Optimizing Operations of an Integrative Practice


The main focus of any doctor should be on healing the patient; but what about the business side of things? From running a profitable dispensary to staffing and scheduling, doctors today are often overrun by back-end tasks and are spread thin. In an attempt to help optimize any doctors office, Innovative Medicine has outlined the keys to running a successful integrative practice, both on the medical and business side. Learn to implement simple solutions that can streamline necessary activities and greatly improve patient care.

In this recorded web event, the following key points discussed included:

  • Successfully separating front-end vs back-end activities (operations vs treatment)
  • Operational foundation that maximizes patient results and experience
  • Staff roles and delegating tasks
  • Setting up a “patient-first” practice that has been proven effective
  • Simplifying and automating processes to free up time
  • Issues of maintaining a medical dispensary, insurance, pricing, scheduling and much more!

Below is a synopsis of the video.

A Patient-Centric Results-Based Clinical Model

In this “patient-first” model or pyramid, the most critical and paramount goal is always to produce the highest levels of patient success through the complete restoration of health. All subsequent levels are therefore optimized to achieve this goal, and doctors / practitioners who work in this model focus solely on healing, rather than be troubled with other administrative and non-medical tasks.

patient-centric results-based model

The Medical Center of the Future

There are four main points that will serve as the foundation of the medical centers of the future which yield extraordinary results in complex chronic cases.

  1. Comprehensive and Personalized Healing
    Solutions Required: A team of practitioners working together, delegation of duties, separation of “front-end” and “back-end” activities
  2. Optimize Patient Experience
    Solutions Required: Redefine success, price correctly, simplify processes, proper education, automate tasks and communications
  3. One-Stop Center
    Solutions Required: Fully stocked dispensary, ability to assess quality of all medicines, multiple modalities offered, specialties under one roof and on same page
  4. Results First
    Solutions Required: Place patients first, insurance free, quality over quantity approach

Separating ‘Front-End’ vs ‘Back-End’ Operations 

Separating ‘front-end’ activities (medical processes) and ‘back-end’ activities (business and office operations) is an important aspect of running a patient-centric results-based clinical model. Just like the left and right hemisphere of a brain, both activities must be organized and work together for success. When correctly delegated and separated, a practitioner and his medical staff should be solely focused on providing the very best medical care for the patients, all the while confidently assured the business operations of the office are running smoothly through the work of the back-end operators.

In the front-end operations, the main operator is the medical director or primary practitioner. Tasks include evaluations, treatments, optimization of patient healing experiences, and providing the suitable environment for restoring health. Roles include doctors, practitioners, nurses, and assistants.

Back-end operations are directed by a operational manager (or a secretary acting as one). Activities here include scheduling, dispensary management, initial points of contact, marketing, and patient relationship management (PRM). Roles may include operational manager, patient coordinator, office assistant, and secretary, among many others..

Correctly Pricing Therapies and Medicines

One important aspect to running a successful integrative practice is correctly pricing medicines, therapies, and evaluations. Too often, non-conventional practices attempt to reduce pricing of services to accommodate associated out-of-pocket expenses and a larger patient base. This is not advised in a patient-centric results-based model. A pricing structure that addresses the immense value as well as all associated costs of running an optimized practice must be considered (remember, quality medicines and instrumentation are required to produce best results, and quality always comes at a cost).

To develop a fixed pricing strategy, the first step is to gather data:

  • Competitor prices and pricing strategies (pricing of treatments in NYC and Tulsa, OK will be different based on cost of living and relative pricing)
  • Medical Operating ExpensesCustomer benefits of products and services (in advanced integrative medicine, the benefits are immense)
  • Cost of goods sold (variable costs / COGS – high quality medicines come at a cost, but offer highest value and best results)
  • Fixed business costs (overhead – currently 40-65% of total medical expenses)

“The medical offices that I’ve worked with closely — when you run the numbers — are charging too low a price. I’ve never seen an obvious example — again, with the offices I’ve worked with — of a doctor charging a price that is clearly too high.”
– Steve P., accountant

Running a Successful Dispensary

Current trends to out-source the distribution of medicines and supplements may seem advantageous at first glance, but are in contradiction to a patient-centric results-based model. The facts remain, maintaining a dispensary in one’s office provides the most benefits. These include:

