Business Planning:Optimising Time & Resources

Mary ToomeyStrand Hotel, Limerick

23rd July 2011

Where We Are• Economic crisis : greater social needs but much reduced

resources • Recent political turmoil : new expectations • Increased legislative demands • Increased patient expectations• Out of date public contracts : unsuitable, abused, and dying

painfully• Several new (but largely uncoordinated) models of Primary

Care emerging• Insufficient planning, poor communication and sometimes

disrespectful / undermining attitudes between government, HSE, and Primary Care Providers

Where You Want to Be

• What are your strengths?• What would you love to see your

Practice achieve in the future?• What are your personal ambitions for

the Practice?• What do your patients/ community

need from you?

Where You Want to Be

• What steps do you need to achieve these goals?

• What resources do you need?

• What obstacles will you need to overcome?

Problems

Most common problems:• Financial crisis, cash flow problems

• Stress of staying on top of daily workload

• Paralysis because of uncertainty / fear of risk, frustration or fatigue at challenges of change

•Spend less and/or earn more

•Take control of your workload

•Change... one step at a time

Spending Less

• Start by looking at bigger spends and areas which won’t affect patient care quality

• What are you using in a wasteful manner?• What can you manage without?• Get cost comparisons and samples.• Look at ‘sneaky’ charges, e.g. carriage/delivery• Look at your bank charges

Spending Less

• Drawings... Monthly and Profit Share• Assistants and Locums – how profitable and

why? Have you the right balance between Partners and other doctors?

• Nurses, Phlebotomists, and other HCPs• Administrative / Support Staff Wages• Pay cuts or freeze; unpaid leave or shortened

working hours; restructuring or redeployment• Redundancy

How to Earn More : Develop a Marketing Strategy

• Any marketing strategy should be based on your patients.

• A marketing plan is an action plan for a given period, usually one year or more, to offer and promote a range of products and services to your market.

• This action plan must fit in the broader and longer issues of your Practice.

The Hands That Feed Us

How well do you know your patients?–Demographics–Social / medical histories–Their needs (physical, emotional)–Their desires and preferences

...their needs / desires are your opportunities

The Hands That Feed Us

• How well do your patients know you?–Your opening hours and location–Your services–Your staff–Your best features

How do your patients feel about you?

Looking at Your Existing Services

• Who availed of what service?• How did they hear of it? • What did they think of it?• Did they think it was good value? Why?• Will they come back for more?• Would they recommend to a friend?• Is there any other service this patient needs?• Who didn’t avail and why not?• Who else might need or want this service?

Creating New Spaces...Marketing

• Who are your target group of patients?• What product or service do they want / need?• How can you provide those services?• Can you revitalise an old service?• Can you find synergy with partners? • How can you make those services profitable?• How can you let people know you offer them?

“Well Woman” Transformation

• Well Woman : cost €290 – patients not availing of the service

• Most patients didn’t know what it was about• Some patients felt it was too expensive• Many patients were taking extended periods

of time in ordinary consultations with various medical-style issues, but not enough to justify referral to Well Woman

“Well Woman” Transformation

• Well Woman broken down into different parts gave us a range of shorter, more targeted and much cheaper check ups:– Women’s Cardiovascular Check-Up (€108)– Women’s Personal Health Check (€108)– Well Woman Comprehensive (€261)– Women’s Mini-Medical (€108)– Women’s Sexual Health Medical (€72)– Sports Medical (€108)

“Well Woman” Transformation

• We also identified patients had need for diet and lifestyle advice so we linked in with the GP Exercise Referral Programme and HSE dietician-led PHEW and Expert Group services

• Women’s Health Evenings to be run in Autumn 2011 to encourage a healthier lifestyle and further our commitment to patient education; also promoting new Women’s Health services

Existing Services

Possible / Developing Services

GP Consult

ICSP Smear

Health Screen

Mini Medical

Chronic Disease Clinic

Late night surgery hours

Patient Type

Private Men 46 + X X X

Private Men 25 – 45 X X X

Private Men 18 + X X

GMS Men 45+ X

GMS Men 25 - 45 X

GMS Men 18 + X

Pr. Women 46 + X X X X

Pr. Women 25 – 45 X X X X

Pr. Women 18 + X X

Pts w. Diabetes X X

Pts. On Heartwatch x X

Your 12 Month Marketing Plan

• Start with season-specific services e.g. flu vaccines

• Plan to fill up times when you may be fallow• Consider pilot projects during quiet times• Avoid taking on too much at busy or holiday

times• Manageable amounts with breaks as needed

Extract from Carlton Clinic’s 2011 Marketing Plan

Aug

•Chronic Disease Clinics; 10% off health screens for summer•Make arrangements for women’s health evenings (speakers, venues)•Prepare fall newsletter (women’s health; back to school; flu vaccines)

Sept

•Send newsletters

•Run women’s health evenings

•Flu vaccination clinics

Oct

•Housebound patients flu vacc’s / pilot review form

•Plan Men’s Health evening.

•Finalise Xmas gift voucher medicals

Nov

•Run Men’s Health Evening

•Prepare & send Xmas newsletter

•Review of activities 2011 and discuss 2012 Marketing Plan and Budget with Partners

Ways to Let People Know

• Word of mouth• Practice Brochure• Notice in waiting room• Mail• Flyer drop• Newsletter• Website• Directories / web listings• Social network sites etc• Newspaper / Radio / TV

It’s not how I see

myself...

...it’s how other people see me that

counts

How on earth did you get

that impression

???

Creating an Impression

• Success comes from doing ordinary things extraordinarily well

• Good management (of people and processes) is essential to create the right impressions over & over

Manage Your Workload

• Micro level : Me– Accept that stress is my reaction to things and

people around me, and can be controlled or eliminated

– Accept that I have limitations– Prioritise the big picture: things that have serious

short term or chronic long term consequences– Focus on managing others well– Say no assertively

Time Management Tips

• Understand the business position and aims• Have a long term plan which is broken into

several clear objectives• Take a few moments to prioritise at the start of

every day, ensure you have one long term “mission” for the day – and get it done!

• Expect the unexpected and accept the things you can’t change – but prevent repeating patterns where possible

Manage Your Workload

• Macro Level : The Whole Practice– Look at the roles required and what each team

member should be doing– Focus on the people, not the processes– Engage them in their own transformation process– Believe in their ability– Reward them for changing for the better

Your Team Needs

• What you are doing really well?• What needs to be

improved?• What needs to

stop?

How we do things?

How we behave?

How we speak?

Self Fulfilling Prophecies

• Be aware that people will most often achieve what you expect from them... Whether that is good or bad...

• Be very aware of your prides and prejudices• Bad performance is (almost) always the

product of bad management!• Your people have enormous potential... Do

you believe they can achieve it? Do they?

Repeating Patterns

• Recognise them – record them (e.g. trends in sick leave, lateness, poor performance)

• Discuss them (informally; return-to-work interview; performance appraisal, disciplinary process investigation)

• Explain the effects of the behaviour on the team and the business – why this trend is a problem

• Ask for improvement as appropriate & follow up• Have the right procedures and stick to them• Stay within the law!

Giving Feedback

• Have your facts to hand (in the background)• Explain why you are giving feedback – so as to

help improve, and achieve better together• Approach it constructively • Tell the truth• Agree a way forward and advise the staff

member of a future date when you’ll follow up on progress

• Make a record of the meeting

Summary

•Spend less and/or earn more...Make a marketing plan

•Take control of your workload ...For yourself and your practice

•Change, one small step at a time