We spoke with Kahiya Jackson and Kurt Campbell about situations that specifically affect smaller practices, tips that help them succeed in their role, the benefits and advantages of smaller practices and more.
Joining us today From the Community, we’re speaking with two practice administrators from smaller sized community oncology practices — Kahiya Jackson from Pontchartrain (PCC) and Kurt Campbell from Cancer and Blood Care Specialists (CBCS).
Flatiron: The experience at a smaller sized community oncology practice is different from the experience at a large oncology practice or hospital. What are some things you deal with that affect smaller practices specifically?
Kurt: The number-one things I think of are the rebate structures, since that favors volume, or has tiering. I think they're difficult to deal with, but more importantly, the slight difference in tiering can often mean the difference between us being able to, in an oral pharmacy, dispense a product or not. And so as soon as you're in a low tiering position — from either one bad month, or a couple of patients rolling off of medication — then you’re in a tier where it doesn’t make sense to give certain medicine, so it will then never make sense to give that medicine because you'll never get back to a second- or third-level tier.
So the rebate structures, I think, are very poorly understood by the manufacturers. For practices as small as we are, I think there should be exemptions for very small practices.
Flatiron: Absolutely. Kahiya, what are some things that you deal with that affect smaller practices specifically?
Kahiya: Well, due to COVID our practice had to deal with several staffing shortages. Being a smaller practice, I’ve found that it’s important to have everyone in the practice cross-trained. Having our staff be knowledgeable about each other's jobs has helped us keep up with our day-to-day operations.
Having our staff be knowledgeable about each other's jobs has helped us keep up with our day-to-day operations.
Flatiron: Staffing is definitely a pivotal part of all smaller practices. Kurt, what’s your experience been with staffing at your practice?
Kurt: I think staffing is a challenge for small practices, just because every individual person ends up having a higher percentage impact as a ratio of total staff, and any one person has a higher level of leverage over the entire business as well, so staffing decisions are ultra important.
I think the flip side of that for a very small practice is improved control. You can implement things faster, you have better control over the patient experience in the practice. So one example during COVID, as a small practice we were able to roll out with telemedicine the Monday after it was approved (on the prior Thursday), so with a bit of prep work we were able to turn that around quickly, where peer practices around us took another week or so to get rolling.
Flatiron: That’s interesting to hear about, the advantages of smaller community oncology practices that large practices might not have. Are there any other advantages of smaller practices that you can think of, or advice that you would offer to fellow smaller practices?
Kurt: My advice is to take advantage of every opportunity you can. So biosimilars, for example, with a small practice and control, you have the ability to roll out biosimilars faster than a larger organization. Oral dispensing is another example where large practices sometimes have a real challenge getting all of the doctors to route prescriptions through the local pharmacy, things like that. In a smaller setting you have more ability to communicate and control the workflows.
My advice is to take advantage of every opportunity you can
Flatiron: Kahiya, are there any tips you have that have helped you succeed in your role as a practice administrator at a smaller community oncology practice?
Kahiya: Working in a smaller office you have to wear multiple hats. In doing so, it’s imperative to stay organized. Each day I start off by prioritizing my day. I put together a list of things that must be done. I start with my time sensitive things first then I work from there.
Flatiron: Kurt, what are tips that have helped you succeed at your role?
Kurt: I would say I’m more focused on how we've been successful as a practice, not specifically in my role. But my first tip, this is very core to our culture, is treating our patients as customers. So we think of patients as wanting to walk into a hotel, or a spa — that's what patients want, or what they respond to. They don't expect it, because frankly, so many practices are terrible, but they want a place where people are friendly and smiling, and there's plants and it's nice. I try to walk through the front door, use the patient bathroom to make sure it's clean, basically walk through with the eyes of the customer, because it's so easy for medical practices to optimize for the doctors, or the providers, or whatever the process is, instead of optimizing for the patient.
It's so easy for medical practices to optimize for the doctors, or the providers, or whatever the process is, instead of optimizing for the patient.
And you see it everywhere, where things just don't even make any sense from the patient perspective because they've been optimized for the process, not the patient.
Flatiron: I think that’s wonderful — and that’s such a good point you bring up. Let’s switch gears a bit and talk about upcoming Flatiron products and features. Which Flatiron HC features are you looking forward to having at your practice?
Kahiya: The OncoAir mobile app has been a great addition to our practice! The app allows our providers access to our patients’ information while making hospital rounds and after hours. Being able to view their medications and visit notes in OncoAir has been valuable in increasing continuity of care for our patients at PCC. We’re also looking forward to the OncoAir enhancements which will allow providers to make changes to patient records, view schedules, and send refills via the app.
Flatiron: Kurt, which features are you looking forward to having at your practice?
Kurt: So the most important thing is optimizing the provider's time. When I think about both my wishes for upcoming things and the upcoming things on the roadmap, it's all about minimizing the time that providers click boxes for CMS.
So the main feature I’m looking forward to is Visit Documentation, and the improvements and the rethinking there. The improvements in e-Prescribing, and we have integration with PDMP, in our state at least, but making that flows well is super important. And then the biggest thing that is probably on the future roadmap that I see for the industry is integrating both voice dictation, which we do, but integrating some of the products that people are looking at that listen to the conversations, and start helping to pre-fill-in notes, or things like that — I think there's a huge amount of capability in that technology.
Flatiron: Thank you so much both for your insight and advice during this conversation — it’s been great hearing from both of you.