Doctors Who Made This One Switch Work Half the Hours and Make More Money

One function of medicine doctor is working 50 to 60 hours a week. Half of that time he’s charting prior off insurance compliance arguably has nothing to do with healing. Midnight runs unusual to not stay up to midnight. Family was suffering very close to leaving medicine entirely. And I’ve worked with dozens of doctors who are like that who really need to transition. When they switch, they typically reclaim 20 hours a week and they go from 50% plus admin to 80% plus direct patient care. Same training, same skills, a totally different life. So instead of theory, I’m going to walk you through a real before and after workflow transformation in a functional medicine practice. The intake process, the workflow, visit structure, time savings, revenue. Okay, so you have a 25-hour per week insurance tax on every EMR practice that does insurance. And most doctors think, I just need to increase my efficiency. Um, they can’t, and they’re not inefficient. That’s not the problem. The system is inefficient by design. Insurance companies create obstacles to paying you. That’s part of their job, and that’s going to take you time to address. And that insurance compliance work is a tax that you’re paying 20 or 30 hours a week. prior authorizations, billing code review, meaningful use, uh, defensive charting for reimbursement. Sure, that I can see that maybe a little bit. One of our doctors really tracked his time, 50 to 60 hours a week of total work, which is that’s a long week for me. And half of it was admin work and somewhere between 40 and 50% patient care. And he said, I used to chart to satisfy billing rules. Now I chart to improve outcomes because I’ve changed my software. And the real cost to him wasn’t that he was just wasting so much time and money, but that he was burned out. And he felt like I just I’m not any good at this. And ultimately, if you’re in an insurance environment, you suffer from the problem that you can’t do the things for the patients that you like because the insurance doesn’t cover it. And people call that moral injury. And I think that is what it is. and being shackled while you’re trying to work. Very difficult. I can’t work like this. I like to have my hands free. So, you’re going to ask how will I how will I get paid and how will that work and how can I do the proper insurance and there’s a lot. You got to consider a lot of stuff. Um, the insurance model is basically, you know, diagnose and bill. The cash model is a patient’s story to heal, right? I’m not diagnosing and billing. I’m actually getting the story and healing, right? Used to build a real short story to pay the bills, like maybe a little nolla, not not really a whole story. But now with the whole story, I have this gigantic option to treat this patient fully and really engage them in a not only a healing process, but then into a wellness program that really works. And when documentation serves the patient instead of the payer, then your visit with the patient becomes kind of like a friendly encounter. You’re not distancing yourself that from them saying like, “Well, your insurance allows this and I’m the the guardian of that relationship. When your patient relationship is really good, you can tend to be or you can afford to be way less defensive. Patients with doctor relationships that are good, they just tend not to sue. Not impossible. You got to good do good documentation, but they tend not to sue. Patient trust increases. They feel it. Patients know that. They know that you’re listening to them and listening to their story and not filtering it through what will the insurance allow on that. It’s a completely different thing, right? So the patients are going to say, “This guy’s got my best interest at heart. This gal has my absolute most important concerns at heart.” Much higher satisfaction, stronger relationships. So if you have the opportunity to to use this, you’ll see the bottleneck is not your visit time, it’s the way that you collect data. And we’re going to show you a totally new way to workflow. So the patient is going to complete an adaptive intake before the visit. Adaptive means that when it asks a question and that question has a positive answer, it’ll say, “Oh, well, let’s go on to the next one.” And if it says, “No, I don’t have that problem.” It’ll it won’t ask her any more questions. These are all based on validated questionnaires, questions that are adapted from that layered on top of each other. So, it covers every system. So those questions are followed up by a graphic that shows the GI system, hormones, mind and mood, immune function, muscularkeeletal history, risk factors. Um, and based on those validated questionnaires, you’ll get a probability score and it’ll tell you which is the likely problem that’s causing this patient’s symptoms or the ones that they’re aware of. also what are the ones that are hidden in the background that actually need to be addressed that you as a functional medicine practitioner needs to know. It’s an expert system. It gathers this data as a baseline. Then you go in after your maybe I don’t know 30 seconds to two minutes of reviewing that data go have a more indepth conversation. It’s called a a centaur system. A centaur has got a huge horse body and a little human head. Right? So the power of computing comes from the horse but the final decision is yours right. So the visit starts 80% of that whole diagnostic picture done by the expert system and because of that the amount of time that you spend with patients is dramatically reduced in terms of history taking which is just one tiny aspect of the benefit because because you have the story from the beginning everything else is connected to the story and the patient doesn’t have any disconnect with their experience. charting happens during the visit because you’re developing that story further. Part of the story is the visit. So based on this story, I see that you have a sleep problem. Based on this, I see that you have a headache. Yeah, the sleep problem is not the thing really the headache. Oh, I’m going to refine my decision-m. So you refine that a little bit and then you head more towards, well, what could be causing the headache? We have a great patient. This is a really good story. You’ll like this. Uh patients got a head injury. Young girl, she’s like in her 20s. um real