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Taking Time Off

When you spend all of your time looking after the health of others, it can sometimes be difficult to take time to look after yourself. There always seems to be one more patient to help, one more report to write, one more bit of paperwork to file before you can step out of the office and into home life.

In this, health professionals are not alone. A recent report by Simply Business revealed that 20% of the UK’s small business owners say they can’t afford to take a single day off work this summer whilst a further 30% plan to holiday near home to keep an eye on their business.

In fact, this problem of work-life balance is seen in many countries. A recent report by German researchers revealed that working outside of core hours on tasks such as checking emails can limit the ability to feel detached from work, leading to higher levels of the stress hormone allied to a feeling of increased tiredness.

Whether working as a sole trader or in a small business it can sometimes be hard to see where you can turn to reduce the workload. The last thing you want to do is to reduce your client base as that will reduce income so instead it is tempting to save up all those administrative tasks for the evenings and weekends. Of course, there is the option of taking on a part-time member of staff to help with the workload, but this can be a tricky balancing act.

Obviously, if you have a regular volume of extra administrative tasks to complete then a new member of staff may well be the answer. However, when the workload is irregular then you may not be able to justify adding to your team on a permanent basis and temporary members of staff will always be around to answer the telephone when it is ringing and you are with a patient.

But there is another way. Virtual assistant services can help to reduce the workload by taking on tasks such as telephone answering, appointment booking and records and diary management. Better still, by using a virtual assistant service you gain the flexibility which you require. For example, you can switch telephones over to the virtual service when you are with clients or on holiday, switching them back when you are free to answer calls.

Tasks such as phone answering and appointment booking can easily intrude on daily business life and create a pressure point which can add to stress levels. Not having to answer the telephone when you are treating patients or meeting with clients, being able to access client notes online rather than spending time in preparing for meetings, even having someone to screen out unwanted sales calls can all make a difference to the working day and to peace of mind.

Of course, at the end of the day virtual assistant services can only go so far in helping to improve the work-life balance. The bottom line is that as a business owner you owe it to yourself, to your family and to your clients to take the time off that you need to refresh the mental and physical batteries. If you don’t, your work will suffer and that helps no-one.

Exercising Choice for a Fitter Health Practice

It’s January and that means only one thing; a host of fitness and diet related stories have hit the headlines. In a bid to either persuade us to keep those New Year resolutions, or to even make some belated ones, news media are leaping on any health related story they can find and putting it out there for our consideration.

Are we swayed by the headlines? Well perhaps some of us will use the research conclusions to kick start an improved lifestyle, but for others the exhortation to improve diet or fitness levels will merely be of passing interest and will have no effect on ingrained lifestyle patterns.

Actually when you stop to analyse some of these stories, the advice given generally only amounts to common sense. The study which concludes that a brisk daily walk, even if just 20 minutes, can add years to life expectancy is hardly surprising; although it was interesting to see that the research concluded that twice as many deaths a year are attributable to inactivity than to obesity. Similarly, a report which concluded that working as part of a team, either with a partner or with others, can help people to stick to lifestyle changes makes sense when you consider that a self-supporting team is less isolated than an individual.

But if some of the conclusions are simple common sense and may well lead to lifestyle changes, others may have varying measures of success. A report which suggests a correlation between wearing high heels and the chance of developing osteoarthritis may be unlikely to sway the majority of those who enjoy wearing shoes with high heels. On the other hand, a report which suggests that moderate alcohol consumption is linked to reduced heart failure risk may well be seized on by those who enjoy the odd drink but were feeling guilty about its affects on health.

In essence this is the beauty of having free will, and not just on health related issues. We can look at all of the advice and choose that which seems best to us. That’s why some businesses interrupt client conversations to answer the phone whilst others have set up a system which diverts phone calls to a virtual assistant. That’s why some businesses still file records by hand whilst others have embraced digital filing methods. And that’s why some health practices offer online booking and card pre-payment methods whilst others stick to phone bookings and collect the payment later.

