Taking care of your Team members

Happy Team members = A Successful Practice

Take time to get to know all your Team members.

Every Monday 11 am all of us meet
We discuss problems we encountered and find solutions together.
It is also a time to remind our team members about a process that is not being done the way I want it to be done.  Sometimes, analyzing this gets me insights that I will not get if we did not have these conversations.
Analyse the week ahead.

Also we talk about finding ways to make our processes better and also cost effective.

I also meet with my team one on one - once a year
This helps me to find out what their dreams and aspirations are.  And also their frustrations.  I try my best to help them any way I can.  And they know it.  (We have a questionnaire they complete before their meeting with me)

Bonuses - I try to give them an year end bonuses
They have to complete certain tasks if they are to earn their bonuses.
For example, one year I wanted them to learn touch typing
This year, they have to do a good deed every month

Another thing we have done is cross train.  Everybody is capable of doing another person's tasks. And the structure we have is more of a net working kind rather than pyramidal.  What this means is that every member is treated as an equal.

Be generous with vacation time.
Make sure that they are well paid

But more than anything else do not forget to Thank them and tell them how much you appreciate them.

New Team Members

Your office is as good as the Staff you have
Their Peace of Mind is crucial for your success

Spend time getting to know people BEFORE you hire them.

We have a questionnaire that we get them to complete
Click here to view our questionnaire

I personally meet with them
After I have made my decision, I get them to meet with my Team
Then we all meet and discuss about hiring them

Once they are hired, we have a printed list of all their tasks
We spend time educating them on how to perform these tasks

Every week for about 4 weeks I meet with them to find out how they are doing

And if I do find something wrong, I privately meet with them and let them know about it.

Less paper = Saving Money and Saving the Earth

Here are the ways we have started using less paper

1. We found a relatively cheap fax / printer  - HP Office Jet 6500
This has a software that will directly convert the fax to a pdf

Since we have EMR this saves us a lot of money, time and man power

And if you are a little bit tech savvy you can set up all your computers to access this fax file from anywhere in your office.

2. There is a free program called CutePDF.com
You can down load the free version and use it to convert any word document to pdf.
This way you can eliminate printing and scanning docs

3. If you use Google Chrome and try to print something off the internet, it automatically gives you the option to pdf the file rather than print.

4. Our electronic EMR allows patients to log into their account and see their own lab results.  This is another way we have cut down printing labs

5. We have a RingCentral Fax.  When we have to fax something, we pdf it and directly fax it using this feature from the computer.  Once again we do not have to print the paper to fax it to another office.    Here is the link to RingCentral   http://www.anrdoezrs.net/click-2204200-10473456

Cell Phones

The options out there are getting better every day

If your long term contract is expiring check month to month options.  We found them to be a lot more cost effective.  And as this industry becomes more competitive the costs are going to come down even further.

So, think hard and weigh all options BEFORE you sign a long term contract

Buying a cell phone may be cheaper than getting a phone "free" with a long term contract

Unlimited phone, text, data prices now range from $30/ day if you live in a big city to $2/ day - for only the days you use the service

Compare this to the past of 2yr contracts and $100 + per month

ACLS certification

Most of us do not have the time to spend a whole day getting this certification

Now there is a very cost effective alternative
It is a web site
And you could study and get the Card mailed to your home within an hour

There are many companies that do this online
Google "Online ACLS certification"  to find one that you like

As always do not forget to check the ratings of the company before you start the process.

Printers and Scanners

They have come a long way.

Also WE have come a long way :)

Most of us use less paper.  And mostly get electronic copies which are directly uploaded to EMR.

Check your Printer agreements.  We just found out that we are paying for a lot more copies than we are using.  Also some of the very small printers and scanners are a lot cheaper and much more efficient.  We decided to replace our whopping big printer and buy a separate, small scanner and printer.

Will let you know whether I will regret this decision later - but just now things seem to be working out very well.

