Business of Medicine | Lessons Learned: Optimizing Practice Management

Lessons Learned Optimizing Practice Management

After a few years as an attending physician, I found myself looking for new opportunities for professional growth. Recognizing that I was still naïve about the business of medicine, but also knowing it is playing an ever greater role in our evolving practice landscape, I enrolled in the Cardiovascular Business and Management Essentials (CBME) program.

Created through a partnership between MedAxiom and the Wharton School of the University of Pennsylvania, the 12-week online course is designed to equip cardiovascular clinicians and administrators with the tools and techniques for defining and achieving personal and professional success with a focus on health care operations, economics, change leadership and people management.

As I near the end of this highly practical course, here are my top 10 lessons learned, all with an eye to transforming cardiovascular care and improving heart health for all.


Investigate Workflow

We've all had hectic workdays that could have run more smoothly and slow workdays that could have been more productive. The first step towards optimizing our workday is analyzing the utilization of time and resources to identify bottlenecks and inefficiencies in the workflow. Often the root problem is not readily apparent and requires the practice of Genchi Genbutsu, the Japanese principle of directly observing a situation to effectively develop a solution.


Work Smarter, Not Harder

Productivity can be increased by minimizing waste within the existing workday, instead of prolonging the workday. The seven common sources of waste include waiting, overproduction, transportation delays, over-processing, inventory buildup, unnecessary motion and defects. Making time to minimize time spent on waste is essential because, in the famous words of Benjamin Franklin, "lost time is never found again."


Embrace Change

We often develop work habits that are comfortable and convenient but may ultimately steer us towards inflexibility. As a safeguard against this tendency, we should routinely elicit feedback on performance and adjust accordingly. Two popular process improvement approaches include the Plan-Do-Check-Act cycle and Lean Six Sigma. Adopting a strategy for iterative improvement can help avoid the trap of complacency.


Streamline the Patient Experience

Health care providers often fail to appreciate the logistical hardships patients encounter when scheduling an office visit. From being placed on hold when making an appointment, to waiting weeks to get the next available clinic opening, to prolonged idling in the waiting room as the provider runs behind in seeing patients, there seem to be endless operational barricades patients must endure. One solution is to triage the patient-clinician communication or encounter "off-site," as either a video call, telephone call or a simple email communication. While these alternative visits may generate less revenue than an office visit, they can significantly decongest office resources and increase patient satisfaction.


Learn the Business Of Medicine

For many health care providers, the business of medicine is a black box: we all experience its consequences, but rarely do we understand how it works. Understanding the business side is essential for clinicians as it provides a common framework when discussing operational changes with hospital administrators, who are often focused on health care economics, cost considerations and financial viability. Money talks and it behooves us to learn the language.


Demonstrate Value to The Hospital

The most impactful process improvements not only enhance clinical outcomes but also business operations. Health care providers, particularly those on the frontline, are best equipped to identify value drivers, the operational variables whose modifications are associated with large financial gains. A recent value driver in cardiology is the adoption of same-day discharge after atrial fibrillation ablation, initially implemented by electrophysiologists during the COVID-19 pandemic to free up health care resources related to overnight stays. It continues to gain momentum in the post-pandemic era as it results in significant financial savings for the hospital and patients appreciate the early return home.


Become a Leader

I've learned that to make a greater impact in patient care, I need to create programs that could benefit patient populations, rather than treating individual patients. To do this requires leading a team. As clinicians, we may not view ourselves as leaders, but we inherently demonstrate leadership qualities as a byproduct of our profession, which, among other things, requires selflessness, advocacy and critical decision-making. Becoming a leader is a state of mind, not a designation, and I challenge everyone to take charge.


Motivate Your Team

The CBME highlights 16 qualities of a successful leader, but I believe the most important trait is knowing how to motivate your team. David McClelland, one of the eminent psychologists of the 20th century, characterized human motives as either achievement oriented, influence oriented or affiliation oriented. By recognizing an individual's motives, leaders can delegate tasks that are more aligned with that individual's behaviors. For example, individuals motivated by achievement enjoy overcoming challenges, taking calculated risks and working alone, whereas individuals motivated by affiliation seek acceptance, avoid risk and prefer to collaborate with others.


Lead Up, Not Manage Up

Managing up is the concept of proactively supporting the leader's agenda as a strategy for achieving team success. Leading up, on the other hand, empowers team members to adopt the mindset of the leader and make autonomous decisions on behalf of the broader mission of the team. The "lead up" concept removes the top-down control inherent in traditional leadership structures and recognizes that even those in nonsupervisory roles can independently advance team goals. We can all lead up, regardless of our assigned role in the health care hierarchy.


Be Happy at Work

At the end of the day, we must experience job satisfaction in what we do. Job satisfaction occurs when work is meaningful, a sense of accomplishment is derived from work, and there is responsibility and ownership from performing the work. Conversely, the absence of job satisfaction has been cited as a major reason for people leaving their job. Surprisingly, financial compensation was not a significant reason for individuals staying or leaving a job.

Edward Chu, MD, FACC

This article was authored by Edward Chu, MD, FACC (@Ed_Chu_MD), an electrophysiology attending physician in Miami, FL.

Keywords: Cardiology Magazine, ACC Publications, Health Personnel, Government Regulation, Patient Discharge, Goals, Patient Satisfaction

< Back to Listings