Remember, that you have to always conduct your
business operations as if money is always tight
and revenues are tough to obtain. This way you
will be fine when times are good, and will survive when times get tight.
Focus on your existing or older customers instead
of trying to secure new customers, and be willing
to slim down your operations and to cut your
rates to secure additional long term business from your current customers.
A good rule is that you should always be
marketing your services, and that if the economy
slows down that you have to quadruple your
marketing efforts to increase sales by 10%. But
be careful because marketing services is totally
different then sales efforts, and a good
marketing programs does not requires a sales push
if done properly. Add to that the fact that the
very nature of TSCM services prohibits sales
activities as they tend to offend customers much
the same way that you physician trying to sell
you a blood test would offend you, but a
physician marketing a new test to you would not
(know the difference between sales and marketing).
It is critical to long term survival to be
relatively debt free, keeping your credit cards
as close to zero balances as possible, and to
have long term relationships with all of your
customers. Also never expand when times are
tough, but rather "Use it up, wear it out, make
it do, or do without" and be in a position to buy
up your competitions business or at least
purchase all their gear and customers.
I estimate that during 2009 we will see the death
of at least 25% of all sweep firms in the United
States, or larger contractors shutting down their
sweep operations but keeping their other
operations... so you need to position yourself to
take over their customers, and crank up your
marketing efforts in 2009 by at least four fold.
-jma
http://www.medscape.com/viewarticle/585990
Economic Blues Trickle Down to Physicians
by Robert Lowes
December 28, 2008 — Although most physicians are
not losing their jobs or homes, they're
nonetheless feeling the repercussions of the
recession that began in December 2007 and
deepened during the financial crisis in the fall
of 2008. Symptoms large and small abound of a financial slump in medicine:
Fifty-six percent of hospitals told the American
Hospital Association in November that physicians
were seeking more financial support, ranging from
reimbursement for on-call duty to outright employment.
Roughly 1 in 2 physicians plan to attend fewer
continuing medical education conferences in 2009
that require overnight travel, according to a
September survey by the publication Medical Meetings.
Some physicians may be receiving fewer holiday
gifts, a sure sign of belt tightening among
patients. Internist Sheree Lipkis, MD, in
Glenview, Illinois, has noticed a decline in such
gifts from previous years from her patients.
"Some of them have lost their jobs," Dr. Lipkis told Medscape Medical News.
Physicians like Dr. Lipkis might expect that
rising unemployment and curtailed consumer
spending would reduce patient volume, but that's
not a universal pattern. To be sure, elective
surgery has tailed off. Six in 10 plastic
surgeons, for example, report a decrease in
cosmetic procedures during the first 8 months of
2008, according to the American Society of
Plastic Surgeons. Yet most primary-care
physicians interviewed by Medscape Medical News
say they haven't slowed down. "Patient numbers
are stable," said internist C. B. Dehlin, DO, in
Lansing, Michigan. "Maybe we're just caring for
the 90% of Michiganders that have jobs."
Patients Postponing Care, Skipping Tests and Treatments
Full schedules for primary-care physicians may be
misleading, though. Thirty-six percent of
Americans are postponing needed care, while
another 30% are skipping tests and treatments
outright, according to a survey in October 2008
by the Henry J. Kaiser Family Foundation, and
both categories are up 7 percentage points since
April 2008. However, with many primary-care
physicians ordinarily drowning in patients,
reduced demand may simply translate into a
shorter waiting time for an appointment slot as opposed to an open slot.
Also, the payment cycles of commercial insurers
may have temporarily softened the effect of the
recession for physicians who enjoyed crowded
waiting rooms in late 2008. By that time, many if
not most insured patients had met their annual
deductible, motivating them to load up on needed
care before year's end while it was less
expensive. Dr. Lipkis said that's the reason why
the last few months of 2008 were busier than
usual for her. Come January 2009, the prospect of
shouldering the entire cost of an office visit or
procedure may discourage insured patients from making an appointment.