2/15/2015
I am very happy with this decision.  We hardly use any paper at all now

Leases vs Buying

When we first start our practices, we do have to lease as you do not have a lot of money.

But after you have been practicing for sometime - I have concluded that buying the equipment outright is the better thing to do

Here are my reasons
a.  Peace of Mind - no long term obligations to others

b.  A lease is very similar to a high interest loan. And sometimes they can be nasty.  They will insist that you pay the money even after the machine breaks.  And at the end of the day, the equipment belongs to them.  DO NOT forget to read the small print - we just found out that we need to pay for the return of our large photocopy machine all the way from CA to MO.  And it is all my fault because I did not read the small print.

Once again this is not a simple decision - it is always to ask your accountant and tax adviser what is best for your situation

Online Reviews / Billing companies

Most of the time these are very useful before you buy a product.

But sometimes they can be very misleading.

The best example is Kareo. An electronic billing system that has partnered with the Free EMR - Practice fusion.

We love PracticeFusion.com   

However, the Kareo reviews were not that good. About 2 months ago I decided to just go ahead with Kareo the medical billing system.  And we have been pleasantly surprised with the whole program.

BTW, a word of caution about informing Medicare about the change - the new application takes 20 business days.  So plan to apply about 6-8 weeks IN ADVANCE to your transition.  Otherwise you will not get paid by Medicare for about TWO MONTHS.

Also try to Google your own practice and your Physicians names - just to make sure that there are no misleading or inaccurate statements about your own practice.  And if you do find something - do not get angry - just explain your point of view on the same review section.

Medical Billing

One of my pet peeves...
How many of you would give 5 - 8% of your earnings to your high school son for a data entry project ?

Friends, that is what YOU are doing when you ask a billing company to take care of your billing.

Long ago, this was a very complicated system.  Now it boils down to simple data entry.  Just spend ONE afternoon and you can figure it out.  And you will save a lot of money.   Hire someone to do the data entry.  I KNOW you can do it.

Most of the EMR will have a billing module.
You can trnasmit these files for free
We use Kareo.com
Most insurance companies have direct deposit options - that way the money is directly deposited in your bank account.  You do have to double check the amounts deposited with the EOBs.  That is not hard either.
Try it.

Practice fusion - my favorite EMR :) has partnered with Kareo.com  This is very cost effective as they charge a minimal monthly fee.  We are not using it.  So I cannot really comment on it.  But I have been told that their customer service may not be as good as Practice Fusion Customer Service.

2/15/2015
We have started using Kareo.com and they are good.

Business Liability Insurance

Over the years we pay for different kinds of insurances.

It is very important to spend some time writing all these down in one place. Also document the policy number and the customer service phone numbers.

This way you could decide which ones to keep and which ones to discard.

For example did you know that some malpractice insurances already cover business liability.

Also just call their customer service and see how hard / easy it is to contact them.  For you may be surprized how hard it is to submit a claim.

Google to the rescue...

Google has really helped us to save money.

1. Now you can get a telephone number and voice mail free. It is a VOIP system
2. Google documents are easy to share
3. Calendar is useful too - the nice thing is that you could access all these from any where as long as you have internet access.
4. Blogger.com is fantastic if you want to share your ideas
5. The check out is good - but overall cost per charge is high.

A word of caution. We had a bad experience with ad words. The problem is that their customer service is online. And it is impossible to talk to a human being.  We tried it once. Got a whopping big bill and had to pay it as we had no way to challenge this.

Money

Money is NOT the end all and be all
It is just a TOOL for you to be Happy and have Peace of Mind

So, once in a while pause for a moment and make sure that you keep this relationship you have with money a healthy one.

If you start defining your life by how much you are earning - Your future decision making is going to be flawed.
Please do becareful...
Regroup.
Readjust your value set.

Secret to Happiness...

Love what you do and the money will follow :)
Or, even if you do not get a lot of money - you will still be happy with what you have
And that my friend is priceless...

