Best Practices

Contingency plans: Because you don’t have a crystal ball

Learn how to create one that works when you need it.

By Allan Walker

While most of our clients are smart, proactive and visionary, some view the future with a bit of trepidation. Today’s challenging medical and business environment — the dawn of ICD-10, changes to the Medicare fee schedule and implementation of key provisions of the Affordable Care Act — does not inspire a high level of confidence in what predictable planning should be or make it easy to see what lies around the next corner.

As consultants, we spend an increasing amount of time advising doctors to focus on contingency planning. Uncertain times mean surprises will pop up regularly, and our goal is to make sure our clients are firmly positioned to turn threats into opportunities and weaknesses into strengths. While planning for the unexpected is challenging, it is not rocket science. However, contingency planning is only as good as the foundation on which it is built.

GET THE FOUNDATION RIGHT

To help ensure that their contingency plan will work when it’s needed, we encourage doctors to embrace the following elements in their everyday practice:

• Adopt the appropriate mindset. It is important that a practice’s managers understand that change is inevitable and relatively constant. While change is not something management wants to face on a daily basis, it should not be feared. Adopt a proactive, adaptable mindset and look for opportunity as change presents itself.
What we’ve seen work: Most of our clients make contingency planning a regular part of their everyday “successful practice” discussion. Many include it as an agenda item at their annual strategic planning meetings.

• Regularly gather good information. The more you know, the better decisions you will be able to make. You will feel more confident if decisions are based on current, accurate information about the global and local economy; your local marketplace and competitors; your practice’s financial and productivity results; your patients and offerings; and industry trends and technology.
What we’ve seen work: We strongly recommend to our clients that they embrace the tenet that “Knowledge is power.” Many of our clients assign specific information-gathering and tracking duties to a responsible party who reports regularly. For example, make sure you stay abreast of all technological and equipment developments and trends to be able to quickly adapt and potentially “own” the local market.

• Be fiscally responsible. Now is not the time to overreact financially, but it is a time to scrutinize all expenditures. Spend where you should and must, but be prudent and practical.
What we’ve seen work: We encourage our clients to understand the delicate balance between being a leading-edge practice and unwise spender. When making an especially bold financial decision, thoughtful leaders take steps such as consulting a trusted colleague who already faced a similar decision or is using financial analyzer tools that are available from societies, consultants or manufacturers. Recently, we advised a client not to jump on a hot-but-unproven trend until the practice had collected all the necessary data (which ultimately indicated its market was not yet mature enough to support the expenditure or effort).

• Empower staff. Managers should always look for ways to build the confidence they have in each employee. Anticipating that today’s business climate will continue to dictate that practices “do more with less,” it makes sense for management to target the ways and means for staff to expand their personal responsibility and accountability.
What we’ve seen work: Practices that recognize staff training and development as an important practice-success component tend to have a happy staff who provide top-shelf patient care. We encourage our clients to develop detailed individual training paths for every employee. Several years ago, one of our larger clients made individual training paths a priority for all employees and has since seen a dramatic drop in its turnover rate.

• Be a strong, proactive leader. Look for ways to make an uncertain future feel more manageable. While you may not have all the answers, manifesting confidence in your direction and decision-making will carry a great deal of weight with staff members who are often eager to participate in the journey.
What we’ve seen work: Doctors (and all practice leaders) must understand that their leadership duties extend beyond the exam lane and OR. We encourage our doctors to seek ways to regularly interact with all employees, not just the ones they work with most frequently. This will build trust and loyalty. For example, the doctors in one of our practices rotate hosting staff lunches on a monthly basis. There is no agenda, and the conversation ranges from work to children and everything in between.

• Make good hires. The best way to avoid or minimize staffing issues is to have good recruitment and hiring processes in place. If possible, recruit people who have multiple skills and a varied, full resume that relates well to your work setting. Practices should encourage and facilitate the sharing of job functions and responsibilities.
What we’ve seen work: While recruitment, hiring and retention do include some reliance on “gut feeling,” in reality they are orderly processes that demand strict adherence to a series of well-defined steps and actions.

EMBRACE THE FUTURE

While no one has a crystal ball that can predict the future, a practice can conduct its business with increased confidence if it has a contingency plan built on a proven, forward-looking, success-oriented foundation. OM

Allan Walker is director of publications with BSM Consulting, an internationally recognized health care consulting firm headquartered in Incline Village, Nev. and Scottsdale, Ariz. For more information about the author, BSM Consulting, or content/resources discussed in this article, please visit the BSM Café at www.BSMCafe.com.