From Fellowship to Successful Otolaryngology (ENT) Practice

SITUATION

An ENT physician fresh out of fellowship was interested in starting a new practice. He contacted DoctorsManagement with aspirations of building a thriving ENT practice in a small community within a medium-size city with just under a quarter million in population.

CHALLENGES

The physician felt overwhelmed by the many steps and regulatory requirements involved in establishing a new practice. He acknowledged that he lacked business and management experience, including hiring and managing a staff, and was afraid this would take away from his strong clinical skills and commitment to delivering quality patient care.

The physician was new in the community and had no established contacts in the local healthcare market. He also had limited time, as he and his wife were about to have their first child.

STRATEGIES

DoctorsManagement allayed the physician’s fears by presenting a clear plan based on his professional and personal priorities. The team built a realistic timeline with manageable steps to move him toward his ambitious goal.

DM got to work implementing the start-up plan and creating systems to enable the practice to run like clockwork. The human resources team at DoctorsManagement placed ads for staff, performed initial screening and confirmed that the final candidates possessed the core competencies required for the position. Next, DM used a proprietary behavioral style assessment tool to identify the ideal candidates that would work well together as a team. Individuals who would have the most contact with patients were screened for excellent interpersonal skills, and those tasked with detail work such as billing and coding were tested to ensure they possessed the ability to focus on details and complete complex projects.

DM’s billing and coding team trained the new practice employees on the best practices of billing, coding and documentation. The staff learned proper techniques to keep claim denials to a minimum and ensure proper charge capture. A high standard was established at the start of operations and maintained going forward.

Revenue cycle management practices to accelerate cash flow and minimize exposure to unnecessary risks were also established and maintained. Every step in the revenue cycle was streamlined using the appropriate staff, process, and technology, thus maximizing the amount of cash on hand at any one time for the practice.

DoctorsManagement helped the group to expand into several areas of ancillary services. During year two of operations, the practice began offering allergy testing and treatment as well as cosmetic services that include facial plastics and surgical hair restoration. In year three, the practice began offering patients hearing treatment options.

RESULTS

By the fourth month in business, the practice was generating a profit, and by month 13, the practice achieved profits that take most ENT practices 30 months to achieve.

The practice experienced extremely rapid growth in its second year of business yet maintained a 61% operating profit and exceptional patient satisfaction. The solid foundation of business systems and well-placed staff enabled the group to manage the rapid growth with confidence and ease.

The practice is currently in the third year of business and is operating in the 75th percentile of ENT practices nationwide. Its staff-to-provider ratio is 1:3; compared to the national median of 1:4.67 full-time equivalent (FTE) employees for each FTE provider.1 The FTE ratio and high operating profit can be directly attributed to the efficient operation of the practice staff.

The practice has a very high rate of patient satisfaction and retention, and its employee satisfaction is so high that they have a reputation in the community as being a fantastic place to work.

RESULTS RECAP

  • Start-up was profitable by month four
  • By month 13, profits equivalent to 30 months in business
  • Operating within 75th percentile ENT nationwide
  • Managed rapid growth with ease
  • Extremely high patient satisfaction
  • Employment morale unmatched by most start-ups