  • Providing patients with medicines on the spot
  • Easily explain each medicine and answer questions
  • Patient satisfaction in ability to start prescribed medicines immediately
  • Additional source of income

Keys to maintaining a dispensary:

  • Keep shelves stocked, but not overstocked – back-end roles must have a simple understanding of lead time, monthly usage, reorder points, and carrying cost – learn more.
  • Regular reordering – once weekly stock assessment by back-end and nurses – order once a week or as regularly needed to consolidate orders, reduce shipping, hit free-shipping points, and eliminate back-order situations.
  • Do not order per patient – Patient should be provided medicines at the office and pay for along with treatment – waiting to order for a single patient increases shipping costs incurred, does not take advantage of economies of scale, produces inefficiencies, patient dissatisfaction, and hard to manage this way.
  • Ensuring products do not expire – First-In, First-Out (FIFO) method – not just for accounting, but for inventory and stocking shelves. Place items that were purchased before at the front of shelves and new orders go behind near the back. Always select medicines at front of shelf and move from front-to-back (this also allows a better understanding of what is running low).

Why to go Insurance Free?

Eliminating insurance from your practice has numerous benefits:

  • Allows practitioner to concentrate on healing patient
  • Patients are more compliant and value the care they receive
  • Most medicines and procedures are not covered to begin with – falsifying codes puts the practitioner and practice risk
  • Direct cash flow – pay per appointment – eliminate payment plans, co-payments, collection agencies, etc.
  • Elimination of extensive paperwork, coding  and wait for payments from insurance/ Medicare

Implementing an insurance-free policy and patient options:

  • Fixed fees for everyone – patients agree through informed consents before initial visit
  • CareCredit
  • Medical costs are insurance deductible
  • Can be paid out of flexible spending accounts
  • Eliminates research and referral process for doctors available in their insurance network

Simple to Implement Solutions

“I’ve worked with practitioners of all types to increase their effectiveness and efficiency,
to see more patients, and get better results by helping them optimize, automate, and
outsource many of the tasks that normally hinder their practice.“
– Ari Meisel, Productivity Consultant at Less Doing

Productivity tools discussed:

  • Mint online financial tracking
  • UpWork – connect to ondemand freelancers from around the world
  • Schedule Onceonline scheduling solution
  • Shoeboxed – turn paper files into digital files
  • Sookasa + Dropbox enables HIPAA and FERPA compliance for cloud storage
  • Evernotesimple note-taking and sharing with the office
  • Basecamp – task management and communication tool

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6 replies
  1. Heather McFarland
    Heather McFarland says:

    I think the Patient Centric Model is proof of medicine done the “right” way, so let’s hope we can collectively get everyone on board with such an idea, because it would work. Just remember though that HIPAA will always loom large, thus its important that Covered Entities and Business Associates focus on the true merits of HIPAA compliance, and that’s putting in place documented HIPAA information security and operational policies, procedures, and processes. I’ve worked with so many healthcare providers that lack the basic and fundamental documentation for HIPAA compliance, therefore it’s easy to see why non-compliance issues are still a major factor with HIPAA. I also hear healthcare companies express cost concerns about developing such documents, along with implementing risk assessment and security training initiatives, but with all the free and cost-effective tools available (some of them straight from hhs.gov!), there’s really no excuse for not being HIPAA compliant. Everyone needs to be ensuring the safety and security of PHI, it’s really that simple.

    • IM Health Team
      IM Health Team says:

      Thanks for the comment, Heather. And you’re absolutely correct – all physicians and practitioners must be HIPAA compliant and understand what that means. One of the recommendations from Ari Meisel, who has worked with many doctors to ensure HIPAA compliance, was to embrace paperless record-keeping and utilize Sookasa together with Dropbox, which enables HIPAA and FERPA compliance for cloud storage. But it is ultimately the practitioner’s responsibility to abide by all state and federal regulations that pertain to them and their license / practice.


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  3. […] well aware that in a Patient-Centric Results-Based Clinical Model, the more information and knowledge a patient has, the more empowered they become and the better […]

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