How to Decide on Your Clinic Hours


I met with my high school bff recently. I am in the medical field while she is in the corporate life for the most of her career. I remember an earlier conversation with her about how great it is for doctors to be able to schedule their clinics  against her fixed office hours.  I told her I envy her 13th month pay and bonuses, so we are even! 

But she is right. One of the great thing about practicing is the chance to shape your schedule as you wish. My clinic hours evolved through the years. I started mine with a toddler to raise. I was definite about being around for him. So I opted to see patients by appointment. Clinic starts not so early  and end not so late. As he grew and start big school, I shifted to a very early clinic and timed its end to his dismissal.  I am a morning person so this is great for me. I also like seeing inpatients early so i dont worry about them the rest of the day. 

Changes happened through the years. With an  administrative position in the hospital and additional reponsibilities, a clinic by appointment worked perfectly for me. I had control of my time.  With the traffic  during early morning commute , I experimented on the best time to leave the house  and the best time to go home.  The 2 to 3 hours early commute to the hospital  plus an hour to prepare is too much to bear.  My house is just 6 kilometers from the hospital. That’s an easy 20 to 30 minutes ride when there is no traffic. I figured its best to leave between 9:30am to 10:00 am. So the  morning girl  now holds clinic  at  11am onwards. I am yawning by the time  its 2pm. Good thing I am used to the schedule now. No more yawning ūüôā . I also make sure I leave for home no later than 4pm so i can get home in 30 minutes. 

So many things  get into deciding clinic hours. Consider your family schedule, your body’s peak productivity hours, type of work you need to do ( eg.early surgeries) and even type of patients you see  (eg.  diabetic patients  who are fasting has to be seen early). 

I learned through time that patients follow the doctor they like, no matter what. But do pay heed to what works best for you and what allows you to give the best attention to your patients.

Learning Jar


No doctor can become a good one without being a life long learner. As I began  my practice, I know  I need to keep learning. Attendance to annual convention is required to get a good standing. There are membership fees  to pay on top of convention fees. I also want to attend at least one general pediatrics  post grad course  and one or two subspecialty post grad courses once a year. Mabigat sa bulsa. Absent pa sa clinic. Kailangan isipin as investment not expense. 

During my early years,  I was going on “round” ( ūüôā kasi isang patient lang) when i chanced upon an admired lady consultant. I appreciate practical tips from her whenever we have chats. We were talking about expenses and how  many think doctors earn a lot. She told me that as one’s practice grows, many would ask for help, most often financially. She most often obliges but it can disrupt or dent one’s budget.  To solve the problem of sudden need for money when someone asks for help, she maintains a separate fund for it that she continues to fill up all year. Some patients and friends who are willing to donate as a way to pay forward because they have been attended to for free, are put in this fund too.  

This gave me an idea to set funds for future learning expenses. This will be my learning jar. A portion of everything I earn goes to this jar.  I can use it for the annual convention fees , post grad  courses, or any skill building expense I need.  As I do it this way, it reinforces the way I think about learning as an investment I need to save up for. It has worked for me through the years. Its  been worth it. After all, the biggest asset I  have is myself. Why not spend generously for my own growth and development. Go get your jar now and start filling it up!

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

How I took my specialty board and exam


Anyone who went through a specialty training and took their specialty board exam have stories to tell. This is how that day went. I remember my written exam  in one big auditorium in Unilab. This is it, I told myself. Months of memorizing and reviewing Nelson, our pediatric bible will be put to test today. So many hopefuls in the room. As examinees enter the auditorium, I saw something being handed to each examinee  from where I am standing  behind. When my turn came, I was delighted to get a plastic that contains candies, a biscuit, a boiled egg and a fruit. How thoughtful! I appreciated the gesture but I did not have time to eat any of them out of nervousness ! The exam was looonng! Managing my time was important. I determined how long I should stay on an item. Its either I know the answer or I don’t. So I skipped those I don’t know and marked it so I can go back for it. Its also important to take deep breathes every 45 minutes to clear the mind. 

My oral exam is another story. We were divided into groups. I remember one consultant attending to us before we enter the hall. He was our cheer leader. Psyching up our spirits. He asked some of us to comb our hair or put on a lipstick so we would look good and confident.  Each examinee will be assigned to 3 examiners. You will only know who they are when its your turn. I will have to get a passing grade from 2 out of the 3  to pass . I think oral exams are more difficult because it is a face to face experience. Its an added challenge compared to looking at a paper in a written exam.  I prayed for  examiners  who will be kind and gentle to me. I was afraid everything I know ( assuming I remember much of the enormous materials I read through the months) will be thrown into the winds if I  get a “toxic and terror ” examiner. 

