INTERVIEW WITH DR. RAINER, OUR SENIOR CONSULTANT

Conducted by James Riviezzo of Creative Medicine, a marketing company that provides marketing solutions to new and existing private practices.

Mr. Riviezzo : What sets Sunbelt apart from other practice management consultants?

Dr. Rainer : To my knowledge, Sunbelt is the only practice management consulting firm founded and operated by a doctor. That doctor, of course, is yours truly. Medical practices in need of help can turn to many consultants. Typically these consultants are quite knowledgeable. However, hardly any actually run a medical practice for a living, like I do, nor are they physicians. Having had my own private practice gives me a substantial competitive advantage over other consultants. When a doctor calls me to assist him with a problem, we connect instantly, since we speak the same language.

Mr. Riviezzo : How did a practicing doctor like you become a consultant?

Dr. Rainer : My life story goes like this: I am an internist and I worked for a group practice in Phoenix that went bust! At that time a family member opened their own private surgery practice and I became the paper-pusher. They have no interest in administration, number crunching and business affairs, but I do. Since then I have been pushing paper with such skill and alacrity that I decided to expand into management consulting.

Mr. Riviezzo : Don't you miss seeing patients?

Dr. Rainer : I get asked that all the time. I do miss it, but it would have been impossible for me to run a family's practice and see patients at the same time.

Mr. Riviezzo : I imagine you learned a lot while you worked for the group practice.

Dr. Rainer : Indeed! The group was very badly run. Its demise was by no means unavoidable; it was the result of poor management. The problem we had was a problem frequently encountered within group practices. Doctors appoint themselves business administrators, but don't take the time to acquire the knowledge needed to run a business. For me working for the group was like going to business school for free: I learned how not to run a medical practice. This sounds silly, but knowing what doesn't work is very valuable knowledge. It saved me from having to go through a trial-and-error phase after opening my family's office. I watched the group make all the errors. I did not need to repeat any of them.

Mr. Riviezzo : Often we hear that doctors are "bad" business people. Care to comment?

Dr. Rainer : By the time doctors wind up in their own private practices, they spent half their lives learning. It is therefore natural to say "I've been in school longer than any other professional. I am stuffed with knowledge and I don't need any more schooling". However, medical school and residencies teach clinical knowledge exclusively and no business skills. Yes, there are some residencies, like family medicine, which are beginning to teach business skills. But the vast majority of residency graduates are business clueless. So, to answer your question, doctors typically are not "bad" business people, they are not business people at all.

Mr. Riviezzo : Isn't it too late for a doctor to acquire business knowledge after residency?

Dr. Rainer : Not at all. The good news is that compared with the enormous amount of clinical knowledge doctors need to absorb, business knowledge is like a mouse next to an elephant. What is critical is the desire to pursue it.

Mr. Riviezzo : In your experience, what is the biggest mistake doctors make when they open their own practices?

Dr. Rainer : That's an easy answer:   coding! Most doctors have some knowledge of coding, but to succeed as a private practitioner you need to be an expert coder in your field. It is not enough to know the criteria for code 99212. You need to be intimately familiar with all the intricacies, such as modifiers, bundling and unbundling, downcoding and so on. Coding is not so hard to learn. In fact for surgical specialties it is very simple. However, primary care coding is quite another matter. I teach business skills to residents and I repeat the bit on coding like a broken record: do not go into private practice if you don't know how to code; you cannot succeed. Many doctors hire a coder instead of learning themselves. That's the equivalent of saying "you examine the patient and I'll tell you what's wrong with him". There is simply no way around learning how to code.

Mr. Riviezzo : When doctors decide to go into private practice, what is the best course of action?

Dr. Rainer : Perhaps I can suggest reading the article titled "Ten Rules for the Private Practitioner" featured in this Newsletter. It is a good starting point because it is based on my own experience. The road to private practice starts with learning how to code. Secondly, any doctor who is starting his own business for the first time would be well advised to hire a consultant to help him along. I did too and learned a lot in the process. Finally, it is important to realize that having your own shop allows you enormous flexibility. You can set your own hours, go on vacation whenever you like and restrict your activities to just the kind of medicine you enjoy practicing. It is a lot easier to have fun at work if you own the shop.