Back ups

There are different kinds

And they are ALL important

1. First is a back up for your computer / servers. You may have an automated back up system - but from time to time - you do need to check your protocol (once we found out that our power cord was defective, another time we realized that we needed more memory, another time we found out that the system was only doing a partial back up.

2. Next is try to do a test restore.  This is very very very important. If you are using proprietary software, you will need that soft ware to restore your back up.  Dell computers want dell parts etc etc.  Never wait for the actual crisis before you try to troubleshoot this.  And NEVER NEVER NEVER listen to your IT person who will reassure you that everything will work fine.  Make him or her demonstrate it to you.  

3. Keep one back up at another location. And change it at least once a month.  If you have a web site, make sure that it is functioning well BEFORE this master back up. The reason, a hacker might have introduced some new files and now you will have a corrupted back up too :(

4. Cell phones - we rarely have any phone numbers memorized. Imagine if there was an earthquake / storm/ hurricane. You loose power. Your cell phone dies. And you have no way to charge it.  That is why you need a PAPER back up of at least one or two important phone numbers. We have an out of state contact phone number for all our team members.

5. Laptops  - I have realized that they die every third year. So I try to buy a new one about 2.5 yrs into my old laptop, recreate everything the way I want to and just keep it as a back up. So if and when my personal lap top fails - I am ready to move on :)

IT "hostage" situations...

An IT person usually stay in one job for less than 3 years. Accept this. And be prepared.. I realized this the hard way.

If you can afford it, have 2 per team - the rationale is that if one person leaves, you will have someone who will know your net work. Most of us do not have this "luxury"

As a small business owner, there are things you HAVE to know.

a. Insist on getting a detailed diagram of your net work.
b. Make sure that you have a list of all the important passwords.  All individual computers have an administrator password. Make sure you know this password.
c. If your business owns a web site, it is important to know the company this is registered with. And make sure that you have access to the email address that you use for these functions
d. All software has licenses. Make sure that you know where these are kept.
e. Every 3 months, go through this check list with your IT person.
f. If you purchase software, have a designated place to store these.
g. Have a place to store all kinds of cables and power cords too.

If you fail to do these things it can cost you very large amounts of money.

Pay roll

Everyone is scared about making mistakes with payroll taxes

So most start ups hire expensive firms to initiate their payroll

We did the same

Now there are lots of online companies that provide the same services for a lot less money

We use the Bank of America online payroll services - cost came down from $250 to $30 !!!

Excellent customer service. And it takes me the same amount of time as it used to take for our previous company.

Taxes Vs Loans

Most small business owners have been 'brain washed" into thinking that getting a business loan is better than paying taxes  (the argument is that you could claim a tax deduction for the loan interest you are paying)

And the hope is that the investment you made in your business will silently appreciate.

A win win situation

I really think it is time we rethink this argument. 

Before you get a loan, check the total interest payment and also the cost of the loan including the prepayment penalties.  Divide this cost over the number of years you are planning to pay off this loan. You may be very surprised at the numbers you get.  Also do not forget the "peace of mind" factor :)

At times it will be cheaper to pay the taxes and avoid all the hassle and heart ache you may get with this additional long term obligation.

If you really pause to think, you are paying "taxes"  masquerading as "interest" to a bank.  You, the person who is actually earning this money did not get anything at all 

This is my personal opinion - please talk to you tax advisors and accountants before any decision.

Be Happy, Don't worry ...

We cannot make objective decisions when our mind is filled with anger or worry
So everyday, try to have 10 minutes of quiet time.
Check to see how you are feeling
Identify the things that are causing you heart ache
Try to resolve them

It becomes a lot easier to make objective decisions when your mind is free and happy :)

Thinking out side the box...