One examiner was a  gracious lady who asked me questions in a soft and gentle voice. Thank god. She does not tell you if you got the answer right but I see a small nod from time  to time so I figured maybe I am okay. My second examiner is one kind lady too. She asked about poisoning. I was praying I did not get the two types she was asking me about mixed up as I blurt out answers. The third examiner was interesting. Without much expression on his face, he just told me ” 5 yo boy with fever was  brought in the ER.” I was waiting for him to say something else. He didnt. So I  asked a  question. How many days of fever? “Five”, he answers. Silence. Then I  asked another, “other symptoms?” He  answers. This kept on going for some time. I realized he was really on me figuring out how I will think through the case . It was a very insightful encounter. It took some days to know the result of the oral exam. 

Knowing I passed is another story to tell. I never really saw the list of those who passed myself. My friend’s husband went to the society office to look at the list. He was the one who told me I passed. Of course I believed him! He would jokingly asked me and his wife if we are really board passers because we did not really see our names in the list  ourselves. Good thing we got a letter for it!

If you are taking your exams anytime soon, go take your exams with the confidence that you have prepared well.  Know that everything you need  you already have in you. Dress up for it. Put on makeup. Carry a big smile. Pray. Give it your best. 

3 Lessons I Learned from The Greatest Showman Movie

 

Have you watched The Greatest Showman?¬† The movie is starring Hugh Jackman sans the metal in his arms. The story is inspired by the life of¬† Phineas Taylor Barnum who founded the¬† Barnum’s American Museum and Barnum and Bailey Circus. He eventually sold it¬† to the Ringling Brothers¬† who merged¬† their¬† own show with it and became known as the Greatest Show¬† on Earth.

 

While the movie may have some cinematic license when it comes to certain details, there were lessons to learn from the movie as presented.

¬† ¬† ¬†1. P.T. Barnum’s dreams came true because he was passionate.¬† He knows what he¬† ¬† ¬† ¬† ¬† wanted and he pursued it relentlessly.¬† He was adamant despite obstacles and¬† ¬† ¬† ¬† ¬† ¬† ¬† ¬† downfalls. He was fired by his purpose.¬† If you are a start up like him, the same¬† ¬† ¬† ¬† ¬† ¬† ¬† passion he had becomes a fuel to pursue your future and make it happen.

2. He knew his audience and delivered what they clamor for.  He knew people are               by  nature are curious and he gave them what they seek  for.  His show became             relevant  to his audience because they were answers to their natural curiosity.  If             you are a start up, it pays to know the customer and respond to their needs.

 

3. He tried his best to make a life not just a living.  He may not have realized it                    earlier, but certainly in the end, he knew its not just about making a living. In                   planning your start up, have your big picture to include a life that makes your heart         smile.

How about you, any more insights from the movie?

Plan a Life Not Just a Living

For as long as I can remember,  I know I have always wanted to be a doctor.

When I was in high school, I met  a family friend  who is an anesthesiologist. She is kind, warm, compassionate.  She attended to me when I had my first minor surgery before entering college.  She is  partly practicing and partly holding an administrative position. She was simple, pretty and elegant.

Mostly I was attracted to her demeanor. Warm, soft spoken but firm at the same time. She reassured me while going through the procedure. She seem to like what she is doing. She has a family  and spends a good amount of time with them.  I sensed a great mix of work and family life. I kept that in my mind through the years.

I want a life like that ,I told my young self.

I have kept that image  of  work life balance in my mind. Many years forward, I am a physician and had opportunities to do administrative and training work in my hospital.

Have I done it?  The balance?  I must admit not all the time.  But I found a good means to  find my way back  when it tips  off to one side.

I would like to teach you how.

Let me share  one story with you.   In one training session, I met Dr. A. She is a young fellow in her last year of training. We had an activity where they were asked to create images of their desired future.

How would life be 5 to 10 years from now?

How would each day of waking up look like?

Where am I ?

Who am I with?

What is my work place like?

How is my weekend?

Do I have a family? How are we?

Many questions. The answer to which had to be placed on a board with the most colorful and representative pictures we could find.

Then it was time to share. As she was called, I noticed she was teary eyed. The exercise was a revelation to her. Looking at her board, she saw that her ideal life was way off with the lifestyle of her chosen field. She wanted a predictable day time job that would allow her to do other things. No night calls. No emergencies.

She cried. I can sense regret and sadness.¬† She is on her last few days of training . Then I told her, “you know, your practice¬† can be as you define and design it”. She couldn’t get back the years she spent training for her field but she can practice in a way that could fit her desired ideal life.

I see her around these days. She is happy. Her practice is mostly ambulatory. She trained further in a subspecialty that makes it more of a day job. This field does not require night calls and is seldom an emergency.

Create your vision of life and work.  Keep it where you can see it. Make it a reminder to yourself each day you wake up.

.Why plan a practice when you can plan a life?

What’s your plan? Share yours.

