Business Education for Pathology Residents and Fellows Understanding the Business of Your Profession

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Business Education for Pathology Residents and
FellowsUnderstanding the Business of Your
Profession

• Presented by
• Suzanne B. Galloway, COO
• Pathology Service Associates, LLC
• Tricia Hughey, CEO
• UniPath, LLC

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Common Practice Opportunities for Pathologists

• Community-based group practices
• With or without independent laboratories
• Academic health science centers
• Government agencies
• Medical Examiner, Health Department,DOD, VA, etc.
• National/regional commercial laboratory companies

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National Characteristics

• 11,500 board-certified pathologists actively
  practicing in the US in 2003.
• (source ASCP data)
• 63 participate in group practices
• 20 employed by medical university
  centers/community hospitals
• 10 work in independent labs
• 7 in solo practices
• Anatomic pathology market remains highly
  fragmented with more than 77 of all pathologists
  practicing in groups with 10 or less
  pathologists.

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Employment Options for Pathologists

• Salaried employee or independent contractor
• Production incentives
• Partnership track
• Sole proprietor
• - the highest offer may NOT be the best
• Evaluate the total compensation package

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Benefits

• Pension and profit sharing plans vesting
  periods.
• Insurance coverages health, life, disability.
• Family coverages.
• Out-of-pocket expenses coverage limitations.
• Malpractice insurance evaluate state by state.
• Paid time off
• Vacation
• Continuing Education (CME) and other (MBA)
• Other (short term disability, family leave)
• Perks and other compensation
• Provision of auto, computer, mobile phone
• Professional dues and licensure fees
• Entitled funds - use or lose.

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Corporate Governance

• The Practice Politics
• How are decisions made?
• How valued is your input?
• Partner relationships
• Trust levels
• Maturity of associations
• Decision bottlenecks.

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Sample Organizational Chart
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Strategic Planning

• One, five and ten year Goals and Objectives
• Who are the participants in strategy design.
• Sources and uses of information
• LIS productivity and proficiency
• Billing statistics wealth of information
• Other metrics specific to your strategy
• Brainstorming emerging trends
• Invite diversity into the process
• Overlay need in your specific market
• Positioning your practice to stay viable
• Use data to identify positive contributors
  financial and other.

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In-House Expertise vs. Outsource

• Classic Make vs. Buy Decision
• Availability of expertise
• Cost of expertise
• Capacity of resources
• Short-term and long-term needs
• Risks and rewards
• What is your core competency?
• What is the cost of the administrative burden?

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Overview Pathology Practice Activities

• Billing and Collection Activities
• Financial Activities
• Marketing and Sales Activities
• Compliance Activities
• Human Resources Activities
• New Technology Assessment
• Management, Administrative and Clerical
  Activities
• Courier Services
• Transcription Services
• Legal Services
• Consultative Services

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Billing and Collection Activities

• Functions
• Charge Entry/Claims Filing
• Accession Tracking
• Payment Posting
• Follow-up
• Assess and Monitor
• HIPAA Compliance
• Coding Compliance and Effectiveness
• Electronic Connectivity Capability (New HIPAA
  Requirements)
• Timely Denial Follow-up
• Trend Analyses and Reporting
• Referral Sources
• Evaluating the Adequacy of Reimbursement
• Monitoring Payor Adherence to Contractual Terms
• Planning and Forecasting
• Technology Assessment
• Impact Analysis of Reimbursement Changes
• Referral Patterns

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Financial Activities

• Payables Management
• Payroll Services
• G/L and Cash Reconciliation
• Monthly, Quarterly, Annual Financial Reports
• Tax Return Preparation
• Other Business Reports
• Budgeting and Forecasting
• Financing and Banking Relationships

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Marketing and Sales Activities

• Marketing
• Practice Image and Look
• Website
• Brochures
• Giveaways
• Understanding the Marketplace
• Selling
• Targeting New Prospects
• Creating Value-Added Services
• Up-selling
• Closing the Business
• Servicing
• Maintain Presence
• Survey/Understand Client Satisfaction and Needs
• Address Concerns Timely
• Thank Clients for Business
• Be Patient Service Oriented

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Compliance Activities

• Compliance Officer
• HIPAA Security and Privacy Officer
• Compliance Plan/Manual
• Documenting Adherence to Compliance Plan
• Annual and new hire Compliance Training
• CLIA/CAP Certification and Accreditation

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Human Resource Management

• Hiring and Recruiting
• Managing your boss, peers and subordinates
• Employment Contracts
• Payroll
• Employee Benefit Plan Administration
• Training
• Performance Reviews
• Employee Handbook
• Locums Tenens

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New Technology Assessment

• Information Technology
• Electronic Order Entry and Resulting Products
• EMR
• Telepathology
• Laboratory Automation
• Rapid Tissue Processing
• Automated Screeners
• Changing Trends in Diagnostic Medicine
• Emerging Technology
• Esoteric Testing
• Molecular Pathology
• Flow Cytometry
• FISH

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Administrative and Clerical Activities

• Practice Management
• Operating Policies Procedures
• Physician and procedure scheduling
• Risk Management
• Hazardous waste management environmental
  concerns
• Specimen, slide, block and document retention and
  disposal

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Courier Activities

• Route Management
• Accountability/Liability
• The dreaded lost specimen
• Client Service and turn-around-time.

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Transcription Services

• System/Methods
• Hardware and software
• Dictation and transcription
• Turn around Time
• Accuracy
• Accessibility electronic sign-out
• Cost

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Legal Services

• Employment Law Matters
• Payor/Hospital Contracting
• Corporate Governance Issues
• Facility and Equipment Leasing
• Mergers Acquisitions Entering and Exiting
  Partners
• Often, engaging the right counsel can achieve
  both better results and more cost effective use
  of services.

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Consultative Services

• Marketing Assessment
• Practice Valuation
• Feasibility Studies
• Mergers Acquisition
• Joint Venture

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The Nagging Little Things That Can Spoil Your
Career

• Practice dynamics What to look for - What to
  avoid
• Frequency of on-call status work rotations
• Workload expectations
• Grossing and autopsies
• Availability of Pathologists Assistants
• Your role in hospital and lab operations
• CQI, QA, QC programs
• Committee memberships
• Clinical rotations
• Multiple worksites in one week? One day?
• The Dysfunctional Associate

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Value-Added Skills That Let You Win

• Communication skills
• Hospital advocacy
• Medical staff resource person
• Community relations
• Governmental relations
• Business acumen

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National Characteristics

• Between 2001 and 2003, the anatomic pathology
  market grew 5-10 annually.
• The United States anatomic pathology and
  cytopathology market totaled approximately 6.75
  billion in 2003.
• Anatomic 5.5 billion
• Cytology 1.25 billion
• (source G-2 data)

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Next Step

• Pathology is a necessary diagnostic service best
  provided at the point of patient care.
• We believe to ensure a viable intellectual group
  of pathologists for the future, todays academic
  and business leaders of pathology must work
  together to ensure tomorrows leaders are
  prepared for the challenges they will face.
• Louis D. Wright, Jr, M. D.
• Founder, PSA