(Note: This is a post submitted by BNET member Peter Lucash, whose bio appears below. To submit your own post, click here.)

It looks like physicians have gotten a last minute reprieve from a 10.6 percent fee cut that really would have sent physicians away from Medicare. The annual battle is getting tiresome, and while the Republican Party clings to the fantasy that the “free market” is the fix for health care, those who work in the industry know better.

OK — say you’re a physician practice. Now what? While you’re not getting a cut, you’re not getting an increase either. I work with physician practices, and wrote a book on business planning for medical practices, and this situation today screams for a five-year business plan. So let’s plan.

• Do a “walk through.” The first target of your work is to improve your back office procedures. There has to be a way to speed things up so you can handle more patients with the same staff, and with less hassle for patients and physicians. So become a “patient” and experience all of the related paperwork, processes and other work that surrounds an office visit, from calling for an appointment (how about online appointment setting?) to the final settlement of the bill (online bill payment?).
• Add some services. Even basic lab tests can add a few dollars of revenue to the average office visit.
• Add clinicians. Nurse practitioners and physician’s assistants can handle many visits, are well received by patients, and enable physician-owners to profit from the work of others.
• Market. Target your promotion to insurance carrying patients, building your reputation, referrals and patient flow.
• Make a financial plan. Physician personal income will be essentially flat over the next few years, unless Congress stirs and puts in some incentives for physicians, rather than leaving it to insurance companies. Your financial plan is a rough budget, going out over three to five years. The sobering reality of how your future looks will help you make the hard decisions — whether to expand, to borrow in order to invest and grow the business, and how to be business smart.

Here’s the free market at work, as the folks who actually can make health care more efficient are the physicians, not the insurance companies. Managed care did its job, but it’s burned out — no more ideas, and no more savings to be had.

Now is the time to start making notes — ideas, observations, dreams, goals — of where your are and where you want your practice to be. Your plan will evolve from here — it’s hard work, and you will have to make hard decisions, but the time and work is your key to building the practice that you want and deserve.

Peter Lucash has over 30 years of business experience, principally in healthcare. He is the author of two books and writes the Medical Practice Business Blog for All Business.com.