Unleashing Optimal Performance in Medical Practice with Juli Quinn

Imagine a world where double-booking is a thing of the past, and your medical practice runs like a well-oiled machine. That's what we're promising you'll learn in this riveting conversation with Dr. Juli Quinn, president of GoSource. We dive headfirst into the intricacies of effective scheduling, underlining its significant impact on the patient experience. Packed with hands-on advice on how to keep things running smoothly, this episode is a much-needed guide for every medical practitioner striving for efficiency.

We're not just about organizing appointments though. We also explore the critical role of communication for cultivating a respectful and long-lasting doctor-patient relationship. You'll gain insights into understanding clinic workflow, handling paperwork, bureaucracy, and the financial aspects of healthcare. And to round it all off, we share some invaluable resources on medical practice management and revenue cycle management (RCM). Get ready for a deep dive into managing the business side of medicine without compromising on patient care. Tune in now and redefine your medical practice.

Resource: E&M Coding


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Though I am a physician, this is not medica

Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.


Learn more about female physicians' journey through burnout to thriving!
https://www.theworthyphysician.com/books

Let's connect for speaking opportunities!
https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speaker

Check out the free resources from The Worthy Physician:
https://www.theworthyphysician.com/freebie-downloads

Battle of the Boxes

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Transcript

Dr. Shah-Haque: 0:00

Welcome to another episode of Worthy Physician. I'm your host, dr Sapna Shahog, reigniting your humanity and your passion for medicine. Today we are engaging with Juli Quinn, president of Go Source, and to recapture what we discussed last episode, we discussed some pearls and pitfalls of trying to get paid for the invisible work or work that we're already doing. I think you said it beautifully when this was a win for physicians in being able to capture and be able to get paid for the work that we're already doing. Now we have the ability to charge for time which is not just in the exam room but, when appropriate, outside of the exam room as well, all the odds and ends and points of contact that go into that medical decision-making. Would you consider that a win for physicians?

Juli Quinn: 1:04

Absolutely. In the past I would see that the insurance way of determining a level of visit only accounted for face-to-face time. Physicians have been complaining for a very long time that there's much more to a visit than that face-to-face. A lot of physician burnout is that doctors are saying I spend hours that I'm not getting credit for. As far as reimbursement from the insurance, it's a big win that we now have this language in our ENM. Coding to include pre and post-treatment chart review, reviewing labs, conversing with other physicians or other family members to the patient is all now part of what you can get paid for.

Dr. Shah-Haque: 2:01

For those of us that may not be familiar, there is a resource and if you go to theworthyphysiciancom and click on free downloads and resources, it should be available there. That way, it can give us a visual of how to navigate this change. Thank you for providing that for us. Today, I really want to dive into the efficiency in practice, with medicine. As beautiful as a profession as it is, also chaotic, because what we think about and what is on the schedule, there's more to that. There's more to that. There are things happening behind the scenes, and I'm from Kansas.

Dr. Shah-Haque: 2:48

I'm going to use the Wizard of Oz analogy Don't pull back the curtain.

Dr. Shah-Haque: 2:53

You don't want to see what's behind the curtain, because a lot of fires being put out, there are calls, there are tasks, there are things to be signed, there are labs to be reviewed, there are things that need to be addressed in real time.

Dr. Shah-Haque: 3:07

For the listeners who are non-physicians, you have to remember, julie and I are patients as well, but let's say, we have a patient every 15 to 20 minutes. As a physician, as a non-physician or the patient, I can guarantee you that when I'm with you, I'm going to give you my utmost attention. But before I get there, there are some things that I have to do, and there are calls that come in and we typically try to determine whether they are immediate. This has to be addressed in the now, within 30 minutes, because it's urgent high priority, medium priority and low priority. It's not to say it's not a priority, but there are some things, medically speaking, that do take priority over things that are not as medically pressing. But with all that being said, julie, how do we make the medical practice more efficient? Because medicine is not really known for its efficiency.

Juli Quinn: 4:08

I have worked with many practices over 23 years as a consultant and the schedule we can start with. The schedule is so critical and the place that the whole day can break down if it's not well-planned. Now, of course, the perfect plan doesn't always mean that it's going to execute correctly, but let's set the day up for success. The best way to do that is to not double-book your appointments. It used to be in the old days we would say, oh, just double-book three or four, because I know someone will know show. Well, now what we need to do is book the schedule correctly and call and confirm those appointments. They're coming in advance the day before and if somebody cancels, you have a waiting list of people that are on the schedule at a future date book. Really, you're interested in having a sooner opening if one becomes available. Make use of confirming an appointment and having a wait list to have a perfect schedule, not double book. Double booking is going to stress out the staff and it makes the patient very unhappy.

