Build Your Master System

Put your team’s know-how about running your medical practice in a tangible format versus locked in the brains of individuals.

Dr. Challa is a highly successful gastroenterologist and founder of the Kansas Medical Clinic, a large and growing medical practice with offices across Kansas. As his practice expanded, however, Dr. Challa and his team began to experience the challenges of outgrowing the systems that had worked well at a single-location GI clinic with close oversight from Dr. Challa.

Remember that PBS television show called “This Old House”? Imagine you’re on that show working on a seventy-five-year-old house with its original electrical wiring and plumbing. What would happen if you plugged in to that house a full complement of modern electrical appliances? You’d blow your fuses, not to mention risk an electrical fire. And what would happen to your plumbing if you went from a well-water system to tapping into the higher pressure of city water? (Can you say “rain gear”?)

The same is true for the systems you use to scale your medical practice. Too much growth that places increasing demands on old, outdated systems can put the whole operation under water. The systems that worked for a $2.5-million-a-year, single-office practice are no longer sufficient to cope with a $15-million, five-location practice. And they’re not even close to being adequate for a $53-million-a-year multicity practice!

At first, the additional sales will cause a few “leaks,” but before long, your practice will have burst pipes and water everywhere.

Leaning on Individual Ability

Of course, the first major hurdle most practices face to efficiently and consistently run the various “pillars” of their practice (i.e., marketing, clinical, HR, finance, etc.) is not having formal business systems. Instead, they lean heavily on individual ability and informal systems that a few key office team members hold in their heads (or perhaps on sticky notes around their desks).

What happens if one of these team members gets hurt, or if a spouse gets transferred and the employee has to leave? Just like you want to protect your practice and your employees should anything happen to you, you need to protect your practice in case a proverbial “bus” hits one of your key employees.

What are Systems?

Your business systems are a crucial stabilizing factor to protect the practice, your staff, and your patients (not to mention their respective families, who indirectly rely upon the practice). So, just what are systems? They are reliable processes and procedures that empower your practice to efficiently and consistently operate to profitably produce great health services for your patients. They include documented best practices that increase your practice’s efficiency and reduce costly mistakes.

Systems include documents and processes such as the checklists your clinical team follows to ensure patients get the optimal health outcome. They also include the orientation process you put all new hires through, the standardized contracts you use with your vendors, and even the scripts your phone team uses to convert phone inquiries into new patients.

In fact, your business systems include any company know-how of how to run and operate your medical practice in a tangible format versus locked in the brain of individual team members.

Setting Up and Refining Formal Systems

Let’s return to Dr. Challa. When he first began working with my coaching team several years ago, one impactful outcome of the program was introducing and institutionalizing the creation, organization, use, and refinement of formal systems across the practice. Up to that point, Dr. Challa’s team had had a hodgepodge of business systems. If one of his clinics had a particularly skilled clinic director, that location developed powerful tools (i.e., systems) to help it operate smoothly and effectively. But thirty miles away, at a different location, those best practices might well be totally unknown.

Think of how much Dr. Challa’s practice invested$ndash;in terms of staff time and attention$ndash;to create those systems at the first clinic. Yet those practices remained entirely siloed and unavailable to their team members down the road. Further, as the practice grew larger, it needed its systems to grow with it. But inside the practice, there was no formal culture of creating, using, refining, and sharing best practices across locations.

The challenge wasn’t just a matter of formalizing best practices in writing, either. Dr. Challa’s team was consistently frustrated and wasting time on things as simple as finding a vendor contract because there was no central, organized storage location for all their developed systems. This lack of a structure to access their systems wasted time and hindered the efficiency and growth of the practice. “Somebody gives an important file a name and puts it in a folder,” Dr. Challa told us, “while someone else goes looking for it, can’t find it fast enough, and ends up creating another file.”

This happened in lots of different situations. When his staff began interviewing to hire a new physician, they drafted a term sheet to summarize salary, benefits, bonuses, and terms of employment. They ended up conducting three interviews in a six-month period$ndash;but every time they needed that document, they couldn’t find where they had put it. So they had to recreate that term sheet three times!

This isn’t a sexy problem, but it’s exceedingly common$ndash;and costly. And even as the Kansas Medical Clinic was outwardly successful and increasingly in demand among patients in their region, Dr. Challa knew they needed to solve this internal problem if they wanted to continue to grow their regional medical group to more locations.

What is Your UBS?

Let me introduce a powerful concept called your UBS, which stands for Ultimate Business System. Your UBS is both the organized collection of systems you develop and use to run your clinic. It’s also the term that reminds your team to make the daily use, storage, refinement, and sharing of systems a part of the culture of your practice.

Most commonly, your UBS is an organized collection of digital folders of practice systems that are stored in the cloud. Your practice systems can include the following:

Checklists for new-patient paperwork, clinical procedures, and even the cleaning of an exam room
Standardized paperwork for new hires, HIPAA releases, and post-procedure release documentation
Databases of key information on referring medical groups, reimbursement-coding “cheat sheets,” and vendor pricing
Documented processes and step-by-step instructions on how to use your EMR system, collect and process co-pays at patient checkout, and send out your monthly patient e-letter
FAQs for new patients as well as common Q&A documents and instructions for staff on how to handle common situations, how to create more consistent service results from your vendors, and any number of other topics

Your Doorway to Systems Thinking

Think of your UBS as the doorway through which to introduce systems thinking across your team. This UBS tool will also give you a coherent and scalable way to store the systems your team creates. That way, your entire team$ndash;even if members are spread across multiple locations, like Dr. Challa’s$ndash;will be able to instantly access your systems from wherever they are.

“It took us four months to build our UBS,” said Dr. Challa. “Whether it’s fee schedules, invoicing, vendor contracts, HR materials, or step-by-step processes for how we do our work, it’s all itemized in the UBS. It’s been a lifesaver. Now, when I want a document, it’s on my desk within three minutes.”

That efficiency greatly helped Dr. Challa as he built the Kansas Medical Clinic into what it is today: a practice that spans four specialties and has nine locations with 120 employees spread over a hundred-mile area. “Put it in the UBS” has become a company mantra.

By implementing a UBS at your practice, you’ll change the way work gets done.