Entrepreneurial Spirit

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March 2002

By Nancy J. Beckley, MS, MBA

Examining your goals for 2002 in order to bring them to fruition.

I negotiated more than $75 million in managed care contracts on an annual basis when I was the administrative director of managed care and business development for one of Florida's largest hospitals. Throughout my career, I have taken many courses on negotiation and have read every version of "getting to yes." But I always felt that my best negotiating skills were learned from being the parent of a teenager.

Well, the teenager is now an adult-a junior in college-and we haven't negotiated much in many years. While she was home for Christmas vacation, I picked up another valuable tidbit from this wise college student-born of her experience as an adult on her own. She thought it was profound, I thought it made perfect sense.

I received a lesson in setting goals and objectives when she profoundly told me that it is not the setting of goals that matters, but rather what lies beneath those goals.

I paused to think about my own 2002 professional and personal goals as well as how to help rehab entrepreneurs frame their goals for the upcoming year, particularly marketing and development goals.

Following are a number of planning exercises designed to help you get under your goals.

Getting Under Your Goals
1. Strength analysis. Look at the "S" in the SWOT (strengths, weaknesses, opportunities, and threats) analysis and create a strength comparison with your competitors based on the information available in the marketplace. Make sure to include phone book advertisements, brochures, Web pages, and advertising in the local media. Put your strengths in perspective of how the public will view them in comparison to the other providers in the market. Keep in mind the substitution effect when considering competitors. If you offer massages, consider all your competitors who offer massages, ie, other rehab clinics, health clubs, day spas, and chiropractors. Study how these materials look, what type of information you are providing, how it shows the experience of the staff, directions to the facility, how to get an appointment, insurance plans that are accepted, and words of praise.

2. Anecdotal data. Continue the development of your strength balance sheet with collection of anecdotal data. Find out what people are saying about you. A good place to start is your patient satisfaction survey, but keep in mind that most of these are designed to elicit positive information from patients about their experience. In more than 25 years of rehab, I have yet to see a program get much less than a B+ overall patient satisfaction rating-so be sure to look elsewhere for feedback that is honest, but not showing up on your official patient satisfaction reports. Very often I am asked by clients to call referral sources including insurance companies, case managers, and referring physicians to get their opinions about them. I always include at least one competitor, and I am honest about the reason I am calling. More important than what the competitor views as your weaknesses is what they concede as your strengths. This is information you will never know unless you ask.

3. Secret shopper. We often think of secret shopping as snooping on competitors when it is actually a good technique to use with your own facility for a variety of reasons. At every facility I have worked with, I routinely called into the office at various times of the day (including after hours and during lunch) to get a feel for how the phone is answered, how the on-hold music sounds, and how I am handled when I make an appointment. The critical element is framing this from a marketing perspective, rather than an operational perspective.

The point was further brought home when I attended a health care marketing workshop where the presenter went through the elaborate effort and expense to have an old-fashioned phone booth as one of his props. He asked for volunteers from the audience who would be willing to have their facility secretly shopped. Several people raised their hand, stating that they were confident that their phones were answered perfectly. The presenter then placed calls to each facility and asked to have a referral to a physician for the purpose of getting an appointment at the facility. One out of the four facilities scored an A by audience consensus, the other three failed miserably-you can only imagine the embarrassment of the participants. When their facilities were called, one phone was never answered, one facility could not help the caller find a physician who could make a referral, and the final call featured a very unfriendly and abrupt person answering the phone. It was amazing to see these audience participants caught so off guard.

Take a walk through your clinic and look at all the details that might not normally catch your eye. Pay attention to what the patient can see and evaluate. Patients have little way of evaluating your clinic. But they do have the ability to evaluate the cleanliness of your facility including the waiting rooms (is the television in your waiting room set to trash talk shows?) and the attitude of your therapists and business staff.

Secret shopping may also help your corporate compliance program. A rehab entrepreneur who had a small clinic with three clinical staff revealed that her Medicare fiscal intermediary called to say he would be in the area and wanted to do an on-site review including review of several charts. The entrepreneur was asked to select a few charts and have them prepared for the reviewers. It turns out that the charts selected did not meet Medicare requirements, so the reviewers asked to see a few more while they were on site. The next batch were also deemed to be deficient, and within a few weeks the entrepreneur was notified that applying the error rate of the charts that had been reviewed against the total number of charts for a specified period of time resulted in payback of more than $400,000, due within 30 days. Don't forget to secret shop your own charts, particularly if you are the one at financial risk. While these charts had passed the facility's quality assurance and utilization review criteria, they had failed the Medicare test on items that were fairly evident.

4. Dream the big picture. It is easy to lose sight of the big picture when you are wrapped up in the details of reimbursement and the complexity of documentation. Two problematic situations can arise: big picture goals may be set at the beginning of the year, only to be left unaccomplished because there was no time; and big picture goals are never set at all, perhaps because they are never seen as a possibility. Take a look at your big picture goals, and dream them into reality by establishing those steps that you can take each and every month to bring them to fruition.

The Bottom Line
When dreaming your big picture, take a look at trends that will help you generate ideas. Read rehabilitation and health care industry publications. Find out what is going on in your community through the local newspapers as well as chamber of commerce and business publications. Your task is to take advantage of an opportunity, or even to create an opportunity to take advantage of.

Hopefully, these exercises will help get you underneath your goals and assist you in refining them, redefining them, and setting daily targets for you to achieve. ®

Nancy J. Beckley, MS, MBA, is president of Bloomingdale Consulting Group in Tampa, Fla. Comments and questions are always welcome at (888) 999-0275 or via email at: bcgbeckley@aol.com.

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March 2002