Whatever the business, whether you offer one-to-one health consultations or regular pre-booked fitness classes, the key to success is to know your customer and offer a business model which will best meet their needs. Special offers and discounts are all very well in attracting new custom, but people won’t stay unless you offer them a level of service which encourages them to return time and time again and to recommend you to friends. So going back to one of our earlier examples, if your clients tend to have busy lives then online booking is a quick and simple way for them to make an appointment. On the other hand, if your client base is more elderly then they may feel more comfortable making telephone bookings.

No matter how seemingly strong the research, whatever the ‘experts’ tell us, at the end of the day all research and all ‘best practice’ advice is there to act as a guide.  What we do with it, how we turn advice into great customer service and a strong and fit health practice is up to us.

Everything in moderation

Saturated fats, salt, alcohol, exercise, diet; the list of potential causes and prevention methods for cancer, heart problems and other life-threatening conditions changes on a daily basis. For every report which boldly proclaims that x is bad for you, another is sure to follow with a counter argument.

Even the idea of healthy exercise is under threat as a recent report reveals that working out at the gym may not help us to lose weight. With all of this contradictory advice it’s hardly surprising that some choose to ignore it completely whilst others present themselves at the osteopath or chiropractor with injuries from having jumped from one fad into another.

Calmer minds accept that the solution is to adopt the mantra ‘everything in moderation.’ Ignoring the fads and balancing a healthy diet with moderate exercise is arguably the best advice which anyone can have. Similarly, when it comes to a busy lifestyle, rather than flying from one extreme solution to another, the best advice is to take a good look at the schedule and find ways to reduce the overall workload.

When we encounter overload in our daily lives it is tempting to cut out some elements entirely. For example, a busy physiotherapy practice may take the decision to stop taking on new patients. Of course the danger in this is that we lurch from one crisis to another, cresting more problems with every ‘solution’ until we fall into some kind of stasis: just about managing but unable to grow or enjoy our work.

But one of the benefits of the internet age is that there are other options available which can take the strain without needing to resort to drastic measures.  Services such as diary management, phone answering and even electronic filing of patient records can all be handled by a virtual assistant service. And with today’s telephony systems enabling callers to be pre-announced, a virtual assistant service can answer calls in the name of the health practice even if they are looking after a number of practices at the same time.

Add in an on-line booking service allied to secure card processing and at a stroke the day to day administration workload of a busy health practice can be switched from overload to manageable. Not only that, by taking card details at the time of booking, clients are far more likely to attend appointments; helping to maximise treatment times and ensuring that the physiotherapist or other health practitioner is spending their time productively rather than chasing no-shows.

With administration time cut, the health practitioner is freer to concentrate on what they do best; helping those who are in need of some form of therapeutic intervention. Best of all, the virtual assistant service is flexible and can be switched on and off as required. So if ‘pinch points’ only occur at certain times of the day, week or month, the virtual assistant can step in then, leaving practices free to self-manage at other times.

Everything in moderation? With a virtual receptionist service on standby, health practices can smooth out some of life’s pressure points and that can only be good for the health practitioners and for their patients.

Tackling Late Payments

The economy may be improving but late payment of invoices is still a problem for small business.  So say the Forum of Private Business (FPB) whose latest survey revealed some worrying statistics in respect of late payers.

According to the survey 23% of respondents say that they have seen an increase in the number of late payments whilst 29% report that the number of days payments have been delayed beyond the deadline have also increased.  In the light of this, respondents have called for better publicity in respect of late payment issues as well as a range of sanctions for late payers to include barring persistent offenders from government contracts.

Responding to the survey’s findings, FPB Chief Executive, Phil Orford MBE said “upwards of £30 billion remains tied up in late payments, costing a typical small business 130 hours a year to chase and meaning that a third are forced to seek external finance to cover the gaps in cash.”  Tackling late payments is a challenge which potentially affects every business and even those within the health sector are not immune.  In fact, businesses such as physiotherapy and osteopathy which rely on patients paying for treatments not only have to cope with potential late payers but also with a loss of income from those who fail to turn up for appointments.

