5 Best Business Tips for Orthopedic and Spine Surgeon Group Presidents

Practice Management

Here are five best business tips for orthopedic and spine group presidents.

1. Share practice reports with physicians and incorporate them in making decisions. When including physicians in the decision-making process, administrators should share practice data, such as financial statistics or patient evaluations, with physicians using a "Presidential" brief form. "Physicians like and enjoy data but they don't want to be overwhelmed by it," says Patrick Hinton, executive director of the Jacksonville (Fla.) Orthopaedic Institute. "If you give physicians the facts in a brief and concise way and then give them a recommendation as to what course of action they should take, they will be supportive of your decision making as an administrator."

Additionally, when the administrator provides a synthesized report about a potential change in the practice, it shows that the administrator is able to competently research the topic and is coming to them with a realistic and valid request.

2. Keep surgeons competitive by showing them individual data. Every physician in the practice should have access to every other physician's practice data. This information includes production, compliance, and business office performance data such as payer mix, sessions worked, charges generated, denials, on-time dictation completion and total patient volume. "In the absence of information, everyone assumes the worst," says Daniel Murrey, MD, MPP, a spine surgeon and CEO of OrthoCarolina. "It really is important that transparency exists to keep people comfortable as part of a large organization. We've developed a data warehouse here that has become an integral part of management and governance. It takes the suspicion off the table because everyone knows everybody's score."

3. Handle physician disagreements eloquently.
All physicians in orthopedic practices have a wealth of knowledge and opinions about practice management. The elected leaders are the liaisons between practice physicians and administrators and reconcile the needs of the clinical practice with the board of directors. "The physicians at OAA operate very democratically," says Rich Battista, MD, president and physician with OAA Orthopaedic Specialists in Allentown, Pa.. "We try to think about what is best for the organization while taking into account individual needs." Sometimes, however, physicians and administrators disagree about the best ways to solve problems and make decisions for the practice.

The best solution is often agreeing to disagree, agreeing to compromise and looking forward, says Dr. Battista. If a particular physician is constantly hindering the decision-making process, it could be necessary to part ways with that individual for the betterment of the group. "At times, making group decisions can be like herding cats. We've not been immune to partners making the professional decision to leave the organization," says Dr. Battista.

4. Optimize new physician recruitment to benefit the entire practice.
Recruiting new physician partners from channels you know will provide you with the best quality physicians. If you participate in a fellowship program, recruit those physicians after they complete their training. You can also look outward for physicians with great reputations, such as those who already have busy practices in the community, or other academically oriented physicians from around the country. Search for physicians who trained in great programs, says Todd Albert, MD, spine surgeon and president of Rothman Institute in Philadelphia, and make sure they will fit with the practice's goals and values.

5. Don't let insurance companies "own" your practice. The Virginia Spine Institute physicians do not have contracts with any insurance companies, says Thomas Schuler, MD, a spine surgeon, founder and president of the Virginia Spine Institute. They elected to do so as this allows us to present the patient with the best and most appropriate treatment options. The patient can then select what is in their best interest. By not being encumbered by a contractual agreement with the insurance company, VSI can provide the patient with what they need and not be limited to what the insurance company dictates.  

The Virginia Spine Institute bills the insurance companies for the patients and is compensated as an out of network provider. The exception is Medicare and TRICARE for which the institute is still an in network provider. Dr. Schuler states that, "Virginia Spine Institute remains in these two networks specifically to assist the elderly and military." The Virginia Spine Institute hires patient coordinators and insurance liaisons to help patients navigate out-of-network care. Insurance companies can make it difficult for patients to receive out-of-network care and the experts guide the patient through the steps he or she needs to take. "We work to create a system that helps the patients understand and be more successful in navigating the very confusing out-of-network experience," says Dr. Schuler.

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