Ideal Micropractice, Part Two

A number of colleagues have asked for more information about what I’m doing with the Ideal Micropractice model. So, asking the forbearance of those who couldn’t care less, I thought I’d dedicate a blog entry to explaining it.

The concept of an Ideal Micropractice comes out of a project supported by Dartmouth Clinical Microsystems and is based on the work of Gordon Moore, M.D. The whole concept is laid out in the project’s web site at www.idealmicropractice.org.

The hallmarks of a micropractice are:

First, very low overhead. The notion is to learn how to do as much as you can by yourself so you do not have to hire staff nor pay other providers. This means you keep more of what you earn, and can have better balance in your life by not having to see so many clients to cover your costs. You maximize your net earnings even though your gross earnings might be less than your competition.

Second, high technology. You use 21st century technology to do things that are traditionally done by staff. You use voice mail, email, web sites and computerized practice management and record-keeping software.

While there are a number of companies that make such software for physicians, there are none that do so for hypnotists. Therefore, a computer-savvy consulting hypnotist needs to “roll your own” using off-the-shelf programs. This isn’t as hard as it sounds and there is a book (Practice Management by Christian Rainer, M.D.) that explains how.

As I run on Macintosh computers I use iCal, Address Book, MYOB Accounting, TypeIt4me, and a Pages template, all linked together by Spotlight, a feature of the Apple OS X operating system. This combined with Adobe Acrobat (which allows me to digitally “sign” documents and lock them against changes) gives me a bullet-proof custom system that works perfectly.

I keep a high speed document scanner on my desk. The office is basically paperless. Anything that needs to be stored is quickly scanned and attached to the client’s chart. The original document goes into the shredder. The computer backs itself up to a removable hard disk system every night.

The third characteristic of a micropractice is called “unfettered access.” This means you make it as easy as possible for clients to get hold of you. A number of micropractice physicians actually offer same-day appointments. While I can’t do that, I update my voice mail message each day telling people when to expect my return call, and I allow established clients (who typically only need to reach me for something quick, such as checking an appointment time) to call me on my cell phone.

Finally, the micropractice model uses something called “continuous flow processing” as much as possible. A continuous flow process is one that you do, start-to-finish, in one quick process. Complex projects are broken down into smaller steps, each one of which is a continuous flow process. You always try to do today’s work today.

The best way to understand this is by comparing it to what it is not. The opposite of continuous flow processes is known as “batch and queue.”

If you open a letter, read it, mark your answers in the margin with a pen, put it in a new envelope and mail it back to the sender, that’s a “continuous flow” process. If you open a letter, skim it, put it in a thick file of “Letters to Answer” and make a note to look at it later, that’s a “batch and queue” process. Where possible, you avoid the latter.

It took a while for me to get used to continuous flow processes but they work like a charm. My bulging ticker file is much thinner, my call back list is tiny and people keep saying “I can’t imagine how you get so much done.”

The benefit of all this is that I have a nice practice, a good income, balance in my life that lets me enjoy my marriage, my martial arts practice, my spirituality, my cooking hobby, and still have time to do a lot of volunteer work for the National Guild of Hypnotists and charity work. I keep looking for ways to make it better, but it’s pretty good now.