bad head injury doing some sports stuff and um before this she was totally healthy and now she’s got this absolutely intractable headache. She’s had everything done um everything that you can imagine. So she did the Aspree questionnaire and um when she filled it out certainly she had structural problems, head and neck problems and um she had some problems emotionally of course because she never didn’t have a headache. So she was depressed and anxious and didn’t sleep and so those things were obvious. But you could have made that assumption based on just saying hi, right? What was not apparent was that her immune system was incompetent at handling fungal infection and that was known because she’d had a long history of antibiotics as a child that she had frequent rashes, sugar cravings, those things very clearly spelled out in uh questionnaers for fungus, right? [laughter] Huh. Interesting. So underlying her headache problem was this pre pre-existing problem with fungal infection. And once we treated that and treated her for fungal sinus, her headaches diminished to almost zero. We did other things as well. We did structural treatment. We had our uh mental health team work with her a little bit on managing her anxiety. Boom. And you have the answer. And it all fit together. And the thing is the time that was spent getting there was seconds. So instead of having a visit with a failure, another visit with a failure, another visit with a failure. Oh, we’re getting there from the first visit, right? And I knew from the very first time what we needed to discuss. So we could discuss, we’re going to put you on a couple supplements that will help your bowel move a little better so you don’t have a fungal problem there. We’re going to give you something to a botanical compound to help you reduce the immune impact of the fungus. We’re going to do these things. And the patient says, “Oh, that’s part of my story now.” And that’s integrated into the story. That’s prescribing. Put her on some medication to handle some of the headache problem in the story. All of this builds the story and it’s all coming together. It’s a big flow. It’s like a snow melt. Her her first story is melting down into the stream and things are being added as it as little trickles of the stream, little tributaries until you have a real nice flow, a workflow that really works. Right? Then your follow-up scheduling is really easy because you’re just continuing the story, right? You have really that that idea of we do shared decision-m that is really not true in most practices. The doctor tells the patient and the patient says okay and that’s called shared decision-m in our practice and with the spree we have your story. Is that story true? Yes, it is. Can we build on the story? Sure. Build on the story. Increase that connection. Then we’re creating shared decision-m. This would be a good idea. I think what do you think? Okay, good. And you have real shared decision-m because you’ve done that. No one’s calling you and saying, “What was that again?” They have a story. Not only that, they have an open note in the portal. They can look at the whole thing. They can look at everything. And because you’ve documented everything in the visit because it’s a story. Because it’s a story. It’s awesome. You don’t have any after hours documentation. It’s already been done because you’re you’re authoring this patient’s visit history. You’re authoring this patient’s health journey. You and the patient. She’s your coowriter, right? Her headaches are better. Bonus. and my life is good. Less questions at the end, higher confidence in the plan, stronger engagement, and the time you reclaim is just unbelievable. And you have you can do with it whatever you like. You can make more money, you can have more time off. Um you can spend more time with your patients. If you’re not spend enough time, you need to spend time with your patients. Um, we have one doctor, um, we’re in Texas, he’s down south and, uh, he’s an older doc and he was ready to retire and we were working together on a a problem case and, uh, we told him about the software and he started using it. Um, and he was going to retire that year and he’s been in practice now four or five years using the software and he’s no end in sight because he’s not doing any of the stuff he hated before. He’s not he’s not burned out using the system. uh he he kind of wondered because he was doing a lot of insurance stuff if he would be able to survive. It’s as if he never quit insurance. He did great and he immediately was happier and was working half the amount of time and making more money. So here’s the deal with this. You can’t optimize your way out of a broken structure. If your story doesn’t if your system doesn’t capture a story, if story isn’t the center, you’re never going to have the ability to integrate the patient’s story into your care and really get the best care. So, you got to change the infrastructure. And there are measurables that you could do. You could have your business person look at it and say, um, what is this going to cost us to get out of the insurance business or what is it going to cost us to change to this different EHR? Um, and you’ll find that for everybody, with very few exceptions, getting out of the insurance business is a more profitable move and it’s measurable, especially because the time that you spend on insurance is immense and completely unfulfilling. So, don’t measure your revenue per visit so much as um your re revenue per hour of patient care because you’re able to see a lot more patients and do a much better job for each one and your outcomes are better because you’re able to understand their story in a dramatically reduced amount of time, right? You have much less administrative burden and your ability to sustain this practice over time. Ask our 70 plus year old guy now in South Texas who was unquitten. Um he’s he’s great and like I said, no end in sight. So retiring nine years early, like is the trend. We’d like to reverse that and we’d like to start with you. Let’s let’s have you have a a long happy practice. Why don’t you give a spree a try? The trial’s free. You get 30 days. You can put patients through it and enjoy learning about their stories and see how that would help you. Um, and it’s easy to do and you can actually do the real thing with real patience. So, um, I invite you to give it a try.