Solo, small practices can expand successfully with careful planning
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LOUISVILLE, Ky. — Solo and small-group practitioners can successfully expand their practices, but should be careful in their planning, according to a talk at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.
“What about this expansion? What about other revenue streams? There are a whole lot of different things we can do,” Priya Bansal, MD, FAAAAI, allergist and immunologist at the Asthma and Wellness Center in Saint Charles, Illinois, said in her presentation.
Opportunities for growth
Remote patient and therapeutic monitoring, patch and T.R.U.E. TEST (Mekos Laboratories) testing, oral and sublingual immunotherapy, biologics and even clinical research all are options for growth, according to Bansal, who also is a member of the Healio Allergy/Asthma Peer Perspective Board.
“But you don’t need to do it all. No one is going to be able to do it all. Pick and choose. What do you want to do?” continued Bansal, who is now involved in remote patient and therapeutic monitoring. However, she did not just jump into these programs.
“How I did that was by planning,” she said. “Plan, plan, plan. If you don’t plan, you are not going to be successful.”
Clinicians need to begin by knowing their patient population and which programs they will be receptive to. Also, practices need adequate staffing to handle these new procedures for existing and new patients alike.
“Is this the right time to start that program?” Bansal asked. “Do I need more staff or resources? And what kind of staff do I need to have it in place?”
When interviewing new staff, Bansal encouraged clinicians to look for people who are different and who are eager to tackle these new programs.
“I want you to be different from me. I don’t want a mini-me. If you want to do oral immunotherapy, fabulous. I can help you get that running. That will help expand my practice,” she said.
Also, practices that want to see the revenues that these new programs will provide need everyone to be aware of coding, Bansal said. In fact, she said, many physicians already do things that they never bill for.
“Did I do an Asthma Control Test [GSK]? Maybe I should put that on the bill. Did I educate the patient about the inhaler? Maybe that 94664 code should be going on the bill,” she said. “Bill the codes you’re doing.”
The problem, she said, is that clinicians often let their billing departments handle the coding.
“No. You have to code it. Your billing department doesn’t know everything you did during the visit. Learn about the insurance,” Bansal said.
When clinicians add new programs to their services, Bansal said, they need to know and report those codes too.
“In a small practice, that’s where you can grow,” she said.
Know your worth
Similarly, Bansal said, clinicians should track their collections.
“I’ve talked to so many employee physicians that I’ve helped mentor, and they have said that they have no idea what they’re making. How?” Bansal said. “How do you not know what you’re bringing in? It’s important to know what you’re bringing in.”
Bansal noted that employee clinicians in particular should be familiar with relative value units (RVUs) and how their practices use them for billing, because practices may vary in which procedures get assigned RVUs.
“You need to know what you’re worth, and if they’re not paying for certain things you’re doing, you need to do that. I think that’s really important if you’re an employee,” she said.
Promotion is the next step in expanding practices through new programs, Bansal said. Clinicians should network locally and nationally, connecting with private practitioners and academics alike, she said. The brand-building process should involve social media and key performance indicators as well.
“Become an expert,” she said. “Find an area that you want to pursue, and make it well known in your community that you are the person who does it.”
Goals are vital in this journey as well, Bansal continued, and clinicians should articulate what these goals are before commencing any expansion. But in pursuing success, she added, clinicians also should be prepared for change.
“What’s your goal at 1 year, 5 years, 10 years? It doesn’t have to be the same goal. You can change it. You can revise it,” Bansal said. “And be honest about what you want, because what I wanted when I was an employee is completely different from what I want now. And that’s OK.”