Why Don't The Core IMP Concepts Work When Applied To The igh Volume Based Model?

[Guest guest]

In IMP the main overhead reductions are staff and rent. Staff is

reduced by harnessing IT, having a low overhead payor mix, and keeping

patient volume at the right amount.

The consequent reduction in overhead readjusts the volume formula so

that less patients need to be seen to create the same revenue which in

turn allows for more time to be spent with each patient.

Hopefully my understandings are correct.

What I don't understand is why the IMP concepts don't work when

applied to my current model? Actually, as I write this, and debate

whether or not do hit the cancel button, it occurs to me that they are

working. I use most of the IMP overhead reduction concepts with

seemingly good results. My P4P reports show that I am doing an

excellent job on diabetes, htn, mammo and we always score high on

patient satisfaction. On the occasion when I have used how's your

health we have had good results from patients.

I think this all amounts to the fact that my patients are happy and

appear to be well cared for. It seems that it's me who is somewhat

unhappy a.k.a burnt out.

So I am going to hit the send button because I think the core IMP

overhead reduction concepts do work in a high volume based practice

quite well...it's just that the volume based practice is not healthy

for the providers. That's irony.

[Guest guest]

Dr Kkeinman, Remember to take some time for yourself. All experience in life are stressful. It is how we respond to that stress that impact our lives. Find something that refreshes you and make time for it. It will help you make the best of your current situation or help you choose to change that situation. Sincerely, Been there and done that, Egly, M.D.drquit wrote: In IMP the

main overhead reductions are staff and rent. Staff isreduced by harnessing IT, having a low overhead payor mix, and keepingpatient volume at the right amount. The consequent reduction in overhead readjusts the volume formula sothat less patients need to be seen to create the same revenue which inturn allows for more time to be spent with each patient.Hopefully my understandings are correct.What I don't understand is why the IMP concepts don't work whenapplied to my current model? Actually, as I write this, and debatewhether or not do hit the cancel button, it occurs to me that they areworking. I use most of the IMP overhead reduction concepts withseemingly good results. My P4P reports show that I am doing anexcellent job on diabetes, htn, mammo and we always score high onpatient satisfaction. On the occasion when I have used how's yourhealth we have had good results from patients.I think this all

amounts to the fact that my patients are happy andappear to be well cared for. It seems that it's me who is somewhatunhappy a.k.a burnt out. So I am going to hit the send button because I think the core IMPoverhead reduction concepts do work in a high volume based practicequite well...it's just that the volume based practice is not healthyfor the providers. That's irony. __________________________________________________

[Guest guest]

Could you let us know a little more about your practice?It sounds really well thought out.What are the panel sizes, how many visits per day/week?It sounds as though same day access is already in place?And what percentage do you think your overhead is?What are your workdays like? Are you getting home when you want to?Years ago, writing an article on burnout, I asked doctors how many visits/day was enough for them. Most replied 12-15. All worked in regular clinics and that would have been a half day for them.  I think that in terms of really connecting with patients and working through the complex issues presented to us daily, we do have limited capacity. In IMP the main overhead reductions are staff and rent. Staff isreduced by harnessing IT, having a low overhead payor mix, and keepingpatient volume at the right amount. The consequent reduction in overhead readjusts the volume formula sothat less patients need to be seen to create the same revenue which inturn allows for more time to be spent with each patient.Hopefully my understandings are correct.What I don't understand is why the IMP concepts don't work whenapplied to my current model? Actually, as I write this, and debatewhether or not do hit the cancel button, it occurs to me that they areworking. I use most of the IMP overhead reduction concepts withseemingly good results. My P4P reports show that I am doing anexcellent job on diabetes, htn, mammo and we always score high onpatient satisfaction. On the occasion when I have used how's yourhealth we have had good results from patients.I think this all amounts to the fact that my patients are happy andappear to be well cared for. It seems that it's me who is somewhatunhappy a.k.a burnt out. So I am going to hit the send button because I think the core IMPoverhead reduction concepts do work in a high volume based practicequite well...it's just that the volume based practice is not healthyfor the providers. That's irony.

[Guest guest]

The illustration I use is that of a stack of boxes. In order to make the most out of what you have, you fill the box you have to the very top without overflowing into the next box on top. As soon as you overflow into the next box, an equal return on investment will not be seen again until the new box is filled to the top without overflowing into the third box. The goal is to keep your box full without overflowing into the next level. I agree that the IMP model works at all levels, the decision is how many boxes one wants to be responsible for keeping filled.

Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

[Guest guest]

nice Lynette! excellent way to teach to resdients!! I loveit

The illustration I use is that of a stack of boxes. In order to make the most out of what you have, you fill the box you have to the very top without overflowing into the next box on top. As soon as you overflow into the next box, an equal return on investment will not be seen again until the new box is filled to the top without overflowing into the third box. The goal is to keep your box full without overflowing into the next level. I agree that the IMP model works at all levels, the decision is how many boxes one wants to be responsible for keeping filled.

Lynette I Iles MD 301 South Iowa Ste 2Washington IA 52353 Flexible Family Care'Modern medicine the old-fashioned way' This e-mail and attachments may contain information which is confidential and is only for the named addressee. If you have received this email in error, please notify the sender immediately and delete it from your computer.

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