Productivity

While practices often talk about clinical productivity, they seldom discuss clinical productivity gains measured over time. The question is, "Are we becoming more productive as practices and as an industry over time." Other industries expect continuous improvement in productivity. Shouldn't we?

Consider productivity gains in other industries - both manufacturing and service. If we go back to the end of World War II (mid 1940s) and track productivity gains through 2005 we find that US productivity increased an average of 2.2% annually for a 385% cumulative improvement! Going back to 1987 we find an improvement of 2.7% annually for an improvement of 50% over 15 years.

How has clinical practice productivity changed during that time? Well the simple answer is that we don't really know for sure. Neither practices nor national associations seem to track it. What doesn't get measured doesn't get managed.

During the past 12 years that I have been benchmarking practices (several hundred over that time) I have not found evidence that there has been any substantive improvement in productivity. In reflecting back 30+ years to my early days in clinical management I would have to say that there hasn't been any meaningful improvement in the industry during that entire time. Why is that?

Of course it is easy to blame increasing documentation burdens third party requirements and the like, but I think the real reasons are more of our own making. Simply stated, "We perform at a level that is acceptable to us" - a level to which we have become comfortable. In other words, "our practices are perfectly designed to get the results they get."

The opportunities for productivity improvement are many including: staffing, scheduling, delegation, supervision, and documentation just to name a few.

As reimbursement continues to erode, productivity becomes ever more important. How high is your productivity bar set. What are your expectations for productivity improvement over the next 5 years. What strategies will you employ to reach those goals. What will you need to do better? What will you need to do different? What will you need to stop doing?

Its time to redefine the productivity discussion. It time to begin talking about annual productivity gains. Its time to make it an urgent priority in every practice. Its time to move the productivity bar higher this year, next year, and every year thereafter! Improving productivity need not mean lowering quality. Aggressive performance challenges are the seeds to break through innovation. Its time to innovate! Our practices and our industry will not survive without it!

Bob Wiersma

Copyright 2007
Performance Builders