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Reimbursement and Practice Management

Getting New Physicians Up to Speed – Fast

Hiring a new physician should do more than ease long work days for the practice’s other physicians. The addition of a new physician should, after a start-up period, allow the practice to improve revenue while expanding access for new and established patients alike.

In this article, you will learn:

  • Effective scheduling techniques to help new physicians see enough new patients
  • Techniques to help keep physicians on time
  • Positive outreach strategies and mentoring to help the new physician succeed
  • Ways competition can inspire increased productivity

View related pearls

Hiring a new physician should do more than ease long work days for the practice’s other physicians. The addition of a new physician should, after a start-up period, allow the practice to improve revenue while expanding access for new and established patients alike.

Why do so many practices with new physicians struggle to achieve these outcomes and contribute positively to their new practice? Too often, the medical practice fails to adequately analyze its new physician’s performance to determine opportunities and remove barriers to becoming a productive clinician.

If a new physician in your practice averages far fewer patient visits daily than everyone else, even after several months, then it’s time to assess whether you’re doing enough to bring the physician up to speed. Here’s how successful practices go about analyzing and improving the ability of their new physicians to contribute to a better bottom line.

Recognize the role of scheduling
What is the new physician’s monthly ratio of new patient appointments compared with the total number of appointments scheduled? You should see that physician’s ratio of new patient visits growing each month or, at the very least, holding steady. If not, look to see if your schedulers are sending enough new patients to the newly hired physician.

The scheduler has a significant influence on the patient’s choice. A schedule who says, “We can schedule you right away with Dr. Smith’s new junior associate who just completed his fellowship,” isn’t doing that new physician any favors¬ and probably failing to book any new patients for him either. Instead, instruct your scheduler to state: “We recently welcomed Dr. Jones to our practice. She has an appointment available on Friday. Would that work for you?”

The knowledge that you are monitoring the percentage of new patients directed to your new physician sends an important signal to schedulers to not overlook the new physician. New patient volume isn’t the only – or always the best – way to measure productivity, but it is a good indicator to watch during the new physician’s first year or two.

Do you have a process in place to regularly monitor whether the new physician stays on schedule? If you notice him or her falling behind on most days, temporarily increase the time allotted for various appointment slots. For the first several months, even five extra minutes can make all the difference.

Like any valuable investment, a new physician on staff must be monitored and nurtured to grow. Careful observation can uncover roadblocks in a new physician’s path, such as failing to use clinical support staff appropriately.

Alternatively, it could be that you are requiring too much of their time for administrative work and other non-reimbursable activities – expect new physicians to spend most of their efforts on building a patient base during the first few years with the practice.

Develop scheduling flexibility
Is the scheduling template for the new physician rigid, or do schedulers have enough flexibility to juggle patient slots in his or her template? Don’t let a new physician define a template so inflexible that slots go unfilled. Avoid allowing vacant slots for established patients to go unfilled if there’s a new patient waiting for an appointment.

Although clinical expertise may certainly define what type of patient is appropriate for the new physician, new physicians should have open templates so they can accommodate new and established patients alike, as well as see their fair share of the more generic patient problems that your practice accommodates.

Clarify expectations
Have you created clear expectations and set down measurable objectives? A new physician might not know how many patients he or she should be able to see in a day, or how to hit the production targets you establish. Frequent follow up, advice and mentoring are important; residency and fellowship training programs don’t always provide a real-world view of building a practice.

Have you established productivity incentives for hitting performance goals? It is common for practices to place new physicians on salary for the first one to three years, but be sure to offer some incentives during that time, too. Tying just a small percentage of salary to goals – meeting expectations of weekly patient volume, for example – will send a clear signal that your practice values physician productivity.

What exactly have you done to help the new physician work faster and smarter? Consider pairing the new physician with your most efficient and experienced physician. A worthy mentor is one who models good work habits and is a teacher – someone who shows the new physician opportunities to work more efficiently.

Avoid assigning the slowest or laziest nurse to the new physician; an efficient clinical support staff is a necessary building block for positive work habits. Deliver sufficient training on the practice’s information systems, particularly the electronic health record, to the new physician –being young does not guarantee instant computer expertise.

In addition to working efficiently, encourage the new physician to meet hospital and surgery center officials, as well as referring physicians. Consider inviting the new physician to observe discussions about the practice, including practice meetings.

Instill competition
Have you sought opportunities to apply a little peer pressure to go along with the mentoring? Present productivity data broken out by provider at each physician meeting. The new physician may start in last place and stay there for a good while, but at least display his or her progress at physician meetings. It may open discussions and sharing of efficiency tips.

Is your new physician trying to do too much? Set up a process for clinical support staff to effectively and efficiently triage phone calls, prep patients’ records and perform comprehensive clinical intakes. Make sure that physicians – new or experienced – do not waste precious time on clerical tasks such as tracking down lab results or searching medical staff directories to find referring physicians’ telephone numbers. Ensure that everyone in the practice is working to their potential.

Have you made the effort to get to know your new physician? A new physician may miss the social connections forged with peers during the intensity of training. Try to develop a professional camaraderie and a personal friendship with your new physician. Invite family members to social functions so they can feel a part of the practice and your community. These informal interactions may offer the best route to develop your new physician into a valued and permanent member of your practice.

New physicians can be both a significant investment and a tremendous asset to your practice. Finding the physician who matches your practice’s needs and meshes with its culture is difficult. Don’t squander all that effort by allowing them to drift along during the initial months in your practice. Motivated and productive physicians will help your practice grow – your job is to put them in the best position to succeed.

Pearl 2/1/13

Twenty-four or More
The percentage of new patients a physician sees is an excellent indicator of patient access, particularly for new physicians. Are the new physicians in your practice getting their fair share of new patients? According to the National Center for Health Statistics, on average, physicians see 14.4 percent new patients as a percent of total. Surgeons, on average, see 23.6 percent new patients while medical specialties average 18 percent.

United States