Reading Matthew Syed’s latest work reminded me of something I’m conscious of when I look at the business performance of a private medical practice.
One definition [mine at least] could be the ability to look at a situation and by training/experience almost have a sixth sense of the cause of the problem. For example: just this week I looked at a pile of rejected medical invoices and knew immediately why they had been rejected. I didn’t have to ask why.
The specific insurance company they were destined for always uses numeric reference numbers ONLY. Those rejected had letters [alpha] in them. But the international division of that specific insurance company always proceeded their reference numbers with TWO letters.
Nope. Experience and training had taught me to spot that. Unlike the poor receptionist who didn’t realise the insurance company concerned had a UK division and a completely separate international division.
I’m told by one of my clients the technical expression for having such an almost sixth sense about something is called “expert induced amnesia” because the knowledge over time has moved from the conscious part of my brain, the explicit, to the implicit part of my brain.
And that got me thinking about how and what I look for when I start considering if and how a practice can improve. Curiously and I hadn’t realised this before, the what is always the same. For example:
Do you know what or how much is owed to you?
Note that is not the same as asking specifically what the number is. It is “do you know how much?”
At the point I’m asking the question, I’m not really interested in what the actually number is. I’m interested in knowing if the business KNOWS! If the answer is “don’t know” that tells me there is a lack of management controls which sets the direction and scope of the assignment. If the answer is yes and, for example, the number is at the end of the last financial year (might be several months ago) that tells me something else. Very occasionally I hear “yes; its £x,000 as at the ned of last month or week”
But if there is no regular and timely basic management information being produced, the likelihood of there also being significant process errors being made increases too.
In other words, it is an analysis designed to establish if there is a meaningful pattern to the performance of the practice.
And that is precisely what I found when I took on my most recent client.
No timely, accurate management information because the process of invoice generation and cash receipt allocation was not being completed. That immediately led to another question: why not?
Yet paradoxically, the concept of “meaningful patterns” can be said to fly in the very face of my training and subsequent application of scientific management. I’m looking for patterns which will point me in the areas where improvements (however slight) can be found. Actually I don’t think it flies in the face of my training and application of scientific management at all. And it doesn’t really matter if it does.
What does matter is that areas for improvement are discovered and then acted upon.
It is the ACTED UPON element that really produces improvements.
What is really interesting though is the reaction from a practice principal or a private practice manager when an error is found. To me its an opportunity to put it right and ensure the error is prevented from happening again.
Sadly however, some reactions don’t exactly proceed down that avenue.
Significantly though, those that follow the path of “opportunity to improve” do see an increase in their cash flow.
It never ceases to amaze me how many private practices are following a pattern that does NOT result in another patient coming to see them or another invoice being processed and therefore more money being paid to them.
Why look for a “meaningful pattern” then not try to improve if the aim is to generate more cash and more profit in the first place?