Running a tight ship
In Practice
By Victoria Houghton, managing editor, January 1, 2019
Dermatology World talks with Susan Weinkle, MD, from Bradenton, Florida, about how reliable staff and the right technology can improve practice efficiency.
Dermatology World: Tell me about your practice.
Dr. Weinkle: I am in private practice and I’m a Mohs surgeon. I also do aesthetics — Botox, fillers, cryotherapy, and chemical peels — and I typically see about 120 patients a week. I have a nurse practitioner, who has been with me for 30 years, seven assistants, and a bookkeeper who comes in one day per week. I also do clinical trials on aesthetics. One of my assistants is a clinical study coordinator.
What do you do to ensure that you and your team are communicating consistently, and what are the important pieces of information that you make sure you communicate?
Dr. Weinkle: My mother years ago instigated a plan called “attitude adjustment” where we’d go out for an early dinner together. At my practice, we all go out to dinner together and have important bonding time. We talk about how important it is that the patients feel cared for. Everybody has to have the same philosophy: We care about the patient.
Also, about once a month we have a lunch together and discuss any challenges that have come up. For example, one big challenge is trying to stay on schedule. I — as a physician seeing a patient — can’t focus on my watch and what time it is. I have to rely on my office staff to give me feedback. For example, “Okay, Dr. Weinkle, you talked too long there and we’re now 30 minutes behind.” I recognize that I need their support to keep me on track. We talk about that when we go out to lunch and improvements that can be made to be more efficient. You have to bond as a team to ensure efficiency. It’s team building and I think that you have to have everyone on the same page.
Do you have a standard operating procedures manual for your administrative staff?
Dr. Weinkle: We just have an OSHA and HIPAA manual. My philosophy is that if one of my assistants needs help with something or has a problem, they know I’m there for them. I know of practices that have strict guidelines where everything is written in stone. They have high employee turnover. At my practice, employees stay forever. The longer your staff has been with you the more they know the job and the more likely things are to run like clockwork.
What steps have you taken to ensure efficient patient flow in your practice?
Dr. Weinkle: My office staff knows how to put the patients who are going to need numbing in a certain room or a patient who needs surgery in a different room, so the patient flow is pretty easy. We also have a light system in the office that tells me where to go and it lets the office staff know where I am. There’s a little panel of lights outside each room and it tells me which room to go to next by what green light is blinking. There’s also a big panel in the front office so my office staff knows exactly where I am. There’s a phone in every room so if staff need me, they don’t have to get up to come and get me. I want them to stay in their position. Also, if I’m in the room with the patient and my assistant is not there and I need an assistant, I push a red button and a beep goes off and a light starts blinking red and that tells my assistant, I need you.’
Effective patient communication can be the key to keeping things moving in the practice. What do you do to ensure that your patients feel heard and that they understand their condition, treatment, medications, etc.?
Dr. Weinkle: My assistants communicate with the patients before I come into the room to identify their concerns and their needs. I come in and do my part, and then my assistant spends time with that patient making sure they understood everything. We have printed instructions to hand to the patient if needed, because I have a more mature population. We have to make sure we communicate in written form.
The recent increase in paperwork, documentation, prior-authorization requirements, etc. has the potential to slow a practice down. What do you do to ensure efficiency with the administrative tasks?
Dr. Weinkle: It doesn’t get in my way at all because I have a really smart assistant who manages those aspects. I think our electronic medical record system really helps us, because we can quickly check if the patient’s insurance covers a prescription. I also think having a scribe once you have electronic medical records — someone who is really smart with it — is worth its weight in gold. We also used DataDerm for MIPS reporting and received a bonus. My office staff is so good at it. DataDerm was efficient and helpful. This whole concept of burnout is nuts. If you run an efficient, positive office, there’s no reason you should burn out.
What do you do personally to get ready for the day to ensure efficiency?
Dr. Weinkle: In the morning when I walk in, I say good morning to everyone and I take the pulse of the office. Saying good morning is communicating and connecting with your office staff. You have to get your team focused and on board.
What is the value of running an efficient office?
Dr. Weinkle: It’s more personally rewarding and less frustrating. You’re happier at the end of the day because you’re not stressed out, and patients are happier because they can pick up on that. Overall, I think the key is hiring and training people who are the extension of you. It’s what makes a practice efficient and rewarding. That’s the bottom line. I’ve been in practice 35 years and I love going to work.
