Career coach: Doctors need to work on their business skills

By Joyce E.A. Russell
Monday, May 10, 2010

With the health-care bill now law and set to take effect this fall, providers are scrambling to figure out what this means for them. For many, it means they better have the business end of their practice in shape if they are going to succeed.

Many doctors likely weren't thinking about business skills when they got into the field of medicine, nor did they have time to take business courses. I recently asked Michael R. Yochelson, associate medical director of the neurological program at National Rehabilitation Hospital, his thoughts as his industry faces major changes in the health-care system. "It doesn't matter whether or not one has an inherent interest in business -- in order to survive, this knowledge will be critical. It will be imperative for physicians to acquire stronger business skills," he said.

For physicians, negotiations with insurers are a complex, time-consuming part of the job. Doctors play David in negotiations when going up against top insurance companies and the behemoth Medicare and Medicaid systems (which provide 80 percent of the country's health insurance). As Yochelson notes, "what is often frustrating to physicians is when the insurance companies say 'no' to the tests, medications and procedures that doctors deem necessary for treatment. If the physician still advocates the treatment plan, then the patient may have to pay higher bills or the hospital or clinic has to cover the costs, neither of which is a desirable outcome."

What do you do when you find yourself negotiating with a much stronger entity?

You may need to be flexible and think about several different treatment plans. Then you'll need to make a very strong medical case for why your proposed optimal treatment plan is essential. You'll need to demonstrate how the situation offers win-win-win outcomes: why ordering only the most critical tests or treatments is best for the insurer, the health-care provider and, most importantly, the patient.

Physicians also have to worry about marketing more than ever before -- both to potential patients and to other physicians, particularly primary-care physicians, who provide crucial referral business. Specialists need to spend more time nurturing relationships with primary-care physicians to make sure they are referring patients for care.

In a discussion with another physician, Kevin Streete, we talked about how speaking the language of business will help physicians. He suggests that doctors will need to "understand the importance of knowing the marketplace, especially developing innovative marketing and branding strategies that will create advantages and differentiation as the industry becomes more competitive. It just may mean survival for some practices," he said.

Identify your practice's strongest competition and come up with a strategy to showcase your strengths. Do you have a small practice that can offer focused, personal attention? Does your large practice with more on-site services make you more attractive? Like any business, have the data to back up your assertions. Highlight your success rates or your sustained patient growth to demonstrate why other physicians should refer patients to you. Present this information in a way that's easy for other busy doctors and patients to understand.

Above all, don't underestimate the importance of polished communication skills. Your communications with your staff, insurers, other doctors and patients can be the deciding factor in the success of your business. Treat all of these clients with the respect you'd expect from any business service provider -- be attentive, responsive and professional.

What else can doctors do to enhance their business skills? More medical professionals like Streete and Yochelson have turned to formal business education to enhance their knowledge. Many organizations, such as the Medical Society of the District of Columbia, the Medical Society of Virginia and MedChi, the Maryland State Medical Society, provide information, consulting assistance and classes to help physicians run successful, profitable businesses. (Disclosure: MedChi partners with the Robert H. Smith School of Business to offer a program that covers negotiations, leadership, finance, marketing and more.)

Yochelson understands his industry's critical need: "The reality is if you don't understand business practices, you can't survive in today's market -- and if you don't survive, you won't do anyone any good. You will no longer be practicing medicine and providing the much-needed care to the patient that you went to medical school to treat."

Joyce E.A. Russell is a Ralph H. Tyser distinguished teaching fellow at University of Maryland's Robert H. Smith School of Business. She is a licensed industrial and organizational psychologist and has more than 25 years of experience coaching executives and consulting on leadership and career management. She can be reached at

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