such issues may jeopardize its future, experts said.

"A practice may need better logistical planning," MacDonald said. "In this economy, patients are paying more for health insurance and more for care. They expect more value and to get the service they require on their terms."

Various aspects of health system reform, such as the move toward accountable care organizations and quality-based payment, mean that practices may want to ask: Are there any care gaps or issues with quality? Are there connections that can or should be built with other physicians?

"There are a lot of things changing right now," Dr. Lowenhaupt said. "The key is to make sure that the patient experience aligns with evolving needs."

Or is the practice already struggling financially? Does the practice need to find ways to bring more patients into the door or collect a higher percentage of co-pays and deductibles before the patient leaves the office? Does the practice have a high no-show rate? Can office space be used more efficiently?

When the larger goals are identified, the next step is to identify how to get there by breaking things down into smaller, measurable targets. For example, a practice struggling with wait times and patient satisfaction may want to look at improving how patients flow through the office. Where can the process get better? Which staffers should be given specific tasks to achieve this end? If practice financials need improving, are there ways to ensure that patients do not leave the office without at least discussing how to cover their share? How can this goal be broken down so each staffer knows how to achieve the goal?

"You need to link everybody in that chain to the success of the goals," MacDonald said.

After goals have been devised and broken down, practice management consultants say the next step is to communicate to staffers the overarching goals and what they mean to each employee. This can include information about how employees and the practice may be rewarded if targets are hit.

For example, practice goals for next year can be incorporated into performance reviews or various bonuses. Staff rewards for hitting respective targets can be financial but may be nonmonetary, such as additional time off or public recognition.

"Every time you achieve something you should be talking about it," MacDonald said. "People will feel valued, and it gives them that positive reinforcement around these common goals."

People who work with medical practices caution that any plan take into account that change takes time.

"A practice needs to ask: How do we want to move our people in the right direction?" MacDonald said. "None of this stuff happens overnight, but once you lay it out there, you will start to see movement. You can really move an organization forward."

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