"The difference is attitude," Korneluk says. "How physicians look at their practice and their lives. They have to have pride in being the best they can be. A Buick is a good car but a Lexus practice has that little something extra.."
Unconventional Ideas in Practice Management
Korneluk's ideas are nothing short of revolutionary, which is why he is in demand as a speaker and teacher by those seeking an edge to manage managed care. Many of his ideas about service and quality were published in the 1985 tome he authored, Practice Enhancement: The Physician's Guide to Success in Private Practice (Macmillan). Some of the contrarian views derived from his research follow:
Solo practice is not dead. "You should not give up what has worked in medicine," Korneluk lectures. "Physicians can still practice as soloists profitably as long as they belong to a larger contracting network."
Generally, Korneluk does not advocate solo or group practice. "Physicians feel they have to join a group and that means they must accept a substandard way of delivering care. That's a non sequitur. Both structures can thrive if the structure around each physician is in the form of care teams with three team members: a physician, a receptionist and a nurse all responsible to each other," he says.
This concept is based on a term he has coined the "condominium-ization" of health care. "Each care team controls their own schedules and everything is focused on the doctor. They meet with the doctor once a month at lunch to talk about improvement and motivation. With teams, you clearly know where patient and staff go when a problem arises. Having teams cleans up communication problems," he adds.
In a team model, doctors do not answer questions about time off or pay. "All human resource issues are directed to the office manager. All other issues are dealt with by the team. That way there are clear lines of allegiance and responsibility," Korneluk says.
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