Earlier in my career I decided to dive into the medical field. Specifically focusing on technology that supported ambulatory care. I started working with several physicians near where I live to help them with their purchases of technology, specifically electronic medical record type systems. During this process, I have to learn how a doctor runs their practice. Everything from how a clinic visit is organized from the front office to back office and ultimately to billing. I learned a lot of new terminology, coding systems, methodologies for tracking patient care, and even started to understand the basics of how a doctor looks at diagnosing a patient complaint.
Somewhere along this journey, I keyed in on a concept that has stuck with me. Whenever I ponder how I can improve my life, or my profession I come back to this concept. The thought is that our focus should always be on the object that provides the most profit. I am not quite sure where I got this concept from, I think it was when I was working with a internal medicine doctor and his wife. Their practice was slowly failing. They had enough new incoming patients to keep them alive, but as the cost of medical care was getting squeezed, so were they. Their employees were constantly turning over, they made far too many changes to quickly to how they were doing business and the complaints from patients were constantly coming into the front office.
This is when I got involved. They were implementing a new patient record system, a new phone system and a variety of other technologies. I started trying to help them, and in the process got deeply involved in how they were running their practice. I could see first hand where the failure was occurring and why. At the same time I was teaching a course on systems analysis and design, which at the time, was focused on object orientated design. An interesting event occurred that caused me to consider this concept of the profitable object.
I was in a back room trying to teach the physician how to input a patient visit into the new software. We were going through this process called SOAP (Subjective, Objective, Assessment, Plan). His medical assistant kept trying to interrupt because he was in a room trying to help an elderly patient with a wound on her shoulder that was bleeding. The doctor kept trying to explain to the assistant what to do, how to dress the wound, how to treat it, how to stop the flow of blood etc. After the fourth interruption, I decided to ask a simple question. Do you think the patient might be on a blood thinner or anti-coagulant medication? The doctor went pale, darted out of the room, came back with a patient record in a manila folder that was the size of a large dictionary and starting peeling through pages. Sure enough, she was on both and her bleeding was just no going to stop. Needless to say, the training was over for the day. He now had a crisis to deal with.
Driving home that day, my idea hit me. The most important object in analyzing a doctor’s practice is the point of care. The actual encounter between patient and provider. That is where all the profit is gained. That is where care happens and all the sources of billing, or events that lead to billing occur during that visit. The process of that visit produces all the workload for the entire office. From that point on, I started to analyze where providers focuses their energy. What was most important to them? The good ones? They were focused on the interaction with the patient, the encounter. The patient visit trumped all other concerns. The bad ones? Everything else. This was a simple equation. The most financially stable doctors understood the object that drives their profit. The doctors that were struggling, were being distracted by other concerns.
I started to use this concept to help a few of the small practices that were struggling. However, my advice was dismissed quickly. Who was I to give advice on this? Just get the damn printer working, and let me focus on running my practice. However, they were not focused on the right things. I saw doctors spending way too much time doing anything but visiting patients. When they would go into see someone, it was only a for a few minutes, hand on the door knob. Ready to get out as soon as possible. They would use insurance as their excuse. I am only paid for 15 minutes, or something like that. There was some truth to that, but the real truth is that the doctor was not focused on the important part of their practice that is the most profitable to them and that is the patient visit.
I learned a lesson watching this and started to apply this to every field I saw. A college should be focused on the student / teacher interaction in a classroom. That is the most important object in that scenario. A sales person should be focused on the interaction with their client. Those are the moments that generate opportunity. You can tell a successful person or business by where they choose to center their focus. Which object gains the most attention? That will be your clue. I started to look at my own profession, my own life and asked myself this question. What is the profitable object?
I challenge you to consider this. Where are you going to spend time today? Think about what “objects” will gain most of your attention. If you are leader of people, then I hope that talking and interacting with people is your focus. If you are responsible for selling to clients, then talking and interacting with clients better be your OBJECTive. Every person, in any role, can determine what the profitable object is and should be. Consider for a moment if you are focused on the right thing, the object from which you will drive the most profit.
Guy Reams