Juli Quinn: 5:30

I think we talked in an earlier episode that it's interesting when you read Yelp reviews where a patient is leaving a review about their practice the five stars. They're talking about the doctor. They love their doctor's patient. Their doctor's kind, their doctor's saved their life, okay, but all one star reviews it's about. I waited too long on hold on the phone. I waited too long in the waiting room. I waited too long in the exam room. They don't want to wait. So that's a message to us. Let's keep things moving by having a really good schedule.

Juli Quinn: 6:11

The next step would be to plan your day so that you have reserved spots for new patients. I believe a new patient is just inherently going to take longer. They have questions. They're interviewing you as much as you have questions to learn all about their medical history as well as their presenting problem for today. So you want to have a little extra time for that new patient and if you reserve spots to break up the new patients with the established patients, that'll help your flow quite a bit, as well as have openings available sooner for when a new patient is calling.

Juli Quinn: 6:59

Let's face it we have to keep new patients coming to our practice. So if it is a four week wait to get in and to see your doctor, that would be acceptable to somebody you already have a relationship with. If I'm a new patient, I'm going to say I don't really want to wait four weeks. And if that practice were to reserve one or two spots of each session, each morning session, each afternoon session, then it would shorten the time of the wait for that patient to be able to get into your practice. And then, if it's not used, you could make your policy be three days before, go ahead and open it up to any caller at that point. Those are really good tips for keeping the type of patient mixed to not bog down the flow.

Dr. Shah-Haque: 7:55

And of course this is something for the listener, not saying that this is an absolute truth. You must do this, but this is a strategic way because I myself find it difficult with, even currently. Sometimes too, there are some things that are very acute that need to be seen that same day. Going back to triaging, and while there are several answers, sometimes the best answer is they need to see me and I'm. But another question is could this be double booked as a telehealth and setting is, I have set aside two slots daily.

Dr. Shah-Haque: 8:34

Okay, if we're gonna be double booked, then for telehealth, let's do it at this time and this time so that way, because I know the flow of the clinic and you're absolutely right, it stresses everybody out, not only the patient, the physician, because you're not completely present and it's not by, it's not by malintent, but again, that is fitting in two patients into a 15 or 20 minute slot and you wanna give all your to that patient, but it's difficult to do when your mind is two or three steps ahead. I'm glad you brought that up, because I feel like there's a culture where it's almost encouraged to double book because that means more revenue but on the flip side, it also drives the wedge as far as wait time, throws the staff back, throws them a curve ball and it stresses them out and they're already working their tails off and a lot of times structures, clinics, hospitals are understaffed, so it fuels the fire.

Juli Quinn: 9:38

Yes, absolutely. And if I'll even go a step further, if you regularly do your practice, each doctor knows their flow and it's not going to be the same for everyone. If you know you regularly are going to need work-ins, just have a spot that you know the first one of the afternoon or the last one of the morning, whatever works for your particular office that's held in reserve for those work-ins and if you don't use it bonus, it's an administrative time for the doctor to catch up on their chart notes.

Dr. Shah-Haque: 10:16

Or you could even go back to that waiting list and say, hey, we have an opening, but you also need to have that constant, competent, coherent staff. And again, going back to staff retention is tough, so I know that that's a real struggle. But having said that, once you get that in place, you need to take the time and sit down and talk with your schedulers and saying, hey, look, let's try this approach. And then how do you reevaluate what that does for your practice? How do you evaluate the efficiency benchmarks?

Juli Quinn: 10:52

You would want to look at completed visits. If you are seeing a steady number, then you probably have a good formula. That's a good flow. If you're seeing big swings of maybe as many as 10 different from day to day, that is actually a warning sign that there's some scheduling issues, opportunities that are not being maximized.

Dr. Shah-Haque: 11:19

And by looking at that, is it just as simple as sitting down with the schedulers and saying, hey, what can we do differently? Or is that? How do we bridge the gap?

