Freedom from Discipline
RISK MANAGEMENT
Ray Foxworth
Freedom: The state of being free or at liberty from external control; the power to act without constraint.
Discipline: A set or system of rules or regulations; training to act in accordance with rules.
Doesn’t freedom from discipline sound great? You may think, “Finally, I’m free to do what I want, when I want! No worry about rules, regulations, and routine!”
At some point in your personal life, you’ve probably thought, “I would love to be free to do what I want to do, when I want to do it, and not have to follow all the rules.” That feeling has most likely crossed over into your professional life as well. We want be free to do what we want to do, which is to help patients, grow our practices, and secure our futures, but without all of the worry about rules, regulations, HIPAA, PQRS, and ICD-10. Ironically, when you think about freedom and discipline, they may seem at first to be polar opposites, but the reality is that one is dependent upon the other.
For us to truly experience freedom in our personal or professional lives, we must have discipline and develop more of it, not be free of discipline. I would argue that the more disciplined we aie in our lives, the more freedom we will truly achieve in all areas of our lives. Let me explain what I mean.
How does discipline lead to more freedom in life? Here are a few examples:
• You will experience freedom from most health problems if you aie disciplined enough to eat right, exercise regularly, and lead a balanced life.
• You will experience freedom from most financial stress if you ai e disciplined enough to pay yourself the first 10% of everything you earn. If you start following that discipline early and stick with it for the rest of your life while allowing the magic of compound interest to work in your favor, you can truly change the financial trajectory of your life and your family’s life.
• If you are a professional athlete, you can experience freedom from most injuries, excel in your career, and be financially free if you are committed to a regular training routine. You will increase your likelihood of success if you are disciplined enough to have a coach who works on your “basics,” even if you are one of the best in the world at your sport.
It really becomes quite clear. When we want to experience freedom or improvement in a particular area of our lives or practices, discipline is the key ingredient, if not the required ingredient. Let’s look at this specifically in our professional lives.
Some doctors may want the freedom to set their clinic hours and do what they prefer instead of what patients prefer. Perhaps they want to work only by appointment and limit time in the office to when patients aie scheduled. Does that work? Maybe. However, doctors who aie more disciplined, who set their hours and stay in the practice for those who might drop in during “régulai' business hours,” will most likely experience more financial freedom because they are available and committed to seeing patients when the patients find it convenient.
Some may not like the discipline of having a “script to follow” for the front desk when answering the phone or going over financial arrangements, not to mention a disciplined, scripted report of findings for the doctor to follow with patients. If you want the freedom to “wing it,” it comes at a cost. Those who aie disciplined enough to insist that incoming calls ai e handled with a script will most likely find that their staff schedules more new patients and loses fewer “shopper calls,” and that those who aie scheduled actually show up. Why? Because a well-trained and scripted staff comes across as more professional, more competent, and more confident, all of which ultimately can bring more financial freedom to the practice.
The same holds true for us, the doctors. I’ll never forget when I brought in a new associate doctor for the first time. I thought it would be a good idea for me to provide him with a script of what I said during a report of findings, so I recorded a few of them. When I listened to them, I wanted to crawl under the table. What I thought I was saying and communicating was far from
For us to truly experience freedom in our personal or professional lives, we must have discipline and develop more of it, not be free of discipline. J J
clear, concise, or convincing for the patient. It actually made me wonder how in the world I was able to get or keep anyone under care. It also revealed why so many patients were dropping out after about four to six weeks of care. In my “unscripted” report of findings, I was clearly indicating we would h eat for four to six weeks and reevaluate. I was not clear that it did not mean the end of care! I should have told patients that treatment may take 10 to 12 weeks, or whatever amount of time required to make physiological changes or improvement based on their history, age, and any complicating factors, and then I would reexamine in four to six weeks to make sure we were on track. That is a distinctly different message. As a result, I actually wrote our “script” and then revised, improved, and modified it. Then I made it a “requirement” for me and any docs who came onboard during the following years. The result? Being disciplined in how we communicate from the initial phone call to the report of findings and to the transition to wellness or preventative care has resulted in a more stable and profitable practice, which leads to more financial freedom.
If you want freedom from employee problems, you’ll find that the discipline of spending time training, retraining, monitoring, and holding regular staff meetings will work wonders. It is so easy to bring on new staff members, play “follow the leader,” and let the existing staff train them. I’ve even been guilty of having a new staff member train under someone who was leaving the practice. The result? If you aren’t training, inspecting work, and monitoring your existing staff, you could be making a copy of a bad copy. You’ll lessen the likelihood of this happening if new staff members aie trained according to “standard operating procedure,” rather than by the tribal method of “just do what she does!”
If you want freedom from the worry of complaints, audits, fines, and penalties from improper financial policies or improper coding or billing, you must have the discipline to leam about the layers of regulations you face when developing your policies and procedures. You must know the mies from your boards of examiners, and then look through the requirements of your provider agreements with PPOs or HMOs. The next step is to find out if your state departments of insurance or attorney generals have any particular laws about how you bill, and especially about the offering of free services or “prepay” plans. Some states have mies for time-of-service discounts and some prohibit charging more to insurance patients than you do to cash patients. The “fun” or discipline doesn’t stop there. You must also leam about the requirements of Medicare and the Office of Inspector General (OIG) to make sure you aie billing, coding, and documenting correctly. You must make sure you aren’t billing for care that
isn’t considered “medically necessary.” You must make sure you aie not creating “inducements” by offering free services or not charging fair market value. You also need to avoid antikickback and False Claims Act violations by making sure you collect deductibles and copayments.
It’s simply a matter of doing the right things, the right way, every time and every day. Being disciplined to do something as simple as reviewing your day-sheets at the end of each day will help make sure you didn’t make inadvertent errors. If you did, you’ll be able to document the error and take collective action to make sure it doesn’t happen in the future. It’s the discipline and practice of ongoing improvement in all areas of your practice.
Is there such a thing as freedom from discipline? Absolutely. The amount of freedom we achieve in most any area of our lives, including our practices, will be in direct proportion to the amount of discipline we have in that area of our lives. It’s not complicated, but it’s just not always easy to do. However, if we do practice such discipline, the reward of “freedom” from worry is priceless.
Dr. Foxworth is a certified Medical Compliance Specialist and President of ChiroHealthUSA. You can contact Dr. Foxworth at 1-888-719-9990, [email protected] or visit the ChiroHeal-
thUSA website atwww.chirohealthusa.com