If patients — insured or not — do book an
appointment, there's also the possibility that
they may not pay up afterward. The Kaiser Family
Foundation found that one third of Americans were
struggling to pay their medical bills in fall
2008, up from one quarter in 2006. Not
surprisingly, a St. Louis collection agency
called Account Resolution has seen the dollar
volume of delinquent accounts received from
physicians increase by roughly 25% in the last
half of 2008, says company president James Hill,
Jr. "These trends are happening all across the
country," Mr. Hill said. And they only stand to
worsen with unemployment expected to hit 8.3% by
the end of 2009, according to financial research firm Standard & Poor's.
One component of the current recession — the
credit crunch — has made it harder for some
physicians to borrow money to start a practice or
expand an existing one. "Automatic loans for
anyone with a medical degree are a thing of the
past," practice management consultant Michael
LaPenna in Kentwood, Michigan, told Medscape
Medical News. Besides requiring physicians to put
up security for term loans, cautious banks are
asking physicians with an existing line of credit
to prove that they have enough accounts
receivable to justify the amount of money made available.
Bolstered Medicaid, Medicare Spending May Help
Prognosticators such as Standard and Poor's
expect the recession to last well into 2009. How
physicians fare will depend partly on the success
of federal bailout efforts enacted under the Bush
administration — bankrolling banks to loosen up
credit, for example — as well as the economic
stimulants that President-elect Barack Obama has
said he will administer. Mr. Obama has
contemplated pouring billions of dollars into
state Medicaid programs that have experienced
budget cuts in the face of higher demand (the
Kaiser Family Foundation estimates that every 1%
increase in unemployment adds 1 million people to
Medicaid and the State Children's Health
Insurance Program). For many physicians,
bolstered Medicaid spending could mean the
difference between poor compensation versus none at all.
The American College of Physicians (ACP) is
asking the federal government to be just as
generous with Medicare. It is recommending that
for 18 months, Congress fund a 10% bonus for all
Medicare services performed by primary-care
physicians. "Without funding to stabilize
primary-care practices, many will go under and
have to close" in light of the credit crunch,
investment losses, slower collections, and
uncompensated care, the ACP states in a letter to
the incoming Obama administration.
While everybody, it seems, is waiting for federal
largesse, physicians can act on their own to cope
with the forlorn economy. For starters, tune up
your billing and collection operation. With
patients losing insurance coverage or switching
to a spouse's policy after a job loss, it's
imperative to verify insurance eligibility and
benefits at the front desk so you know whom to
bill, said practice management consultant Mr.
LaPenna. Collecting copays and patient balances
at the front desk is another must for the sake of
maximizing revenue. If patients are short on
money, offer them an installment plan. It can be
as simple as keeping their credit card number on
file — with the patient's authorization — and
automatically charging it over a set number of months.
Improve Marketing to Current and New Patients
Practices with openings in their schedules should
try to make it easier for patients to make
appointments, suggested Hobie Collins, a practice
management consultant with the Medical Group
Management Association in Louisville, Kentucky.
Extended weekday hours, for example, cater to
employed patients who might find it hard to come
in otherwise. "Eliminate as many barriers as you can," said Mr. Collins.
Stepped up marketing can also help fill up the
waiting room. Target your existing patients
first, advises practice management consultant
Jeff Denning in La Jolla, California. "Go through
your charts and see who's overdue for preventive
or follow-up care, and give them a call," Mr.
Denning said. A practice Web site may help a
surgical specialist attract new cases.
Cost control is an indispensable virtue during a
recession. "Remember the motto from the Great
Depression," Mr. LaPenna said. "Use it up, wear
it out, make it do, or do without." To achieve
the right economy of scale, Mr. LaPenna said,
physicians may have to go beyond mere downsizing
and consider merging with another practice.
How drastic the solution needs to be, of course,
depends on the length and severity of the
recession. Dr. Lipkis, for one, will be watching
how many tins of popcorn and bottles of wine she
receives from patients when the winter holidays
come around in 2009. In the meantime, she's giving thanks.
Dr. Lipkis said: "We remind our staff during
stressful days how lucky we are to have jobs and be financially afloat."
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Received on Sat Mar 02 2024 - 00:57:16 CST