Alongside diary management and appointment reminder solutions which aim to cut down on missed appointments, health practices may also wish to turn to secure card processing as a means of ensuring swift payment for treatments.  With booked appointments backed up by a pre-authorised card payment the health practitioner knows that they will receive prompt payment following the appointment.  And if the patient fails to turn up, a card payment can still be taken in accordance with the practice’s cancellation policy.

Pre-authorising a card at the time of booking doesn’t commit the patient to using that card following their appointment.  If they choose to pay by cheque or cash or to use another card then the pre-authorised amount can simply be cancelled.  This means the patient retains payment flexibility whilst at the same time the practice receives prompt payment; helping to smooth over cash flow issues.  The simple fact that a payment has been pre-authorised also helps to act as a spur to patients to keep their appointments, helping to reduce the number of gaps in a practice diary and ensuring that those who need treatment receive it promptly.

A ‘Wellcome’ cure

The Wellcome Library has opened up its archives of historical memorabilia for general use.  According to the library the collection encompasses ‘manuscripts, paintings, etchings, early photography and advertisements’ and amounts to some 100,000 images.

Releasing the images under the Creative Commons Attribution Licence means that they can be used free of charge by anyone for personal or commercial purposes, provided that the image is accompanied by an acknowledgement as to source.  So whether you are treating your patients for gout or for sprained limbs, for persistent pain or for an aching tooth there may well be a suitable image which you can use to amuse or to inform your patients.

In opening up the archive the Head of the Wellcome Library, Simon Chaplin, said “Together the collection amounts to a dizzying visual record of centuries of human culture, and our attempts to understand our bodies, minds and health through art and observation. As a strong supporter of open access, we want to make sure these images can be used and enjoyed by anyone without restriction.”  The earliest image in the collection is a fragment of an Egyptian herbal, inscribed on papyrus.  From that early beginning the collection encompasses medieval manuscripts, Victorian cartoons and some early photographs exploring the movement of the human body.

Providing effective patient treatments can be challenging at times and those working in the health profession know that keeping the tone light and adding touches of humour can help to alleviate patient anxiety.  Access to an archive such as this can help to make the difference; although whether some of the images such as the Gilray cartoons portraying gout sufferers drinking port will teach us anything is a matter for debate.

But to be truly effective light heartedness needs to be tempered with professionalism and this is not always easy to achieve in a busy health practice.  Answering the phone, finding or filing patient notes, sending out invoices and other administration tasks can all disrupt patient treatments.  Outsourcing some of this work to a virtual assistant service can help to smooth over the working day and maximise time taken on treating patients.  Virtual Assistant services can be taken on a permanent or ‘as required’ basis.  This means that health practitioners can concentrate on what they do best, treating and reassuring patients, whilst being reassured themselves that behind the scenes day to day administration tasks such as phone answering, appointment reminders and invoicing are not being neglected.

Chinese Whispers

A GP who is at the forefront of patient engagement and empowerment has revealed that 99% of his communications with physiotherapists are still carried out on paper.  According to the Chartered Society of Physiotherapy, Dr Amir Hannan said ‘I don’t think we use email as productively as we might or technology in general.’

With letters being used as the prime communication method, it can sometimes be weeks before the results of patient treatments are conveyed to the general practitioner, resulting in delays in considering appropriate follow up treatment.  This affects the perception and actuality of patient care and can in some cases lead to a worsening of the patient’s condition.

In fact, Dr Amir highlighted the way in which delays in receipt of letters can result in the patient having to brief the doctor on the methods and results of treatments.  Whilst this does play into the hands of those who advocate patients taking responsibility for their care, it also means that treatments and findings can be filtered with a ‘Chinese whisper’ effect resulting in distortions.

Dr Hannan’s comments were echoed by NHS England’s director of systems, strategy and technology, Beverley Bryant, who confessed herself to be amazed “how much paper flies around our hospitals”.  As we have previously reported, one solution to this paper mountain is to adopt smarter practices which benefit from the use of current technology.  The health care authorities are working towards this end but there are options available now for those who need to find a way to communicate more effectively.