Juli Quinn: 11:31

I think, to bring each member of the team into the delivery of care to the patient. This is about the patient we talked about. Community was the word we used in the last episode, but this is a team all focused on the patient. So understanding what happens in the exam room helps the scheduler to be a much more efficient scheduler. Often it's because they just are not aware. Invite them in to that part of your office to see the flow. Here's an example I worked in OBGYN for 14 years and in OBGYN we would have a new patient that the doctor would sit down and talk to them before they were put in to undress in the room. So wherever the consultation happened that we had a little consultation room, or if it was in the exam room, it was I'm going to come in and I'm going to meet you, I'm going to introduce myself, let's talk a little bit and then we'll have you undress and we'll continue the visit with the exam portion.

Juli Quinn: 12:45

This was the flow, for that practice was perfect that when you have this new patient and the doctor is in one stagnant area, talk in this conversation, then the MAs could fill two, three exam rooms with returned patients, especially if it's a return OB. Those are really super quick visits. We could have three return OB patients in the room so when the doctor came out of that consultation could go boom and and see those three patients pretty quickly while that new patient is now preparing for the doctor to come back. Now, when the doctor is back, seeing that patient filling those rooms again, we had a formula of new patient return OB. Return OB that was, or an annual exam Same thing that took a little longer, and then return OB. It was a three to one formula and it worked beautifully. And once we were in the back watching the flow of how long it took to room a patient, how fast is the doctor in each type of visit, it was an aha moment for the schedulers.

Dr. Shah-Haque: 14:01

So really learning the back flow is, I would say, empowering and eye opening for the front. And why are we spending so much time on this? It's because I think schedule is a big deal, and this is, of course, in the caveat that you have that ability to discuss the clinic flow. But also, if you can look at and say hey to the Paris Abbey, if this is, for example, owned, giving up the autonomy for scheduling is one of the things that is a driver of burnout because of the corporatization of medicine. Having said that, it might be possible to say, hey, look, let's look at this flow and make it a win. Let's utilize this relationship to optimize and let's try to create a flow that makes more sense for both the bottom line financially because otherwise we can't keep doors open as well as physicians and patients, because it has to be that win relationship win Because, honestly, without patients there is no medicine, without physicians there is no medicine, without the financial portion there's no medicine.

Dr. Shah-Haque: 15:21

So it's like a triumvirate or a triangle that we need to keep on, keep at the forefront. But again, it's about the patient. What about communication with physicians and patients? How is that? A big piece, and it's not just the communicating of treatment plan. It's also expectations.

Juli Quinn: 15:45

As the financial side of consulting for practices. I'm going to answer that obviously from the financial perspective, and I feel that patients have adopted this when it comes to my bill deal with my insurance, and it's out of their own frustration of being overwhelmed, maybe not understanding all of the process, feeling stuck sometimes with a bill they don't understand. So communication is so important in this relationship, the doctor-patient relationship, again in your triangle analogy. We are a business, so there has to be the business and patient communication and that would start with the time of making that appointment. When we're putting a patient on the schedule, if we have their information in advance, then we can do some really quick basic verification that they are in a place that is appropriate for their insurance and, if not, just inform them hey, we still want to see you. But here's what you would be looking at for a financial perspective. Or if they have insurance that we can know that it all checked out and we can get paid trying to do that chasing down of information. After you see the patient is taking away what little bit of profit we have in these visits. Let's face it, we're not making tons of money and every dollar counts If you're not getting paid for one of your patients because we just didn't have the right information. That's your profit for the whole day.

Juli Quinn: 17:36

So that's really important to make sure the patient knows what we need, when we need it from them, whether it's information or their payment at the time of service. I think every patient should be paying something. Unless they're Medicaid, they owe a copay, or there should be a deposit towards deductible, or their 20% if that is what their insurance benefit is, or payment in school if they do not have insurance. Now, I'm not saying this is all about money. You may make the business decision. I really want to see this patient. They don't have it today. We'll set up a payment plan. That is still an agreement, that's still a communication and an expectation that both sides have communicated, and that's what is needed. That's important for every patient to have.

Dr. Shah-Haque: 18:34

So it's just that upfront communication on even the financial piece, because medical debt is real and medical debt is expensive, making that the idea extra few seconds and at least communicating. That is again going back to communications and expectations. But at the same time it's important that we expect the patients to give us the most updated information, regardless of whether it be name change, insurance change, address change and really being focused on the forefront of the front desk. Really are the gatekeepers and we have to make sure that there are procedures and protocols in place in order to help maximize all the way around. We don't, then we're spending a lot of time in callbacks or recovery of that information when it should be given at the very front first time. I know it's so simple, but it's not always done and I think everybody has a story or two or several of where we thought we did that but yet we get a surprise bill. And you have to remember we're patients too.