Photo by Free Photos.cc from Pexels https://www.pexels.com/photo/coffee-creative-notebook-office-64769/

Seeing It Through Their Eyes

eyes of the patientIt’s a challenge to see things in the eyes of others.¬† As a child , its “me-my-mine.” Slowly it becomes “we” (as seen during parallel play¬† in children or maybe when there is a¬† significant other).¬† But seeing it in “yours” and completely give up mine , I must admit is not an easy thing to do.

To shape our practice in the “eyes” of our patients maybe one of the best thing we can do. I dare not say 100% but it sure is not impossible.¬† I invite you to walk the way of your patient and find out what they would like to see.

  • When you go to the clinic, how long do you like to wait? How do you want to make the waiting more pleasant? Is the waiting area comfortable enough for you?
  • Is the secretary approachable? Is her work area organized and uncluttered? Do you have a sense that your records are safe and intact?
  • Is the clinic clean and¬† uncluttered?
  • Is the doctor accommodating, unhurried and¬† fully understands your concerns?
  • How do you like the doctor to explain things to you?

Picture yourself as the patient and see the whole process  in his eyes. You might see something surprising to say, why did I not think of that?

How about you, whose eyes  do you use in shaping your practice?

 

photo credit: idea go/freedigitalphotos.net

 

 

 

 

What is Your Brand?

brandingA couple came into the clinic a few days ago. They are expecting their baby soon and would like to speak to me.  As they came in, I asked how  they came to know about my clinic.

Expectant Dad said, he told a friend that they are looking for a pediatrician for their first born. They would like to ask for some names. His friend asked “what kind of doctor would you like for your baby?”¬† Expectant Dad went on to enumerate what they want. So my name came up. “Go to Dr. E.”

This little conversation made me think. What can we do so that when potential patients ask their friends  for doctors they can go to, we can  easily be  top of mind? We need to develop our brand.

Brand?¬† Isn’t that for products only?¬† But we¬† are not selling products, you might say.¬† In our world, in the service profession, WE are the product.¬† Ha? I am the product?¬† Yup.¬† We are the product.¬† In the same way, real products try their very best to connect and evoke a relationship with their consumers–how are we doing so on our end? I looked for a few definitions of branding that we can easily understand. Here’s a few:

From the Marketing Spot:

‚ÄúA brand is a person‚Äôs gut feeling about a product, service, or company.‚ÄĚ
Marty Neumeier

‚ÄúA brand isn‚Äôt a brand to you until it develops an emotional connection with you.‚ÄĚ
Daryl Travis

‚Äú‚Ķbrands speak to the mind and heart‚ÄĚ
Alina Wheeler

 

Branding helps¬† build an identity that makes patients easily spot you.¬† It makes you standout. It makes it easy for others to think of you and refer to you. This identity is often emotional.¬† People make¬† a lot of choices based on their emotions. You only need to read forums and see how¬† people choose one product or service over another.¬† Most often it is because of the emotions evoked as they experience the product or service. “Mabait sya, hindi nagmamadali, hindi ako naiinip kasi hindi mahaba ang pila, on time sya, magalang yung secretary, okay lang magtanong…”

 

For  a very useful checklist on building your brand check out  here.

Can you now answer, What is Your Brand?

 

photo credits: freedigitalphotos.net/Suwit Ritjaroon

 

 

 

Managing the Wait

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One very rainy day, I went to the grocery. I had to stock up because Mr. Weatherman said its going to be a wet and stormy week and my pantry is empty. As soon as I stepped into the grocery, I realized I was not the only one thinking that way. So with EVERYBODY else!! It looked like panic buying! The next hurdle was getting to the counters to pay! The lines were long and slow ūüôĀ

Waiting is not fun. I admire establishments who are able to manage waiting lines. I have a few good experience waiting.

I stayed in a hotel for a convention. During such time, rooms are filled up with delegates. Breakfast time will find you lining up to get in. Long, long line. My stomach is already grumbling. Out came the manager carrying mini sandwiches and offering drinks to those in line! I couldn’t help but smile.

I accompanied my aunt for an eye check up in a busy eye center. This center is known for its good doctors and good service. I was expecting a long wait. I went directly to the receptionist who got her name and gave me a form I helped my aunt to fill up. I gave the form back and we sat in a waiting area. After a few minutes, another person approached us and asked my aunt a few questions then he excused himself and told us to wait and he will get back to my aunt. He came back and led us to another area where my aunt’s eye was briefly examined using a machine. Then back to a sitting area where we waited. Not too many minutes after, we were asked to move to another area and enter a consultation room. We waited for a while again. My aunt was seen by an eye doctor who discussed her condition and medications. Another person came to lead us to the next area where we were asked if we want the prescriptions filled or we would like to proceed to payment. We paid and off we went. I am sure there was a line. But we moved from one station to another with a manageable wait in between stations. There was always someone attending to us. There was something being done to my aunt in between waits. It felt like we were progressing. The waiting became manageable.

