Toxic Mindsets in Family and Specialist Practices: „We’re a Team!“

Data, facts and instruments on the German health system

What it’s all about

„Alone we can do so little, together we can do so much.“ (Helen Keller)

They are widespread, catchy, readily accepted without scrutiny because they spare them action and self-reflection, but are false and influence physician action: toxic mindsets in outpatient medicine. One example is the statement, „We are a team.“ No term is used more frequently in the external presentation of medical practices, e.g., on websites, than the term „team.“ Yet the reality is that in most practices, there is no team-based collaboration at all. This has far-reaching negative effects on efficiency, productivity and quality of results.

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Toxic dogma in outpatient medicine: „There are so few good staff!“

Data, facts and instruments on the German health system

What it’s about

They are widespread, catchy, readily accepted without scrutiny because they spare them action and self-reflection, but are false and influence physician action: toxic mindsets in ambulatory medicine. Example.

„Every physician has the staff he deserves.“

In the evaluations of the IFABS Betriebsvergleich-Tracker© for GP, specialist and dental practice management, complaints by practice owners about poor staff, who work more incorrectly and are not committed or are not committed enough, frequently stand out in the free text information provided by participants.

However, the detailed analysis of work routines, management behavior and team structures show that, regardless of what the individual practice manager understands by the attribute „good“, a large number of management errors impair the quality of work, for example

  • Lack of work objectives
  • Hardly any definition and delimitation of areas of responsibility
  • Too little freedom for independent action
  • Unclear rules of cooperation
  • Lack of support for necessary conflict resolution
  • Unequal treatment
  • Lack of unambiguous decisions
  • Too little internal communication
  • No promotion and development of skills
  • Lack of feedback on performance
  • Too little appreciation and recognition
  • Suggestions are not listened to / accepted
  • Lack of solidarity towards patients
  • Reprimands in the presence of patients
  • Moody doctors
  • Unhealthy workplaces

The remarks make it clear: doctors are responsible for the quality of their staff, apart from individual cases of actual lack of skills. Or formulated in another way:

Every doctor has the employees he deserves through his behavior and the set work framework.

Do not work in real teams in medical practices

In addition: the average Teamwork Quality Score (TQS), i.e. the satisfaction of medical assistants regarding the degree of realization of the best practice team standard in their practices, is – viewed across all specialist groups – currently only 43.7% (optimum: 100%),

i.e., groups in primary care and specialty practices generally work together, a fact that surprises many practice owners after determining the indicator for their practice.

In this form of collaboration

  • the synergy of individual activities is only slightly pronounced: people work with each other, but always only within the framework that is given; own initiative or helping out with problems are rather rare,
  • there are often unresolved and unproductive conflicts,
  • Every medical assistant strives to do her job well, but there is no sustained commitment to continuous improvement.

At the same time, however, the status is a starting point for reorganizing the work in the practice by examining the reasons more closely and adapting the conditions for cooperation accordingly.

Strategic management for primary care physicians and specialists: Not more, but more efficient and productive work

Data, facts and instruments on the German health system

What it’s all about

The results of the IFABS Betriebsvergleich-Tracker© for GP and specialist practice management show that deficits exist in almost every medical practice, the elimination of which could significantly improve the entrepreneurial scope of action and the financial result.

If one examines the profit before and one year after a practice management comparison© consistently implemented in the results, increases of up to 25% are found.

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The future of outpatient care: Doctors must come to terms with the popularization of medicine

Data, facts and instruments on the German health system

What it’s all about

General practitioners and specialists are still unfamiliar with the Internet knowledge of their patients on health issues, but this must change in the future in order to communicate in a targeted manner.

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Mastering the medical mindshift: The problem child of organisational quality

Data, facts and instruments on the German health system

What it’s all about

The functionality of the practice organisation decisively determines the possibilities of individual patient care, the economic success of the practice and the working conditions of the entire practice team. However, the results of patient surveys and the assessments in doctor rating portals show time and again that there are organisational deficits in medical practices on a broad level.

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GP and specialist management: Systematically finding the right practice management consultant

Data, facts and instruments on the German health system

What it’s all about

„We need a consultant!“: more and more GPs and specialists in private practice feel the need for support in their practice management and are thinking about seeking external help. With the help of a simple procedure, practice owners can define their problem so precisely that a consultant who fits the task exactly can be found and the costs of the support can be minimised.

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Mastering the medical mindshift: Successfully avoiding dangerous mismatches

Data, facts and instruments on the German health system

What it’s all about

The better practice teams are able to assess the needs and satisfaction of their patients, the better they can align their care and support services. Reality shows that a central starting point for optimisation lies in the match between self-perception and the image of others.

