Giving Back – University of SA recognises Health and Life valuable internship program

This is about giving back.

A big thank you to Daryl Mc Mahon, Vice Chancellor for Business and Law Professor Marie Wilson and team Uni SA for putting on an amazing internship event.

We really appreciate the opportunity to present Health and Life to over 170 employers and students at the Hotel Intercontinental. It was a real honour for our staff to present and participate.

A special thanks to Jonathan Markey who was a successful intern that presented his Health and Life internship experience to leading industry employers. Deanna, Christian, Mark, Amin (marketing internship) and Ashley for your assistance on the day. Most importantly to the many students who came up to say hello and find out more about us. We were impressed by the calibre of students and overwhelmed by the significant interest in Health and Life.

Thanks to Peter Andrinopoulos for the great pictures. Best of luck to all students and employers we hope you got a few helpful tips.

See our video https://www.facebook.com/healthandlifeaccounting/videos/1435713986579303/ 

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A BIG THANK YOU – International Healthcare Standards and Ethics Board (IHSEB) project

The Patient Advocate – the need for a not-for-profit International Healthcare Standards and Ethics Board (IHSEB). 

Nobody can be an expert at everything. This is known as the Dunning Kruger effect. To overcome this, the INTERNATIONAL   STANDARDS AND ETHICS BOARD (IHSEB) will bring in the professionals you need before making those important decisions.

One patient at a time, we aim to provide the global healthcare community useful and meaningful healthcare information from a set of centralised and globally agreed healthcare standards and an ethical framework. This will improve the quality of patient care and reduce the number of preventable deaths. 

The aim is to have 190 countries participating in a centralised body that standardises useful and meaningful healthcare and ethical standards globally by 2030. Thank you to the many people and organisations who have nationally and internationally supported this project. This is a global effort to implement standards of healthcare delivery across the globe to help everyone.

Honourable Federal Senator Stirling Griff

Honourable former Federal Senator Nick Xenophon

Honourable State South Australian Premier Stephen Marshall

Honourable former Federal Member Christopher Pyne

Julian Burnside, QC

Dr Mukesh Haikerwal

Professor Ian Olver

Professor Bill Runciman

Dr Tony Bartone 

Dr Ewen McPhee

Dr Harry Nespolon

Dr Daman Langguth

Dr Charlie Teo 

Dr Dean Soares

Mr Channa Wijesinghe 

Mr Danura Miriyagalla 

Mr Nick Voudouris 

Mr Rick Carter 

Mr Stephen Ma 

Ms Sarah Bartholomeusz 

Accountants Professional Ethics and Standards Board

Xero 

University of South Australia 

Carnegie Mellon University

AAPM National Board 

Innovation in the City 

Health and Life

One Moment Foundation

There are many other volunteers and people we would like to thank, including our interns for the remarkable assistance they have provided to us. 

These are just some of the amazing people and organisations that have assisted in the project!

Julian Burnside QC and Dr Mukesh Haikerwal with David Dahm debating human rights, the definition of clinical peer review and whether patients are affected by current health law reforms. 

The national Accountants Ethics and Standards Board (APESB) (that represents all the major accounting professional bodies) CEO Mr Channa Wijesinghe and the team have been invaluable assistance in sharing knowledge on why and how the APESB was formed. Thank you for your assistance. We appreciate your help. They are performing world-leading work in this area for the accounting profession. 

Trent Innes CEO Xero Australia with David Dahm. Many thanks for recognising and creating a national awareness of our work with the 2019 Community Partner of the Year Award. 

How to prevent the third-largest killer of human life: preventable medical and healthcare system errors. It is an honour to be invited by Carnegie Mellon University, a top US Ivy League College, to pitch to students on such an important issue. Thank you to the students, Faith Yong and Deputy Head Danura Miriyagalla, Professor of Practice.  

We love pure maths: David Dahm working with Google Maps co-founder and CTO, Stephen Ma, to crack the DaVinci code to humanity for an independent, not-for-profit healthcare standards and ethics board (IHSEB)

Thank you to Rick Carter and his team for promoting the INTERNATIONAL HEALTHCARE STANDARDS AND ETHICS BOARD (IHSEB) project at the Innovation in the City Event. This was well received by the Adelaide business community. 

In 2020 we have many more big announcements to make and look forward to your support in listening and sharing the news on how you can help. Many thanks to the many of you that we have not mentioned but have been of enormous support.

2019 RACGP Practice Owners National Conference Panel – The Future of General Practice

RACGP Practice Owners the Future of General Practice ‘RACGP President Dr Harry Nespolon, Chief Executive of the Health and Life accounting firm David Dahm, and Chair of the Australian General Practice Alliance Dr John Deery discussed future challenges posed by technological disruption. Panellists were enthusiastic about the possibilities presented by technological developments, with Mr Dahm pointing out that GPs can reduce their back-office costs by up to 40%. ‘Doctors will be able to work at a higher level now, that’s the benefit,’ he said.’ 
Source: RACGP RACGP Practice Owners Conference

2019 Sydney West PHN and Responsible Billing Symposium Brisbane – Medicare Audit Anxiety is it hurting patient care?

It was a pleasure to be invited to talk on Medicare Audit Anxiety. We presented to the Sydney West Primary Health Network a unique national survey. We wanted to find out if Medicare audits were harming patient care. Thanks to the PHN for the opportunity to speak on this important topic.

