Shifting Patients From The Senior Doc To The Junior Associate
Dear Jerry,
I am the owner of a practice that will produce collected gross revenues of about $1.5 Million in 2009. Our net is 33% and that includes paying my two part-time associates.
I'm 50 years old and feel like I am carrying too much of the patient care load. I would really like to cut back, but not have a large decrease in pay.
Do you think I am ready for a full-time associate? If so, how can I reimburse the associate fairly with incentives to motivate them to pay for themselves?
Secondly, how do I keep my associate busy when most of the patients ask to see me?
Thanks in advance for your help, Peter Roberts, OD
Dear Dr. Roberts,
Congratulations, it sounds like you have a great practice!
If you are producing $1.5 Million per year with a 33% net, I am quite sure you are ready to take on a full-time associate in a way that will allow you to maintain your income and pay them fairly.
As far as how to compensate them, you have two main choices. You can put them on a salary. That is how large practice consultant Neil Gailmard, OD does it. (gailmardconsulting.com)
Or, you can pay them on some type of production basis.
Of course, you can do a combination of both techniques and pay a salary with some type of performance bonus.
If you use a straight commission or production formula, be sure to consult an attorney for guidance so that you do not violate state or Federal Stark Law.
This complex law contains some limitations on how you can compensate employees who provide so called Designated Health Services under Medicare and Medicaid.
Regarding your question about how to book patients with your new associate when they ask for you, I went to the 'man' himself, and got this response from Dr. Gailmard.
Hi Jerry,
As you know, we have a large one location practice with four ODs. Because I am the founder and senior doctor, many patients still ask for me.
My staff is instructed to always honor a patient's wishes about the doctor they want to see.
However, it often turns out that my next available appointment is pretty far out as I have cut back on my clinic hours to spend more time on managing the practice. Plus, I no longer see patients on Saturdays or evenings.
My lack of availability gives the phone receptionist an ideal opportunity to tactfully offer the caller an appointment with another doctor in our office who has a more convenient opening.
That is often reason enough for the patient to choose another doctor. If not, we have a few other strategies we use to try to gently move patients over.
In the end, our goal is to always satisfy the patient by giving them what they want.
From a consulting standpoint, I have found that the problem is half solved once the receptionist clearly understands what the goals of the practice owner are!
It's my experience that the senior doc is often not completely committed to moving his/her lifelong patients over to the new associate.
When the senior doc isn't crystal clear about what he/she wants to do, the employee booking appointments will be confused and less effective in their job of getting the new associate booked up.
Best regards,
Neil Gailmard, OD, MBA, FAAO
President, Gailmard Consulting
630 Ridge Road, Munster, IN 46321
www.gailmardconsulting.com
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Disclaimer: The information and opinions contained on this site are for discussion purposes only and are NOT intended to serve as legal, accounting or investment advice. ©2009 Jerry Hayes, OD. Not to be reproduced without written permission of the author.
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I've worked with 2 successful
I've worked with 2 successful practices over the last 15 years, where a senior doctor wanted to tranfer many of their loyal patients to a newer doctor at the practice. One of the keys is to have the staff and senior doctor build up/edify the newer doctor to the existing patients. And it's not enough just to say, "He/She is great!" The senior doctor/staff need to show enthusiasm, and give specific reasons on why that newer doctor is great for that specific patient. (Been practicing over 15 years, specializes in dry eyes, specializes in difficult contact lens fits, very personable, ect...) This helps to make the transition as smooth as possible for the patient, where they'll feel confidant about scheduling with the newer doctor. (Of course, then the newer doctor has to live up to the task!!!)