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Practice organisation: GPs and specialists should know these key figures

Data, facts and instruments on the German health system

What it’s all about

The benchmarking function of a practice management comparison makes it possible to quantify the qualitative descriptions of the work of a medical practice and to compare them with objective-representative measured variables. In this way, it is possible not only to record the type and intensity of the regulations used to manage the practice, but also their effects, so that a 360-degree view of the practice’s work emerges. Key performance indicators (KPIs) can be derived from the comparison. An application example for the field of action „organisation“ illustrates their potential.

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Mastering the medical mindshift: Streamlining for GPs and specialists

What it’s all about

In engineering, streamlining means constructing shapes with low air or water resistance in order to improve the speed and ease of movement. Applied to organisations, the term means an analysis and, if necessary, a redesign of practice management so that

  • effectiveness, efficiency and productivity, but also the working conditions of the staff are improved and
  • a business remains agile and active even under changing requirements and changing conditions of action.

Medical practices can also benefit from such an approach.

The benefits of streamlining

A smoothly functioning, i.e. formed, practice management is the central starting point for achieving all conceivable practice goals: reducing work pressure, increasing efficiency and productivity, further improving patient satisfaction, increasing success or securing the future. But how do practice owners manage to streamline their management adequately, even in the context of dynamically changing working conditions?

Practice management: one term for many interdependencies

The problem for GPs and specialists is predominantly that „practice management“ is a conglomerate of many different areas of action that are closely interlinked and, to a large extent, condition and influence each other. Only when these areas – from planning to patient management, leadership, organisation, marketing, market research and controlling – mesh with each other like finely tuned cogwheels does management excellence emerge that is malleable.

Classical solutions only help to a limited extent

In this context, the application of tips, tricks and advice provided to practice owners by various sources does not lead to a noticeable change in their work, because this is – as described – only possible in a holistic way.

Seminars sometimes impart knowledge on individual or several of these interdependencies, but the contents inevitably follow the principle of „one-size-fits-all“, so that the participating doctors – returning to their practices – have increased knowledge, but still no plan for concrete action.

The last resort is to use consultants, but a complete analysis of the practice management is too expensive for many doctors.

Streamlining is easy

A general practitioner or specialist who wants to streamline his practice management in the context of his goals, i.e. improve, develop or realign it, first needs a status description of his work. This is the starting point of the concept of Key Performance Indicators (KPI), which

  • solves the aforementioned problem of the complexity of practice management by generating orientation parameters,
  • makes it possible to determine the actual state of practice management without great effort and
  • simultaneously identifies strengths, but also deficits as well as unused opportunities and risk factors.

With the results of this initial analysis, concrete target parameters for the practice work can be defined and monitored and controlled in a simple but comprehensive way by means of follow-up examinations.

How the indicators are created

KPIs are parameters that are created by comparing the practice management data of a medical practice with objective and representative measured variables. For this purpose, with the help of structured analysis forms (doctor, MFA, patients, referrers, if applicable), the design of the practice management is first described and made measurable via scaling in the later evaluation. In this way, not only the type and intensity of the regulations used for practice management are recorded, but also their effects, so that a kind of MRI image of the practice work is created.

Insights via benchmarking

This information is then subjected to a best practice and a specialist group benchmarking. The best practice comparison shows whether all the regulations, instruments and behaviours that ensure smooth practice operation are actually implemented. The specialist group ratio provides additional information on the extent to which the practice management under investigation meets the minimum market standard. From the KPIs determined

  • results in a detailed status overview of the strengths, weaknesses, threats and opportunities of the examined practice with a detailed action plan for improvements, changes and developments, furthermore
  • individual practice management development goals can be formed on the basis of the practice strategy and monitored with regard to progress in implementation.

Thus, a KPI status report corresponds to a balanced scorecard, a „streamlining plan“ for practice management.

„Easy-to-use“ and „Ready-to-go“

The special feature of the KPI concept is that the collection of the necessary information can be done solely by means of questionnaires that are easy to fill in, without the need for an on-site consultant:

  • the doctor’s questionnaire takes about 30 minutes to complete,
  • the MFA document is completed in about 20 minutes,
  • in addition, a patient survey is carried out in which up to 100 practice visitors can be interviewed.

No specialist knowledge or supplementary materials are needed to complete the documents.

KPIs open up design possibilities

Based on the KPI status report created from the questionnaire data and the associated action plan, practice owners are able to decide whether they want to implement the listed suggestions themselves with their teams or resort to external help. In the second case, the prior preparation of the Balanced Scorecard leads to a significant cost saving, as the consulting objective for external help can be precisely delimited and defined.

The instrument for determining KPIs

is the Practice Management Comparison©.

To the information overview and download of the analysis documents…