MOTE Conference 2013

1. Practice Management in the
21st Century
Healthcare
Teetering on the Edge?
Mark Stallwood
Dip Practice Management, B.V.Sc, Grad Dip Ed. MBA.

2. Macro View
WHO defines healthcare system as the
organization of people, institutions, and
resources to deliver health care services to
meet the health needs of target
populations.

3. Entitlements
• The right to a system of health protection
providing equality of opportunity for
everyone to enjoy the highest attainable
level of health;
• The right to prevention, treatment and
control of diseases;
• Access to essential medicines;

4. Healthcare Models
• Traditional
• Foundational
• Biomedical
• Social
• Economic
(Arbuckle 2012)

5. SO...
• Different countries approach healthcare
in different ways and this determines
how we manage practice…

6. • Government (Federal &
State)managed
• Includes Medicare, PBS, Public
Health
• GP’s are gatekeepers
• Taxpayer funded universal
system (levy), medical (pays 85%
of costs) and some
pharmaceutical & dental
• Private system is ancillary,
insurance (52%) & provision of
services.

7. • Government managed
• Includes medical, prescriptions,
some dental
• Taxpayer funded universal
system
• GP’s are gatekeepers
• GP co payment $30
• Private system is ancillary,
insurance (32%) & provision of
services.

8. • Government managed
(Provinces and Territories)
• Includes medical, hospital, in
patient prescriptions,
• Taxpayer funded
• GP co payment $30
• Private system is ancillary,
insurance (66%) for additional
services.

9. • Government managed
• Taxpayer funded universal
system
• GP’s are gatekeepers
• Prescription co payment $15
• Private system is ancillary,
insurance (11%) & provision of
elective services.

10. • Fragmented management
• Mix of Private and NFP
• Private cover (56% -50%
underinsured)
▫ 500 companies
• Govt. Public (27%)
• No Cover (16%)
• GP’s not gatekeepers

11. “In a perfect world, you would see a
patient, submit a claim, and get paid. In a
perfect world, what you charged for the
procedure or service would reasonably
reflect both the cost and the value of what
you did, and you would, in fact, be paid
what you charged” (Cohen 2011 Medical Economics)

12. What is Practice Management
• focus on the best use of resources to
achieve the best outcomes for patients,
in the most cost effective and efficient
manner and provide an acceptable
return to all involved in providing that
service.

13. What many people think
• Focus on billing patients
• Ensure patients bookings are happening
• Basic administration

14. What it actually is…
• Human Resource Management
• Financial Management
• Risk and Compliance Management
• Marketing
• Logistics
• Planning

15. Practice is a business
Some interesting facts….
• 75% have no plan
• 80% have no budget
• Medical practices go bankrupt
• Accreditation is not best practice it is
minimum standards

16. What else has changed
• Patients in many countries now have
choice – Healthcare consumers
Issues are now:
▫ Time
▫ Convenience
▫ Outcomes
▫ Perceived level of Service

17. http://www.youtube.com/watch?v=7_qwjcxwUqw&NR=1&feature=endscreen

18. So what are the issues for
my practice manager?

19. Human Resources
75 – 80 % of day to day issues are people
related
• Lack of training
• Poor staff selection
• Lack of policy and procedure manuals
• Staff motivation

20. http://www.youtube.com/watch?v=u6XAPnuFjJc&list=PLEFA1641CDE7AFEA6

21. Financial Management
• No budget
• No cash flow management
• No asset management
• Few audit processes

22. Risk Management & Compliance
• Poor understanding of business risk
• 120+ pieces of non medical legislation
• OWH & S
• IR

23. Marketing
Applies to all practices
All about communication to:
• Patient
• Colleagues
• Potential Staff

24. Marketing (2)
• Practice Image
• Logo, Letterheads
• Newsletters
• Web Page
• Social Media

25. ICT
Keeping up to date
• Practice management systems
• Webpages
• Social Media
• Communication Systems
• Online Booking systems

26. Planning
• No shared values
• No shared direction
• No goals
• No succession plan

27. So where is the evidence?
Department of Education, Employment and
Workplace Relations funded a study by the
Society for Knowledge Economics Leadership in
2011
Culture and Management Practices of High
Performing Workplaces in Australia
• Only service industries
• 5600 employees

28. Findings
1. People management is a key priority
2. Involvement of staff in decision making
process occurs
3. These organisations are more responsive
to customers and key stakeholders
4. They have a learning culture
5. They enable staff to fully utilise their skills
and abilities

29. Findings – Startling Bits!
• High performing workplaces
generate 12% more revenue than similar
businesses that were low performing.
• The profit margin in High Performing
Workplaces (HPW) is nearly three times
greater than in Low Performing
Workplaces (LPW).

30. So what is your next step?

31. Questions?