From: "Lowell Kleinman" <drquit@drquit

From: "Lowell Kleinman" <drquit@drquit.com>
Mailing-List: list Practiceimprovement1@yahoogroups.com; contact Practiceimprovement1-owner@yahoogroups.com
Date: Sat, 22 Jan 2005 07:32:32 -0800
Subject: RE: [Practiceimprovement1] Keeping expenses down
Reply-To: Practiceimprovement1@yahoogroups.com

At what point is going cheap actually a hindrance? For example, I am wanting to be a one stop shop for a variety of reasons. One is that when I suggest that someone go for nutritional counselling, smoking cessation, diabetic training, etc, they are more likely to get these services if I offer them in my office and I know the quality will be top notch. Hence, I am planning on hiring a health educator to provide these services in a group setting ideally, but also on a one-on-one basis. Not having enough space to do this is an obvious dilemma. Not hiring someone to schedule these things is another.

I don't like to look at overhead soley as an expense to be avoided. Rather, I think it should also be looked at for what revenue it generates. I have what would be considered a huge overhead regarding rent. However, this space allows me to offer more services and what I think amounts to better patient care. I am moving towards the one-stop-shop especially now that I have an EMR. Speaking of which, who is going to run all of those Registry reports and who is going to schedule all of those follow up visits based on those reports if I don't hire the additional staff.

To state is differently, it's not cost per unit of space that's the sole issue. It's revenue generated per unit space as well. As one's practice matures, the opportunities for the latter become more apparent but at some point i believe one has to shift vantage points.

I suspect some of what is at hand falls under lifestyle issues as much as what makes good business sense. I have been in a largew group and a medium sized group, both of which were dysfunctional from a what's best for the patient and a bottom line perspective. However, it was a lack of leadership, a lack of an EMR, and a lack of vision that was the problem, not overhead expenses.

In my office, we are growing rapidly but we are keeping a watchful eye on those lifestyle issue. all is lost if we feel exhausted, overworked, and that we are doing more paper work than patient work. Yes, my overhead is high, but so is the patient and financial ROI.

Lowell