Many people have questioned me for not having a billing specialist in my office. Instead, I have relied on software to do the same function. Keeping overhead low is the true key to success with running a practice. In that vein, I also do not have a personal office. At this point some of you are probably joking, “No biller, no office, no patients.” But the truth is the future of healthcare is very uncertain. To survive any changes that come our way, lean and mean is the way to run a practice.
Let’s take a step back in history. There was a time when a patient would go to the their doctor. They would be taken into an exam room where the doctor would evaluate them. Then they would dress and meet the doctor in his office where they would discuss the findings. That rarely happens today. In ophthalmology, it never happens. So what is the private office used for today? In my past position in an academic center, it was a place for me to hide from patients, wolf down a sandwich and catch up on patient charts and call backs.
So what has changed? Due to my low overhead I don’t have to see tons of patients who are arguing about the wait times. Patients are seen on time almost every time. I now have a longer break scheduled so I can actually get out of the office if I want to eat lunch. My patient charts are in the cloud so I can access them from anywhere. My office is wherever I am as long as I have a phone, iPad or laptop with me.
I mentioned that I didn’t have a biller because my EMR—EMA Ophthalmology from Modernizing Medicine—and PM system—Care Cloud—do the coding, posting and tracking of charges for me. I also don’t use a scribe because the EMR is intuitive and fast for me to use. Charts in the cloud means no back room required for storage of patient charts.
No scribes, no billers, and a small office space. Removing all of these expenses gives me the freedom to say, “I don’t need to be on this HMO or that capitated model.”
So how does it work in practice? Great! I see fewer patients and I am more profitable per patient than my colleagues. If a patient needs a medication refill over the weekend, I know what they’re using, which pharmacy they use, and with a couple mouse clicks can refill their drops from home in a few seconds. I can be out of town, and should a patient have an emergency, I can send any past patient records to a covering colleague in seconds.
Patients appreciate the on time, personalized care they receive, and I am able to go to work every day loving what I do and still get home in time to play with my children. This is the evolution of the ophthalmology practice.