Educating "Difficult" Providers in the Medical Practice - DoctorsManagement Educating "Difficult" Providers in the Medical Practice - DoctorsManagement

Educating “Difficult” Providers in the Medical Practice

by Sean M. Weiss, CMCO, CPMA, CPC, CPC-P, CCP-P, ACS-EM

Everyone has one, and everyone is frustrated finding a way to with deal with “The One”… I am talking about the difficult medical provider! However, put yourself in their position and ask yourself this question: How would you feel if you spent the better part of your adult life in school mastering the “Art” of healing only to enter the job force and realize everything you learned in school from medical professionals has been turned into policies tied to reimbursement by a bunch of hacks rather than how best to treat a patient? Then as yourself how you would feel having to deal with continuous changes related to: Meaningful Use, PQRS, PQRI, ICD-10CM, Modifiers, Procedure Coding, Evaluation and Management Services, MACRA, MIPS, Audits, Call Coverage, Staying up to date with the latest drug therapies and disease and injury treatments, Maintaining CMEs, Malpractice Suits, Fair Market Value, HIPAA, OSHA, CLIA, OIG Compliance and the list goes on and on…

I think you are hopefully beginning to see where this is headed. In my 21 years of working in healthcare I can tell you without doubt that 95% + of all providers are just trying to do the right thing when it comes to managing the business side of medicine. But, their primary concern is providing quality care to their ill or injured patients. That is why, when someone who is considered a “suit” or someone from a coding or compliance department takes up time on their already behind schedule to tell them they are doing something wrong, they are less than thrilled to see you and often times are aloof or even a bit rude.

While it takes a special person to provide education to a collegiate your approach is as important if not more important than the content you are trying to deliver. I often times get to watch individuals deliver education to providers and it always seems like they are trying to impress them with their ability to use fancy words or clinical terms (often times mispronouncing them) or using them in the wrong context and then watching the provider yawn, look at something on their phone or concentrate on the next bite of food entering their mouth. Don’t be this person, be the person they need you to be, which is their business expert in your given area of specialization! If you are not a clinician, don’t act like one… there is nothing worse than having to listen to some “Blow-Hard” who loves to hear themselves talk and more often than not, what they have to say means little to nothing.

Below are the dos and don’ts of providing education to medical providers:

  1. Do deliver just the facts… keep opinions to yourself;
  2. Do make them feel you are on their side;
  3. Do have supporting documentation to back up your recommendations;
  4. Do, if you have written a report have a copy for the provider, make sure it has been proof read and is free of typos, spelling errors, grammatical and punctuation mistakes, etc.; and
  5. Do keep the meeting to 60 minutes or less

 

  1. Don’t go off on a tangent or get on your soap box;
  2. Don’t be late;
  3. Don’t be wrong with your analysis;
  4. Don’t provide answers to questions that you are not 100% certain of the answer; and
  5. Don’t pretend to be something more than what you really are.

When I meet with providers I always begin my message especially if it is not a great message I have to deliver by saying, “I appreciate you taking the time to meet with me today regarding __________. I know you are very busy so, I want to provide you with the facts related to my findings, the supporting documentation from authoritative sources, and answer any questions you have to ensure you are comfortable with the process moving forward and to ensure you remain in compliance with your organization’s and the payers guidelines.” This allows me to first set the agenda for the meeting in a decisive manner. Second, it shows the provider I am confident and secure with what I am doing and makes them think twice about challenging me.

Now, I am not saying that every time I do this it works the way I want it to because there are those providers who just have to always vent and complain… so, when this happens I allow them to head off on their rant for a few moments uninterrupted and when there is a natural break in their statement I nicely interject and say, “I completely understand and can feel your frustration(s). However, I hope you understand I am on your side (I work for you) and the truth is, I don’t set policy I simply work to make sure my clients remain compliant with those policies to avoid unnecessary scrutiny. If you give me just a few minutes I think I can help you through this process and together we can develop something that works for you and gets you back to being a medical provider and brings peace of mind to your compliance department and general counsel.” This usually works like a charm because it shows compassion for their frustration but also reinforces the fact that their personal feelings on how unfair something is, in the grand scheme of things is irrelevant because if we are out of compliance how we feel about something is immaterial.

I hope this short article is something that provides you with some useful information and ideas of your own for how best to deal with “The One.”

Sean M. Weiss is a Partner with DoctorsManagement and serves as the Vice President of Compliance. Sean is a nationally recognized speaker and consultant with more than 20-years of service in healthcare working with and for some of the Nation’s largest and most respected health systems. Should you have questions or are wanting to speak with Sean regarding his services in your organization email him at sweiss@drsmgmt.com or contact him at 800-635-4040.