It has been a real honour to work alongside Julian Burnside QC and Dr Mukesh Haikwal on whether due process applies to providers and whether this is fair and just. Thanks to Prax Hub for recording this important event and my topic Another Model, The Road To Self-Regulated Healthcare

for everyone to share. David Dahm shares his story and reflections on challenging the PSR over the past decade.

Five signs of a well-run practice or business

Evidenced-based practice or business management works; take out the guesswork in running your practice or business with proven and cost-effective internationally best practice tools and techniques!

Every practice or business owner wants their business to thrive, but it can be tough to keep the money coming in the door while staying on top of all the necessary paperwork.

One way to ensure success is to understand the behaviours that separate a well-managed practice or business from one that’s just muddling through.

Getting the basics right

1. It’s not just about making money

Making money is not why you do what you do, it is a result of what you do well.

After your health, it is time to build the second most invaluable investment in your life – your practice or business – with strong foundations. Thinking that running a practice or business well is about cutting costs or corners is a big mistake and can be a serious risk. Be wary of those who are in it for the quick dollar or short run. Cutting costs or corners can provide a false sense of security for the owners, staff and customers. This is much like going cheap on the most important tools of the trade that keep a roof over your head and food on the table. In this new digital world, it is easier than ever to get caught out and some things are not worth taking the risk. 

There is no such thing as fast money – taking a slower and structured approach will ensure you set up a socially responsible and sustainable practice and will save you money in the long run. We do not mean legal and tax structures – although they are still important, the smart money lies in how you work every day.

2. Keep informed

Understand that there are four key areas to watch when running a practice or business. It is important to set and share these expectations with your fellow co-owners (if you have them) and staff for feedback. It needs to be a shared vision. Consider: what do you want your practice or business to look like?

We have provided some examples below you can use. In priority, the following steps should be taken. The analysis below is from the internationally well regarded Harvard University’s Balanced Scored Card. This is used by the majority of leading companies in the US, Europe and Asia.

Step 1 – Finance

Work out how much your practice or business is worth and how much you would like it to be. This is your single most important investment that meets your lifestyle and retirement needs. You need a structure and goal – don’t throw good money after a bad idea.

Step 2 – Customers

Be clear of who your customers are. They are the ones that pay your practice or business expenses. For practices, it is the patients and the providers who pay a service fee to the practice or business. Ask, are they happy? Are they committed, or just interested in the practice? Do they love it or like it? How do you want them to feel about you?

Step 3 – Process

Be clear how you deliver those goods and services. Is it a manual or automated process? Which one is more reliable in the long run? Which one is more sustainable that will meet the practice’s or business’s needs? How will you monitor progress? For example – will you use automated smart systems that compare your performance to the industry? 

The example below is a national monthly practice benchmarking report our clients use to contextually manage their business in a useful and meaningful way. This enables timely and less overactive decisions e.g. if patient numbers are nationally low for a certain time of year. This means you do not have a poor or underperforming practice. No need to panic.

Step 4 – Learning and Growth

How do your staff learn about new systems and processes? How are staff or customer expectations monitored? How do they receive and provide useful and meaningful feedback? Do they love working or like working for you?

3. Keep up to date

The final positive marker of a well-run business is that all its details are up to date – particularly with the ATO and other statutory bodies. 

Although many of these indicators are straightforward, it is surprising how many Practices don’t take these simple actions. We understand some costs like legal and accounting fees may feel like a grudge purchase – like going to the dentist. You need to budget for it, as with the right experienced advisor at the helm it is worth it in the long run. 

Behaviours to avoid

Just as there are habits that mark a well-run practices or businesses, there are behaviours common to operations heading for trouble.

Practices sometimes expose themselves to risk through decisions such as omitting income by depositing it into business accounts that are for private accounts. For example, money collected on behalf of a provider and deducting payments without written (via a signed service agreement) permission run the risk of being accused of fraud.

The same goes for failing to account correctly for private use of business assets or funds. 

Making errors because you don’t understand your tax or your legal responsibilities is also a sign that things are not being well-run.

4. Nobody can be an expert at everything

Bring in the professionals

With so many rules and regulations, it’s not surprising that practice owners may occasionally overlook some of their obligations. There is an easy solution though. 

Well-run practices seek professional advice when they need it. We can work with you to improve your business overall, not just to meet your tax obligations. 

In fact, the ATO’s 2017-18 research and audit work with around 120,000 small businesses indicated that those who have regular contact with a tax professional are more likely to get things right.

