General practitioners and specialists: restructuring case of practice management

Facts and figures on the German health care system.

What it’s all about

The Best Practice Standard defines all instruments, regulations and behavioural patterns that guarantee smoothly functioning practice work in every work situation and even under changing stresses. On the basis of comparisons of practice management operations and depending on the degree of implementation of this standard, a typology can be derived for doctors and their implementation of practice management.

Why typologies are important

Typologies are important because they provide a framework for understanding how problems or solutions can be identified, categorised and eliminated.

For doctors, it can be concretely identified which measures a practice owner would need to introduce in order to make the work optimised, efficient and productive as well as successful in the long term.

The doctor typology

With regard to practice management, there are four basic types:

Best Practitioner practices.

These practices are managed professionally, comprehensively strategically and with unrestricted success. Through early indicators, the owners anticipate trends and opportunities, are highly willing to change and open to innovations.

Best practice candidate practices

In these practices, a large part of the performance characteristics relevant for professional-strategic practice management is already implemented, although not yet with the consistency and success as in the businesses of the best practitioners.

Borderliner practices

In terms of the intensity of implementation of strategic practice management, practice owners in this group are located between the Best Practice candidates and the Passives. Many borderline practice owners know that changes would be necessary in their operations, but do not currently act. The direction in which they move depends largely on the future development of their entrepreneurial mindset. If they initiate improvements in practice work, they can develop their enterprises into best practice candidates. Otherwise, in the medium term they will pass into the realm of minimalists.

Minimalist practices

They are characterised by rudimentary practice management, which allows them to run their practices within very narrow limits, but lacks any strategic orientation.

Restructuring practice management

In medical practices, only 53% of the regulations and instruments necessary for smoothly functioning practice management are used on average – across all speciality groups and practice forms and sizes. The resulting patient satisfaction meets only 61% of the requirements and wishes.

The average German practice is thus a borderline operation in terms of practice management.

The concrete effects of this state are experienced daily by practice teams in the form of stress, anger and demotivation. And even in operations where the teams do not acutely feel any impairment of their work, there are often risk factors that lead to problems in the medium to long term.

In self-direction to improvements

The „tragedy“ of this situation is that most of the solutions to problems in the practices are known or can be identified through a simple self-analysis. However, many doctors lack the basic knowledge and / or the time to deal with this adequately in the practice. One way out would be to resort to external consultants. However, their help is expensive and the specialists used often only offer standard solutions. One way out is to carry out a practice management business comparison, which can be implemented in a very short time without an on-site consultant and without great effort. On average, it identifies 40 previously unused opportunities for improvement in management for the individual practice.