One of the main barriers to swift communication is the simple lack of time available to those who want to maximise patient treatment time.  Every time papers are filed, every time the phone is answered, every time an invoice is sent out is time which takes health practitioners away from their core task.  Simply by using the services of a virtual assistant to take control of telephone answering, diary management, electronic records and invoicing enables practitioners to free up valuable time.

Working smarter, not harder may be a mantra which is parroted around the business-speak airwaves on a regular basis but it does carry an element of truth.  Health practitioners took up the call to treat and improve the lives of others.  By concentrating on that calling and leaving the day to day admin to others, everyone benefits.

Divide and conquer

A hospital in Derbyshire has been reaping the benefits of a new cleaning rota.  Using an idea gleaned from overseas, the Royal Derby Hospital split its cleaning workforce into teams, each responsible for specific areas such as corridors or toilets.  Previously a single cleaner had been responsible for an entire ward or area of the hospital.

The new system of team cleaning by area has lead to a reduction in cross-infections, traditionally a pre-cursor of the need to close wards for deep cleaning.  In fact this new working pattern has been so successful that the hospital has been put forward for two Nursing times awards including the Golden Service award.

Hospital bosses have also found that by using teams rather than a succession of individuals, cleaning patterns are more flexible.  This in turn has reduced the incidence of wasted cleaning processes, such as cleaning a patient area just before a patient is due to be discharged as well as ensuring teams are on hand in case an emergency clean is required.

The story is a perfect example of the way in which those at the forefront of health provision are finding ways to work smarter rather than harder.  For example many health providers are looking to make savings by replacing follow up appointments with telephone calls or using the phone to make routine check-ups on those with ongoing problems.

It has to be acknowledged that telephone coaching is not universally successful if used in isolation as a study by UK researchers revealed earlier in August.  They concluded that telephone coaching of those with long term conditions is not effective unless it is carried out as part of an integrated system of care.

Health professionals too are using this “divide and conquer” principle to maximise patient treatment time and minimise disruptions.  Simply by outsourcing their phone answering to a virtual assistant service, health professionals can ensure that their phones will be answered, appointments made and reminders sent out whilst the health professional can concentrate on treating their patients.  With no need to interrupt a treatment to answer the phone and no missed calls, professionals such as osteopaths, chiropractors and others can provide a more streamlined and efficient service to their patients.

The Wimbledon effect

If you are toying with the theory that everything and everyone are connected in some way then the annual feast of tennis at Wimbledon may help to cement your belief. For no sooner has the first ball been struck on the hallowed Centre Court than gardens and roads across the country resound with the thunk of old tennis ball on broken racket.

For two weeks every year it almost seems as though every child is a tennis player. Whilst the professional players may be contesting for pride and £millions, never has a match been more keenly contested than that staged in the alleyway between the garden shed and the cabbages.

Unfortunately, at the time of writing the first few days of Wimbledon 2013 have been dogged with controversy about the state of the courts and the numbers of those who have withdrawn due to injury.  No matter that a higher number of players withdrew at the same stage of the US Open two years before or that the first couple of days always sees a number of slips at Wimbledon as the grass beds in; the toll of injuries has lead to much comment both in the press and in the players’ lounge.

In truth it is impossible for any sports person to go through their life without picking up one injury or another.  Writing for the BBC, Andy Murray acknowledged this saying:

“As athletes, you spend a lot of your time carrying injuries of one sort or another.  I’d say there are three categories: about 20% of the time your body feels great and you feel nothing; quite a bit of the time you’ll have something that might be a bit sore, but it doesn’t affect your tennis at all; the rest of the time you can be carrying something that means you have to compensate and make adjustments to your game. Everyone has to deal with it.”

Whether professional sports person or not, when an injury strikes the quicker treatment starts the better.  Physiotherapists, osteopaths and other health professionals know that early treatment not only promotes a swifter return to form it can also help to prevent the occurrence of further compensating injures.  But maximising the availability of treatment times is not easy when time is also taken up in managing diaries and answering calls.  Using a virtual assistant service can relieve the pressure and enable health professionals to concentrate on helping patients to return to form without compromising on service.

