I was recently invited to be one of only 3 non-doctor attendees at a Joint Presentation by Dr April Armstrong and Dr George Forgan Smith. This charismatic pair have been hobnobbing up and down the East Coast of Australia educating doctors and practice owners alike on two very crucial aspects of General Practice.

The first- April’s area of expertise- is the MBS.

The Medicare Benefits Scheme, as you know, ensures that Australian’s can access rebateable medical services. It has been the subject of heated debate, as the government have reviewed the “freeze” and we have noticed that General Practitioners have mixed thoughts on what the solution and “the right thing to do” is.

April has a clear solution- use the darn thing the way it was meant to be used.

At first glance, you may think that this passionate woman is concerned about income and revenue. Anyone who has attended her sessions and spoken to her however; will understand that this is not the case.

The Medicare Benefits Scheme was developed to ensure equal access for all Australian’s and for General Practitioners- it encourages you to provide continuity of care and to provide holistic patient centred medicine.

Many practices- I say many but not all- have built a culture of medicine that doesn’t provide this type of care. It’s fast, mean and efficient medicine where the patients get what they need and then they get out. It has its place, but it is not what many General Practitioners move into General Practice for- this type of medicine takes the love of General Practice right out of the job!

The suggestion that is being made is to bring General Practice back to the “Family GP” where a patient comes to a practice, knowing that their GP is going to improve their health and general quality of life ongoing- not just curing their current ailment but guiding them to a healthier lifestyle and watching for warning signs of impending ill health. You, as their GP, have the expectation that they appreciate your time and respect your expectations of them and their conduct in your clinic. This type of General Practice is the true meaning of continuity of care. Doing this not only improves your relationships with your patients and their long-term health outcomes, it is good for your income as well.

The MBS sets you up to do all this. It’s called “Stacking” – hospital based doctors do it every day. It is legal, ethical and promotes a better level of care not only to your patients- but to yourself as well.

Talking about “Money” is not a taboo topic. You’ve done the study, you’re putting in the time with your patients and the system is set up to ensure you are paid accordingly. It is simply your responsibility to do the right thing- by yourself and your patients.

The second- George’s love outside of Medicine- is marketing

George explains that building a patient base is building your brand. As a doctor, you can rely on the practice to source your patients or you can take an active role in attracting them yourself. As a practice, there are methods you can use to attract patients and it all starts with having the right expectations in place.

First and foremost, you need to decide what type of service you want to be. I write it like this because this is relevant to any service industry. You need to ask yourself- are you providing a ‘budget’ service or a ‘luxury’ service. Both are perfectly good models of care and both will attract different type of patient base (or client base).

Set that expectation with your staff or management, and with your patients.

George uses an excellent example of airlines- you do not expect to get fed on Jetstar now do you?

The same can be said for medicine. If you’re going to a bulk billing clinic, the expectations from the patients are far less than if you’re heading to a clinic where you pay $90 a consult. As a doctor or a clinic owner, you need to decide which model you’re following and develop your business and marketing plan around it. You need to live up to those expectations- if your patients are paying a fee for the consult, make sure you’re providing the level of service they deserve and expect otherwise, you’ll find your patients are not coming back. Equally, if you’re providing a bulk billing service, it’s hard to provide all the perks that a private billing clinic can and if you try then it won’t be patients walking out the door, it will be your ability to pay your rent.

For George, going the extra mile is how he attracts his patients. He chose a specific ‘target market’ and he has been an active part of the community- providing information in forums, building information websites and providing clear directions on where to find him. His patients have a clear understanding of when and how they can approach him and his expectations of them are made very clear.

It’s hard to put into words everything that I learnt from George- it really is something you have to see for yourself!

The key points that I learned from April & George- and they relate not only to the medical industry but to my own- are these

• Self-Sacrifice doesn’t increase your favour with your clients- you deserve to earn money for the hard work that you’re putting in. Our culture encourages us to work long hours above and beyond what anyone expects of us, because we feel that is what is expected. We need to give ourselves a break and realise that it is OK to earn money for the amount of effort we are putting in.
• Know Your Stuff. Know how to do it well, in the way that is going to benefit you and your patient. You do not have to do things the longest hardest ways- there are shortcuts that help you work more efficiently. No- not the type of shortcut that is a grey area in ethics, I’m talking about developed procedures to make things more efficient! Templates, FAQ’s and “cheat sheets” to prompt you.
• The best way to provide good customer service is not to know everything- but to know people who do. If you have a good group of specialists and allied health to refer to whom you’ve built a relationship with then you can call them to ask them questions, you can refer your patient to them. Remember that your referrals reflect on you so it’s important to build a network for people who work like you do. Do not be afraid to ask for help.
• Listen to your patients. You need to listen not only to what they are saying but to what they’re not as well. Pre-empting, planning and thinking forward is how to build strong relationships with your patients and ensure their best care.
• Time Management is Key. Know how to manage your time whether it is time blocking, to do lists or even a PA (How we all wish!), know how to manage your diary and know how to wrap up consults, meetings and your own admin if it is threatening to go over time. That isn’t to say be efficient to the point of inflexibility- if you need to take time for something then do, but know how to manage your diary so that isn’t going to release your panic hormones!
• Communication. Explaining why you’re doing things to the people around you- your staff, your managers, your patients and/or anyone else in your life is an important way of ensuring everyone is on the same page. For your patients, it ensures they understand and feel a part of the process.
• Be Prepared. Set yourself up for the day with everything you need right where you can reach it. Simple.
• Always be open to new ideas. Visiting other practices, learning new ways of doing things and changing things up is the best way of ensuring you have the most efficient style.
• The Extra Mile. This doesn’t have to be much- it links in with things like “know your stuff” and “be prepared”. You as a doctor need to do what is best for your patients. How can you reduce their medical costs and build a plan for their long-term health? Is it enough just to prescribe them Vitamin B shots, or should you perhaps let them know that taking magnesium is going to help them absorb it. Little things that are going to make you stand out as a doctor.

This presentation and now my follow up blog has a purpose.

Know your worth.

Live up to it.