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Reimbursement and Practice Management

Can a Medical Practice Be Too Lean?

Skinny Doctor

When medical groups use lean initiatives to optimize resources and improve the patient experience, they sometimes take those initiatives a little too far. After a lean process has been implemented, I’ve observed:

  • Bottlenecks in revenue cycle processing, patient registration, visits and procedures or patient pre-visit data collection where there were none previously. These bottlenecks happen after shifting emphasis to a different part of the process or reallocating resources.
  • More complaints from patient and referring physicians. For example, automated responses are a common lean initiative that can lead to trouble if there is no “escape to attendant” option for callers. Clinic and support staff resistance or indifference. The initial excitement wanes when lean is perceived as merely the next initiative.
  • Decreased productivity. For example, resources that are diverted to demonstrate lean benefits may impact operations by slowing patient flow or prior-authorizations.
  • Analysis paralysis. Attempting to analyze the big data without a narrow focus and sufficient time to “do the math” leads to underutilized information.
  • New systems supersede quality patient care. For example, EMR clinic documentation takes time away from the direct patient care.

Maintain essential focus on “putting first things first,” as Stephen Covey maps out, when taking on lean initiatives. Something simple, like stepping back to evaluate your own practice during its busiest moments, can also provide valuable insight on becoming leaner.

When you go lean, try not too get too skinny!

United States