"Physician, heal thyself" might not be such great advice when it comes to addressing the ailments of medical practices, it seems.
Eric Gibson, Principal/CFO of ClearlyMD, LLC, a Memphis practice management company, points out that medical professionals are often so deeply (and understandably) immersed in their mission of patient care that business management may be frequently overlooked or neglected.
"We want doctors to practice medicine and see patients and provide quality care, and someone has to make sure that the back office and the financials are being done properly," he said. "You'd be surprised how often financials are an afterthought."
This is where ClearlyMD steps in to help practices fill in the gaps with billing, accounting, financial services and more, effectively becoming partners who share a strong interest in their mutual success.
The rapidly evolving nature of the medical arena presents a challenge even to those whose business it is to keep abreast of changes, Gibson points out. "When I first started, technology was a little bit of an afterthought," he said. "We didn't have a lot of servers; we barely had email. Remote access was slow. Things have changed a lot.
"The business itself has always been challenging from a standpoint of the money, billing, dealing with the insurance companies, trying to get paid, the rules ... but over the past 10 years, healthcare has gotten so much more complicated and complex with meaningful use, more compliance requirements, HIPAA, electronic medical records. ... If you take a practice that didn't have the basics already going well, then you add these further complications, it's a quick disaster if you're not careful."
A dual major in accounting and psychology from Union University gives Gibson a unique combination of strengths that provides an advantage in dealing with the two most frequently cited client complaints: billing and staffing issues.
His first job was in Nashville with the national accounting firm of Arthur Andersen. The work honed Gibson's natural tendency to focus on details -- and question everything. Another position, in which he served as controller and internal auditor with West Tennessee Healthcare in Jackson, gave him exposure to a healthcare climate that led to an interest in the physician practice side.
He started in 1999 as controller and CFO with Uniphy Healthcare, where he met and worked with his current partner, Robert Burns. Together, they established ClearlyMD, LLC, in 2013.
To go in and fix years of client mistakes, where things had not been done the right way, can be challenging and costly, he said. "So my advice is to get the right people doing the right job from day one. It's worth the money to pay a professional to do an assessment every couple of years -- like we pay a doctor for an annual physical exam -- to make sure things are happening as they should -- and there's a heartbeat."
Even though it may not always be profitable, Gibson allocates about 20 percent of his time to troubleshooting for practices that need urgent care to stop the bleeding, and even assisting dying practices with palliative care to help them transition with dignity. If he can't help, ClearlyMD will at least provide enough advice, consultation or references to help practices address the problems they face.
"But I definitely prefer helping successful practices stay successful," he added.
As doctors and their businesses age, he explained, they must have a long-term strategy to survive the next generation. "If you're not bringing in new doctors or finding ways to create a 10-year future, then it's just a matter of time," he said.
A common failing he sees in practices is a lack of attention to details, especially the billing and accounting for the money, exemplified by something as simple as the doctor taking cash for lunch one day. "It's his money, he can do that, but he still needs to account for it, otherwise there's no balancing out how much revenue he really generated: 'You're saying that you had money, but if it's not in the bank, where is it?'"
This attention to detail is what Gibson identifies as his strong suit. "I'm naturally a confrontational person who tries to verify; I have a healthy skepticism when it comes to the truth. If it's true, you should be able to prove it and not take things at face value. I keep asking questions; I keep digging. I have to verify things."
Confrontation, as Gibson describes it, can be a good thing. "Especially in a complex business, you've got to ask great questions, which means you have to confront the answers."
Where others may not have the time to invest in critical thinking of this type, or the natural ability to size up root cause analysis, Gibson does, and he knows how to use it to their advantage.
So rather than expecting physicians to heal themselves and their practice management ills, such healing might best be undertaken with the guidance of professionals such as the ClearlyMD team -- and, Gibson suggests, through supportive collegial relationships like those fostered within the Mid-South Medical Group Management Association (MGMA), where he is reportedly on track to become the 2020 president.
"It's probably more important now than ever," he said, "to be plugged in. Being engaged with the local MGMA, with peers that are fighting the same fight, dealing with the same issues and challenges, and working together to find best practices and solutions for those problems, is critical to long-term success for both the small practice and individual doctors within large practices."
Gibson takes pride in the strong relationships his business has built and maintained with doctors for the past 20-plus years -- and in his six children. "Having children has been a blessing," he said. "I'm still learning how to be a good father."
His leisure pursuits range from reading to playing piano and writing music; and since the arrival of a new son, he has given up motorcycles to enjoy golf.
RELATED LINKS:
Mid-South Medical Group Management Association