What Doctors Need to Know: From MGMA CEO

Leslie Kane, MA: Hi, I'm Leslie Kane, Executive Editor of Medscape Business of Medicine. I am here at the Medical Group Management Association (MGMA) annual conference in San Antonio, and I am speaking with Dr. Susan Turney, who is the President of the MGMA and a physician. Dr. Turney has a lot of knowledge and some pretty strong ideas about what physicians need to do to remain profitable and successful in the coming years. Dr. Turney, thanks so much for being with us today.

Susan Turney, MD: Thank you, Leslie.

Ms. Kane: Given everything that is happening in healthcare, do you feel that any practice can remain independent and profitable, or do you think there are some practices that just don't have a prayer?

Dr. Turney: The world of practice management is extremely complex. We have, in our membership, 13,600 groups that represent small, large, single-specialty, and multispecialty practices. When we look at what practices need to do, not just to survive, but to thrive in the future, much of what they need is the same. They need to have data to understand the business side of medicine. They need to have the information to tell them how they are performing, in terms of both physician performance and patient satisfaction.

We need to make sure that providers wed the data to get the best value. We think that the models of healthcare are going to be represented by myriad different types. We know that the government has some programs out there right now to test and pilot test different ways of delivering care and getting reimbursed for services. Much is going to depend on what a practice looks like, where the practice is located, and how they can work with their partners in their communities to best solve the population's needs.

Ms. Kane: Are certain problems or practice situations more readily corrected than others?

Dr. Turney: Every practice has issues. It's situational; it depends on the size, the type, and the location of the practice. With our member engagement, we try to provide the information that they need to best run their practice. A big part of the role, certainly of the practice administrator, is managing the events that occur in the clinical environment from the time the patient makes an appointment to the time of zero balance.

The practice manager has responsibility for everything in between, other than actually seeing the patient. So, our work involves trying to figure out what we can do to help the practice managers to set priorities and get the work done in the most efficient and effective way possible. They are really the champions of the practice. They are the ones who are there to support the physicians, and ultimately the patients, who we want to have the best outcome.

Ms. Kane: In terms of making a struggling practice more successful, what are the biggest internal challenges as opposed to the external forces?

Dr. Turney: The inside and outside challenges are really the same. If a practice is dealing with a lot of uncertainty, that uncertainty creates a lot of issues for practices when trying to decide whether they have enough people to support the practice. Can they hire another physician? Are they best serving the needs of their patients? Do they have the technology that can support the data that they need to best run the practice? Healthy practices means healthy patients, so we want to be there to help them, but it really depends on the way that we provide the care and the way that we are being paid for the care. Uncertainty, particularly related to Medicare payments, keeps practice managers up at night.

Ms. Kane: There has been a lot of advice to add technology to a practice, with email, patient portals, videos, and home monitoring. But it has been said that these take a lot of time and don't necessarily bring in revenue. What is your take on this?

Dr. Turney: Technology is extremely important, and our practices want to not just implement but also optimize the use of technology, because it can help in so many ways. It can be used to streamline the process of care, allowing better access for patients, whether it is through some electronic communication or the ability to schedule appointments online to see the physician or other provider.

It can also be used to report results and to allow patients to check their children's immunizations -- whether they have received them and when their next immunization might be due. Technology is a tool that, when it works, it works really well. The struggle is getting it into the practice and having it work in a way that will best optimize not just the business side of medicine, but also the clinical side of medicine.

Ms. Kane: As revenues decline, many practices are looking to add ancillary services. What guidelines would you give practices when they are deciding whether to add ancillaries?

Dr. Turney: Practices are always looking at opportunities to best serve their patients, and it's very situational. If you are in a larger area and you have access to a lot of the technology, laboratory, and specialty physicians who can support your practice, you are in a very different environment than if you are a small family medicine group in a rural community. The best advice that I have is decide who you are, and what you need to be doing for the patients that you serve.

Ms. Kane: Since you have become President of the MGMA, you have been very positive about the future of medical practice. What words would you like to leave the physicians?

Dr. Turney: I am very excited about medical practice. Being a physician, I am always putting the patient up front and center. We know that our practice managers are the champions for the practice. If we can make our practices healthy, we know at the end of the day the outcome is going to be healthier patients. That's what gets me up every day.

Ms. Kane: That sounds very good and very optimistic. Thank you so much for taking the time to speak with us.

Dr. Turney: Thank you very much.

Ms. Kane: We are here with Dr. Susan Turney, who is the head of the MGMA. I am Leslie Kane from Medscape, and thank you for joining us.