How to Customize the New Patient Course

Hey Shaun,
Its Amy Seaman with Freestone Rehabilitation in Bozeman, Montana. Nate and I were in the New Patient course in Calgary in April. The results are fantastic. I am looking ahead to the 11th and 12th week and I had some questions regarding the "program" which is normally the Spine Program with PTs. We are looking of course for upper extremity focus and I remember you mentioning a OT group that had done this prior to us. I was just wondering what approach they took in regards to this program letter. Any info you have would be great!
Thanks, Amy Seaman


Dear Amy,
Here is how I would handle the program letter. We have other OT practices as clients of MS and what we have them do on the substitute of the SPINE program is to do what is called an "invoice survey". An Invoice survey for a clinical practice is to simply look through your database of people who have purchased your services (patients) and find out what they most commonly purchased from you (meaning what is the most common broad category ICD-9 diagnosis) and promote that service. It is most likely, unless you are sitting next to a hand surgeon, that you see a variety of patient conditions but there is likely one that you see more of. Maybe its cumulative trauma I am not sure but one thing to get your wits around is that if you promote a post-surgical condition you have dramatically reduced your referral pool to just surgeons. I have seen this many times where PTs promote to doctors for ACL Patients which is a much smaller base that back pain and get a significantly smaller result. So pick something that:

1. Has a reasonable reimbursement rate

2. Is a large enough condition that doctors (all) would know about and see in their practice and not just the specialists.

3. Is a non-surgical condition.

Once you guys sort out the condition you wish to promote for the New Patient Course the format of the program is a piece of cake.

1. Speak in very broad general agreements and "never tell them how you do what you do!"
2. A simple gradient to almost any patient condition would be to 1st get the symptoms of pain under control. Next work on passive ROM within the limits of a patients pain. Next move into an active or resistive range of motion or strengthening and lastly independence in ADL or return to work training.
3. Look over the simplicity of the Spine Rehab Program for the simple points of agreement and design your program much like that.

So Amy I hope this has been helpful. I am expecting to hear some great things come out of Bozeman very soon.

Do well,
Shaun

Ask the Owner!

When it was suggested that Jeff and I set up a link on our blogs so that you could ask us questions I felt like I had just had a “V-8” moment!

Since this is something new I thought I would start the ball rolling by letting you know why I want to do this. I do what I do because I want to help others and I think that having this line set up will not only provide me with an opportunity to help you as an individual but also to help the group as a whole.

So, any questions I receive that I feel are valid for the entire group I will post along with my answer.

I am really looking forward to fielding the questions that you may have so fire away and I will do my best to answer back quickly!

Shaun

How to Handle the Recurring Lows and Highs of Patient Visits

Sometimes a practice owner will find himself running into the same situation again and again. One area which most practice owners commonly don’t handle on a permanent basis is the actions they take to drive new business in the door.

Most practice owners put the quality of the care, the time they spend with patients, the results that they get in clinical practice as the areas that they put most of their attention on. This does not mean that practice owners should weaken their quality of care, because if their quality of care is weak their success will be short-lived. It does mean, however, that if no one knows of a practice owner’s results in clinical practice, he or she is going to have some difficulty.

There is commonly a feast or famine situation when it comes to running the practice. Practice owners will become busier for some reason and then things slow down, often with the same degree of surprise. Part of the reason for this is that practice owners are not fully handling the situation of consistent marketing.

A typical PT practice is such that a certain volume of patients come in the door and when the patients are discharged, the practice has to create some more business. So typically the owner will go out and knock on doors and talk to doctors to get them to refer patients to the clinic. Unfortunately in most cases, the owner is also the clinician, so when the patients start coming in the owner has to now treat the patients. As the owner is moving through that process of treating the patients, he no longer continues to handle the situation of getting in more new patients. Consequently, the patient volume drops.

This is a situation that becomes handled and then has to be rehandled again. The problem of getting consistent patients is not a terminatedly handled situation.

If an owner was fully handling driving new patients into the practice, there would be actions within the practice that would occur every single day and every single week that would keep the practice growing and expanding, instead of only taking action when the numbers are down.

In other words, a practice can be put together in such a way that the owner has activities going on that make his or her results in clinical practice broadly known. These activities get done on a regular basis, regardless of whether the patient volume was already through the roof or not. These are in fact ordinary activities which resolve this particular problem of having consistent patient visits.

Of course, when the situation of having consistent patient visits is handled, the owner finds himself facing other problems, such as not being able to hire on staff fast enough to keep up with the demand.

I have to admit that one of the problems that we create for many of the people who have attended our New Patient Course is that the volume increases to a point where they have to hire new people and FAST. In a slow growing practice, the owner might have an idea that he needs to hire a therapist perhaps in the next 3-4 months at the rate of expansion that he is having. And commonly he will go through whatever actions he normally goes through to bring on a therapist in the next 3-4 months. But if the practice owner is truly handling the situation of what it takes to drive in a consistent volume of new patients week after week, he might have to find that Physical Therapist in a much shorter period of time, possibly 3-4 weeks. But that is a better problem to have.

By survey, many practice owners have two phenomenally weak areas when it comes to confronting and handling. These two areas are getting a consistent volume of new patients and getting paid for the services that you deliver. In the absence of this ability to confront these two areas, all kinds of problems come up which have to be handled such as: “We have no patients” and “We have no money for payroll.” These problems can have very serious ramifications on the practice, but if the owner handles them only when something blows up in his or her office, it slows down expansion and can give the owner quite a lot of headaches.

So what I am trying to share with you is that there is a way to terminatedly handle the worry and stress of bringing new patients in your door. Having consistent patient visits could give you some other worries such as, “How do I handle bringing staff on fast enough?” but even that we can help you with. I will tell you this – there is significantly less worry and stress when you have certainty on the expansion of your practice than when you don’t.