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Today, this problem came up again during a consultation with a concierge physician that has been in practice for 4 years. I thought it would be an excellent blog post to share with you.
As you outline the steps involved in a typical office visit and the procedures you will perform in your office, consider the following items, how long each step will take, who is involved, who will be responsible, and so forth. Use one worksheet per activity (IOV, ROV, EKG, PFT, etc.). Then when you are done, place them in your notebook.
NOTE: So often, I listen to the “sellers’ remorse” of concierge physicians who set membership amenities and service inclusions in their package without knowing the cost of those inclusions. 24-36 months into their operations, they now complain that their contract with the members stipulates to certain inclusions, and they cannot cancel or modify those services without causing a lot of grief about contract amendments, and they expect that any reduction would be met with an expectation of a lowered membership fee, when in essence they priced their program recklessly. In fact, a competitor could file an antitrust complaint with the Federal Trade Commission for predatory pricing[1].
| ACTIVITY / CPT Code | |
| What supplies do I need? | |
| From whom will I procure them? | |
| What is the price range that I can easily procure them? | |
| When do I need them? | |
| How long do they remain fresh or usable? | |
| How much labor is required and how much will it cost? | |
| What is the activity-based cost of this activity? | |
| What margin do I hope to realize? | |
| What price or value is assigned to this activity? | |
| How will I set standards or where will I borrow the standards that are already accepted in the industry? | |
| How will I reduce inefficiencies in the process? | |
| How will I ensure worker safety? | |
| How will I ensure patient safety? | |
| How can I reduce waste? | |
| How will I dispose of waste? | |
| Additional considerations: | |
This worksheet is one of the many I share in my latest book, the Handbook of Concierge Medical Practice Design (2014, Productivity Press).
[1] the pricing of goods or services at such a low level that other suppliers cannot compete and are forced to leave the market.
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