Juli Quinn: 19:48

Yes, yes, and it also adds to the respect in this relationship. I feel that patients respect their doctor for their medical knowledge and the care that they receive, and the business side we could improve in that area. And the way to improve that level of respect that I have for you as the patient and that the patient has for us, the clinic or facility, is to just have this communication and an understanding that medicine is not free. And how can we approach this that is going to be agreeable and respectful to both.

Dr. Shah-Haque: 20:36

Absolutely. And again, it's about setting expectations and trying to carry those through and it's about being transparent. I think that it goes back to wanting to cultivate that relationship and keep that relationship with the patient and the physician and I'm going to say the business side as well again, because we can't do what we do if it weren't for the business side. One thing I can say is that ensuring that. Going back to the community, I think it's really important to try to have that inner communication, the inner respect and that longevity. If you have some positions that keep turnover, that's also detrimental. And it also goes back to having the funding in order to keep the staff, that we have to reward good behavior, to have that retention bonus, but also to hire competent staff and to grow.

Juli Quinn: 21:35

Yes, we need to be able to attract the right personality as well as knowledge base for representing us. That first contact, that first impression that a patient has with you the doctor is making the appointment on the phone or walking in and sitting in the lobby observing the front office staff that is really a very key position representing you, and so we want someone that is delivering the message in the way you would if it were you sitting there. So, yes, it takes training and it takes finances to be able to find that person and retain them.

Dr. Shah-Haque: 22:27

And that's again. That's just so hard to do these days. It really is, but that's the reason why we're highlighting this is because finances matter. Let's capture for work that we're already doing by optimizing RCM, by optimizing schedule efficiency and by optimizing getting paid for our invisible work, that before that was not quantifiable, but now it is. And, Julie, with somebody that might be listening to this and saying, what does that have to do with burnout? What would you tell them?

Juli Quinn: 23:00

Burnout comes from feeling like what you do doesn't matter, or that I'm the hamster in the wheel. I'm working, I'm working and I'm not getting down the road. Custom efficiencies will definitely help that. If you're getting paid all your efforts, it now relates into being able to hire good staff, have fun again at work, patients are happy, staff are happy, the doctor is happy, you're taking care of patients and everybody is feeling good, both intrinsically and in profit and that's again going back to.

Dr. Shah-Haque: 23:43

I know I've told you before, but I appreciate the insight that you bring to this, because it's not about oh, we're going to collect this and that's just it. You really break it down to. It is about the patient. But we can't keep serving patients unless we keep the doors open. And we got to do that by making sure that we're getting paid for everything we're already doing, and all the way around, all the way around. So that's the ethical part I like and that's why I think GoSource would be a great potential answer to optimize the RCM. So how can the listener get ahold of you?

Juli Quinn: 24:20

Great, thank you. We have a website. It's gosourcein.

Dr. Shah-Haque: 24:25

And is there a link that they can click on and set up a discovery call?

Juli Quinn: 24:32

Yes, there is. There's a phone number or you can do an online request. You can schedule to talk with me. I love interacting with our doctors and administrators on just pointing out what your pinpoints are and coming up with ideas, solutions for them and really good chance. Gosource would be the answer, and if it's not, I'll tell you and point you in the right direction, because what really matters the most is just taking care of each other. We are part of this community and whatever's the best way that we can serve the medical practices so that they can keep serving the patient, then it's a victory. So I'm hoping I can chat with some more of your listeners.

Dr. Shah-Haque: 25:25

Thank you very much for that information and this will be in the show notes and, through your years of consulting what is maybe one pearl of wisdom, you could leave our listeners.

Juli Quinn: 25:40

It's hard to pick one that I would say. Surround yourself with a very competent staff to handle all this paperwork and bureaucracy, and it's become very complicated to submit insurance claims. So take care of patients and get processes in place so that the RCM can be most efficient, but they are definitely setting it up at the clinic at the time of seeing the patient. Tips to help that to happen better.

Dr. Shah-Haque: 26:19

Thank you so much and, as always, it's a pleasure talking to you.

Juli Quinn: 26:25

Thank you, Dr Zappman.