Learning the lessons of 111

NHS England has reported that the 111 telephone service has successfully coped with the May Bank Holiday weekend without major problems.  With providers taking on more call handlers in the run up to the weekend the early signs are that the 111 service responded to the vast majority of the 100,000 callers over the weekend.

However, chief nursing officer Jane Cummings acknowledged that improvements were still required before all forty-six 111 services were up and running as expected.  Run by a mix of providers including private firms and ambulance services, the 111 service has seen some teething problems.  This has resulted in some services being suspended or receiving special help.

Last week NHS England agreed to commission an external review to look at the problems which have beset the introduction of the 111 telephone service; both as a guide to actions required to bring the service up to full strength and as a learning point for future projects.  Whilst some areas of the country seem to have experienced a fairly smooth transition, others have been beset with problems including calls not being answered and major delays experienced by those waiting for calls back from medical specialists.

Designed to serve the needs of those who are too ill to be able to wait until they can see their doctor within hours but are uncertain if they should call an ambulance the 111 service is designed to be able to direct callers to the most appropriate service for their needs including GP out of hours, A&E or calling an ambulance if required.  This means that the service may receive a wide variety of calls from those who are concerned about their own, or a loved one’s, health and in those circumstances any delay in responding can lead to distress and anxiety.

In fact it’s not just the 111 service which can suffer from delayed call answering.  Any call which goes unanswered can potentially lead to frustration on the part of the caller, whether the call is to a health practitioner or not.  For those health practitioners who work closely with patients this can cause a dilemma.  If the answer a call they may be interrupting an existing treatment but if they ignore the call they risk losing a potential patient or their goodwill.

The solution is to appoint a virtual assistant service which will respond to callers, book appointments, manage diaries and take messages.   Appointing a virtual assistant service which specialises in health matters will also pay dividends as the call answerers will be able to talk knowledgeably to patients about their treatments with empathy and attention to detail and will better understand when messages should be marked as urgent.  We will be keeping an eye on the NHS England review as well as the progress of the 111 service and will report on any findings which may be of interest to our health practitioner clients.

Handing power to patients and professionals

As the fallout from the Francis Report continues to echo around the health sector it was refreshing to note an event recently which was purely aimed at innovating health care rather than indulging in recriminations.  Think tank Reform got together with Imperial College’s Institute of Global Health Innovation to draw attention to some of the positive innovations around the world which we may be able to learn from within the UK’s health sector.

Acknowledging that innovation can be defined in many ways, the event focused on three fundamental innovations which could improve the quality of care and patient outcome throughout the health service; workforce innovation, self care and personalised medication.

A shift towards personalised medication is only possible thanks to the leaps which science has taken in understanding the human genome.  With a greater understanding of personal risk factors comes the ability to target treatment on an individual basis.  We are already starting to see the benefit of targeted treatments in areas such as cancer and as our understanding grows the potential for more effective treatments is limitless.

Personalised medication does in part require a buy-in from the patient in understanding the risks of certain life styles and family traits and the next step is logically to encourage patients to take more responsibility for their care.  Self-diagnosis, arranging appointments directly with health professionals such as physiotherapists, managing self-treatment programmes is a step forward in understanding for patients but it will help to streamline the health service and target care where it is most needed.  For example, a patient with muscle or ligament damage needs to see a physiotherapist or osteopath straight away and making them travel the health nurse/doctor route first is a waste of resources and time.

This leads on to the third and most important change which the UK’s health services desperately needs, that of workforce innovation.  Doing away with rigid hierarchies and instead focusing on the individual patient means doctors, health care workers and support services all providing a flexible individual service.  Beacon Health Strategies, working with the poor, elderly and mentally ill in the USA has done just that. Over three years the flexible approach has reduced emergency hospital appointments by 60%, reduced suicide rates by a half and got 44% into work.

Innovation within the health sector won’t be easy.  It will require a sweeping away of the old hierarchies and a combined doctor/health professional service which is flexible and focused on patient care.  Those health professionals who have taken steps to outsource telephone answering, diary management and patient records and who are therefore able to maximise the time which they spend on patient care are in a perfect position to step forward into the new innovative, personalised era.

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