Becker's Spine Review

36 Improving Spine Practice Profits 6 Strategies to Make Spine Practice Business Models More Patient-Centric By Carrie Pallardy T hree spine surgeons share strategies for creating and maintaining an effective patient-centric business model at spine practices. 1. Shrink patient wait times. Not long ago it was common for patients to wait an hour or more past their scheduled appointment time to see a physician. "Now, patient expectations are higher," says Douglas Won, MD, founder and director of Minimally Invasive SpineCARE in Dallas. At his practice, if the office is running behind schedule the front desk will call patients ahead of time so they can arrive later when they can been seen right away. "It starts with timing. We are very careful about getting patients in quickly," says Kenneth Hansraj, MD, of New York Spine Surgery and Rehabilitation Medicine in Poughkeepsie, N.Y. Both the patients' time and the staff 's time is valuable. Based on this understanding, New York Spine Surgery and Rehabilitation Medicine adheres to a comprehensive intake method. Patients give complete histories before seeing a physician. The time a patient spends with Dr. Hansraj is face time, not time spent gathering a patient's background information. As with any physician practice there are days when timing doesn't run smoothly, but Dr. Hansraj points out with the complexity of spine cases this can be even more of an issue. While dedicated to seeing patients quickly, Dr. Hansraj does not believe in rushing a patient out of the office. "Some patients require 20 minutes, some require two hours," he says. "The biggest challenge and the biggest reward in a patient-centric business model is timing. Time can be difficult to manage, but once a practice implements a system of doing so, the benefits are tremendous," says Dr. Hansraj. Patients love to be seen in and out on time, physicians and staff can leave earlier and it costs less when everyone is home on time. 2. Give patients multiple treatment options if possible. Roger Härtl, MD, chief of spinal surgery and neurotrauma at Weill Cornell Brain and Spine Center in New York, concentrates on providing his patients with treatment options. "We need to stress to the patient that non-operative treatment is the best initial choice," he says. Though this is a key tenet of patient-centric care at a spine practice, it is also an inherent challenge to convince patients that there are other options. "Many patients assume that if they're seeing a surgeon, they must need surgery. But that's not always the case — I often refer patients first to physical therapy, or pain management, before considering them as candidates for surgery." Dr. Roger Härtl Dr. Härtl stresses the importance of understanding the relationship between pain and psychology. Cognitive therapy and psychological intervention can be just as important as any treatment when it comes to addressing and treating the root cause of a patient's pain. 3. Keep flexible hours to accommodate additional patients. Medical practice is increasingly becoming a service industry. Minimally Invasive SpineCARE has multiple locations and Dr. Won uses this to his advantage. "We expand office hours in order to see patients. If you are in serious pain you can't wait weeks to see a physician," said Dr. Won. Patients are able to make an appointment with an available physician at the time and location most convenient for them. Dr. Douglas Won 4. Appoint a staff member to coordinate patient schedules. Spine care can be very fragmented. Patients are seen at different locations by different specialists. Between diagnostic, therapy, physician and surgeon appointments, its easy for a patient to become confused. One of the important elements driving patientcentered care at Weill Cornell Brain and Spine Center is the spine center navigator. This navigator is a nurse that Dr. Härtl described as "the glue between all of the elements of a spine center." The navigator directs patients through the entire center and places them as the central figures of physician care. Dr Won's office also has a staff member in charge of patient coordination. "We have a coordinator overseeing patient care and a patient log. Our coordinator follows up to make sure a patient understands how to properly schedule all appointments and how to get to each one," he says. On their own, patients may not follow up and this can lead to treatment gaps. If your staff tracks and follows up on each individual's treatment, patient outcomes may noticeably improve. Dr. Kenneth Hansraj

• Cover