First identify the problem
Then look around you - you are bound to find a solution
And most of the time it is adapting something you already have to do what YOU want to get done

Example
http://www.naturalreaders.com/index.htm
This is a FREE software for people with poor vision
If you have to deposit a lot of checks, you could use Microsoft Excel to create a list
Now, if you paste this on to Natural reader, it will automatically read it back to you
This helps you to double check your list with ease :)

Water Bills

Little things go a long way
a. Find plants that do not use a lot of water. And try to use indigenous plants.
b. Pay attention to your sprinkler system and the timer. And do not hesitate to challenge your gardner. Their goal is to give you a beautiful lawn. And they would water your lawn as long as they can. Also it is best to water twice for shorter times. (we were able to cut our water bills by 1/2)
c. Artificial grass - initial investment is high - but will save you money in the long term
d. When it is time to replace your toilets, use mechanisms that use less water

Helping others - no cost to you :)

Everyday we wish that we had more time and more money we could spare to help others.
Now you can

Use the links posted at www.ShopSaveFeelGood.com
Staples, Amazon, Dell, Zappos, NewEgg, TigerDirect and 700 reputable stores are participating.
A few cents from your purchase will benefit a non for profit organization.
No extra cost to you :)

Electric bills

There are so many ways you could save.
a. Using low voltage bulbs
b. Educating and encouraging your team to switch off lights in rooms that are not being used
c. In Southern California there is an additional charge if there is a surge in demand.  We created a timing system so that all our air conditioners do not come on at the same time.
d. Solar panels are good for the environment - but at this moment, it may not be economically feasible for a lot of us. But if you can invest - please do.  And be proud that you did help to save our earth :)

Billing companies

This post is for Medical Practices

My personal opinion is that Billing companies charge us too much.
Do a detailed cost analysis.
Most of the time it is easy to train a staff member to submit your bills
You will be in control of the process
And you will save money

Saving on Furniture

Furniture in medical catalogs are expensive

Exact reason for this is unclear

Go to your local furniture store - or check walmart, costco or similar stores

You are sure to get a bargain

2/15/2015
We also found out that "massage tables"  on Amazon is about 1/10th the price of "Exam tables" on medical catalogs.  

By the way if you are using Amazon.com, please take a moment to use the link to Amazon at www.ShopSaveFeelGood.com  - a few cents from your purchase will help the needy.  NO extra cost to you

Time saving measures

Online bill pay saves a lot of time
Also it saves the hassle of going to the post office
Best of all - if there is a discrepancy, most of the online banking teams handle it them selves - all you have to do is to send them an email

Your biggest asset

As a small business owner your biggest asset is you...
Don't forget to take care of your self

Take some time off.
Get adequate sleep.
Eat right.
Exercise.

And never forget to count your blessings and pause and view your achievements :)

Electronic Medical Records

Health Care Reform has made this more affordable.
After doing extensive research, we decided on www.Practicefusion.com
It is very user friendly.  Very intuitive
And yes, it is free for all health care professionals all over the world.

Best part - their customer service team is phenomenal :)

Answering Services

For some, this is an ancient concept
But for others, this is the only way to get some sleep at the end of the day...

In my opinion, out sourcing may be good for some big companies
But for others an intelligent, automated system is the way to go
We personally use RingCentral.com
Savings over $200 per month

Here is the link to Ring Central  http://www.anrdoezrs.net/click-2204200-10473456

Video conference

In my opinion, Skype is better
We can even have more than one person join in
Love chatting with loved ones - both locally and over seas :)
Best of all it is free...

Alarm companies

Having an alarm for your office is a must
We used ADT when we first moved into our office.  But after you have paid for the equipment there are a lot of reputable companies that monitor for a lot less
Price difference could be as much as $100
We currently use AlarmRelay.com

You can save even more if you are tech savvy and know how to just purchase the alarm equipment online and set it up your self :)

Saving on phone bills

When we first started our business we had 6 land lines !!!
Now we have 2
We use Google Voice for all our outgoing calls - and yes it is free.
Google voice gives us a FREE phone number, Free voice mail and email notification
Therefore we think that this is better than Skype.