Paying bills can also involve long waits. Stores have made use of numbers for queiung. You get the number. Find out what number is currently being served either by asking or through the dashboard displayed. You still wait but knowing your order in the line eases the waiting because your mind has been prepared to accept it. You can choose to do other things or come back at an approximate time. For those who chooses to wait, a television plays a video or show to keep you entertained.

Fast food needs to be fast! With several persons ahead of me before i get to the counter to order, the store manager starts to take orders from people in the line and calls the order in advance to the kitchen staff. I still have to wait but knowing its getting prepared and all I had to do in the counter is pay made waiting okay.

We can learn from these experiences to manage waiting time of patients in our clinic.

1. Make waiting bearable. Offer something to ease the wait. Something to eat or drink. Something children can do like coloring books or book to browse for children and parents or toys children can play with.

2. Give patients a sense that their visit is progressing. For pediatricians, it can start with getting measurements.If you have a nurse or an associate, have them conduct preliminary interview before they enter the consultation room. If there is fever, paracetamol can be given. If the presenting problem is known, for example diarrhea or fever, materials to read can be given for parents to read. Just like my eye center experience, the wait seem shorter.

3. If patients need to wait because you will not make it to the clinic on time, inform them of the approximate time of arrival. Under promise, over deliver.

There will be ocassions when waiting is inevitable. Managing it makes it acceptable. How is your patient waiting?

photo credit: Vlado/freedigitalphotos.net

Numbers Game

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One day, I was talking to one of the medical representatives covering me in the clinic. I asked about their never ending quest to get the doctor’s signature as they visit. I was told they are required a certain number of visits per week . The signature is their evidence. The more visits, the higher the chance their product or service is remembered.

My brother in law who is in sales also talked about prospecting. The more people they are able to talk to, the greater chance they will make a sale.

My dad calls it the numbers game.

How can the numbers game work for start up doctors? I learned a lot from my consultants when i was starting. Here a few things they shared:

1. Stay in your clinic. My dad emphatically states it “stay put”. Man your clinic. Even if no patients come for a string of days. One day he will and if you are not there you lose the opportunity. There are many variations to this nugget of advise. Some choose to stay all day in most days of the week. Some choose to start with just one or two clinics. You must be there when opportunity knocks.

2. Work on your ideal set up but do something while you wait.I spoke with my newly graduate mentee today. She is eyeing a mall clinic near her home. However the clinic is still up for construction. It can still take months. I told her she might benefit from starting her clinic in a nearby site that she can occupy right away. The time it will take for the mall clinic to be set up and get running is more than enough time to start building a patient base in an area just nearby. Should she decide to let go of the clinic in favor of the mall clinic, patients are most likely to follow.

3. Associate work is okay but but set up shop at the same time. Many busy consultants engage new graduates as associates in the clinic to help them with patients. This is fine as long as you also set up your own clinic schedule. If you do, you also start having your own patient who will see you and come back to you. Associate work provides an income we all need but the patients you see are not your own.

Build the numbers. Spend time for it. Remember,you only need one to get started.

How about you, can you share what you have done to improve your numbers?

If you like this article, go ahead and share to friends who may benefit from it.

photo credit: justt2shutter/freedigitalphotos.net

To HMO or Not to HMO

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Health maintenance organization (HMO) is one of the ways our patients avail health care.

In most hospital settings particularly in bigger tertiary hospitals, HMO comprises a great percentage of patients. Sometimes the numbers may reach half or even more of those availing services.

Engagement in HMO as a health service provider is a personal decision you have to make. In some outpatient ambulatory set up, it becomes part of the arrangement. So, To HMO or not to HMO?

Lets take a look at the pros and cons.

PROS

1. Provides a steady stream of patients. This is helpful for start ups who are building their patient base.
2. It can be a source of referral. If the patients like you, they can tell friends and relatives, with HMO or not.
3. For pediatricians who offer other services other than consult like vaccination, patients are more likely to avail of your other services once you have engaged them in regular consults.

CONS
1. Fees maybe smaller than your regular consult or professional fee for in patients depending on where you practice.
2. Payments may take months. But if it is consistent, eg. every two months, then it becomes a cycle that evens out. If it becomes unpredictable,then the amount the HMO owes you becomes bigger through time.
3. You need to fill out forms for documentation. You will be required to submit these forms and provide summaries in order to be paid your fees.
4. You need to keep files and reconcile which services rendered has been paid or not.

But HMO or not, our patients deserve the same quality of care.

To HMO or not to HMO? What do you think? Please comment below if you can think of other pros and cons. If you find these information useful, please share or like us on facebook.

photo credit: naypong/freedigitalphotos.net