Orthopedists must take steps now to avoid downward slide in 2008

SAN FRANCISCO — Many orthopedic surgeons experienced a successful 2007 in terms of watching their caseloads and practices grow. But for many of these surgeons, 2008 could present a rude awakening.

"I am here to advise you that it is 2008, and I want you to take a new view this year," said Karen Zupko, a practice management consultant who spoke at the American Academy of Orthopaedic Surgeons (AAOS) Practice Management Symposium for Orthopaedic Surgeons, here. "If you do the same things in 2008 that you did in 2007, you won't be sitting here at next year's meeting telling me what a great year you had. Things are changing."

With a sinking housing market and weakening stock market, many Americans are facing tougher times ahead. And although many doctors have not been directly impacted yet by some of these changes, they will eventually be affected through their patients.

"Many people are choosing to pay their credit card debts rather than their mortgages," she said. "And if patients are having problems, those [problems] eventually affect the physicians who care for them."

She cited a recent USA Today article in which a credit counselor interviewed for the story said that he knew times were getting tough when three doctors came to see him that week.

But despite the increasing costs and decreasing reimbursement that many orthopedic surgeons face, they can still take steps to improve their outlook, she said.

"Many surgeons and practices still let weeks and months go by before completing the paperwork and submitting claims," she said. "To me, that's unacceptable. And you can no longer walk around saying, 'That's the office manager's job.' That's silly business. You need to start paying attention, and there is enormous power in paying attention to what's happening in your practice."

She also criticized those practices that don't enforce no-show policies.

"Why is it that a tattoo artist can charge a deposit for services and you don't?" she asked. "Medicare allows you to charge a patient for a no-show, and you can have a policy that enforces that, and not just with your Medicare patients, either. ... New patients, in particular, need to understand that rule. It's equivalent to pick-pocketing when you consider the work that goes into scheduling the patient and fitting him or her into a busy caseload."

And while enforcing such a policy should be done consistently, it should always be done with "grace and understanding."

For more information:
Zupko K. Getting paid for what you do. Presented at the AAOS Practice Management Symposium for Practicing Orthopaedic Surgeons. March 4, 2008. San Francisco.