Maintain good business records, keep an eye on your competition using Health and Life’s new monthly Business practice benchmarks.

5. Just do it

Well-run practices and businesses know when they need to walk and chew gum. As in the Nike commercial Just Do it. They have to act both on urgent as well as important matters. They give equal priority to both and book it in their calendars. They have a low tolerance to missed deadlines unless there is a good reason for missing one. Staff are rewarded for this, as the bottom line grows when everybody’s expectations are being met.  

WATCH:

Live Monthly National Practice Benchmarks

Doctors Pay (Service Fee) Calculator 

Doctors and Staff Contracts Video

If you think your business could do with a financial tune-up, contact us. 

2019 Awards and Recognition

2019 Recognition for national AAPM founding Chair Certified Practice Manager post nominal designation

It was an honour 

2019 National Xero Community Partner Award Winner and Could Champion Finalist

Thank you to Amanda Newton and Trent Innes for recognising our work as national Cloud Champion Finalists in our healthcare sector. But more on this later! Most importantly, we also thank them for recognising us as a national Community Partner of the Year Award Winner for our global pro-bono work in creating an independent non-for-profit International Healthcare Standards and Ethics Board (IHSEB). 

This will help us raise awareness for a more sustainable and safer healthcare system.

According to the World Health Organisation, ‘Five avoidable deaths per minute shows the urgent need for action on patient safety’. The project’s aim is to have an internationally recognised body  in 190 countries by 2030. So please watch this space. 

This award is not only for us, but for everyone around Australia and the world who have helped us along this journey.

David Dahm receiving the Xero award from Amanda Newton and a Xero team member.

As mentioned earlier, Health and Life were  a finalist for the 2019 Cloud Champion of the Year. This was primarily given for our innovative work in producing Live Monthly National Practice Benchmarks, Doctors Pay (Service Fee) Calculator and a number of cloud automations. 

It was an absolute surprise and honour to be nationally recognised in amongst a strong group of individuals and firms. Congratulations to all winners and finalists on a well-earned award. 

Chair Certified Practice Manager post nominal designation

2019 Recognition for national AAPM founding Chair Certified Practice Manager post nominal designation

David Dahm Health and Life CEO & Founder is humbled and honoured to be recognised for establishing and chairing Australia’s first Certified Practice Managers (CPM) program. This recognizes the skills and expertise of healthcare practice managers. At AAPM (Australian Association of Practice Management) 40th Anniversary Past national President Mr Gary Smith noted this as one of the key achievements in recent years for the national association.

Congratulations to all of you who have completed the program and earned this well-deserved recognition for your commitment to the profession. We will be able to recognise you as you proudly wear the nationally recognised post-nominals after your name ‘CPM’ Certified Practice Manager. 

Practices facing tough penalties for MBS abuse

A recent headline in the Australian Doctor may set some alarm bells ringing “Corporates face tough new laws for MBS abuse”.

Legislation just passed by the Federal Government means that, from July next year, where a practitioner has been found guilty of inappropriate billing, the practice not just the practitioner will have to refund the money to Medicare.

This may mean that where practitioners have been pressured by the practice to provide clinical services that are found by Medicare to result in an excessive number of services or provision of services to patients that are not clinically relevant, as determined by the medical profession’s peers, then those billings will have to be paid back to Medicare.

We agree with Medicare’s approach in principle. However, in the absence of any open and transparent peer-reviewed clinical standards, it remains uncertain how a practice and its practitioners will know whether or not they are crossing the line in terms of excessive, properly documented or clinically relevant services.

For example, at what point does an owner/practice manager stop promoting, say, an obesity or Pap smear clinic?

Some issues to consider:

  • What is the peer reviewed protocol and standard applying to a treatment or regimen? At what point does providing it become excessive?
  • How does the practice determine that the treatment has been correctly documented?
  • Do practices now have a responsibility to examine each practitioner’s medical records to ensure compliance?
  • Do financial incentives create pressure on practitioners?
  • Should practices now update their practice agreements with their practitioner providers so as to disclaim any undue pressure, and re-word the incentives contained in the agreements?
  • Should practices upgrade their indemnity insurance policies to cover the possibility of MBS audits?
  • Should practices change their Practice policy and procedure so that only the billing practitioner and not staff initiate billing patients to prevent unauthorised up-coding or errors?
  • Should practices avoid proactive healthcare screening and preventative health programs for patients as they may be too aggressive? What is the benchmark or speed limit that practices need to follow?

In our experience, Medicare’s efforts to reclaim money can apply retrospectively – going back several years. This can become a big problem especially if a practice has already paid staff and/or incurred practice expenses such as rent from the billings.

It begs the question; have the risks of practice ownership gone a step too far?

‘There have been long-running concerns about the way doctors are ordered to pay back the full value of inappropriate claims even after they have given a large slice of their billing to contractors.’

Source: Australian Doctor, 11th July 2018

If there existed open, transparent, Government-approved and recognised, clinically peer-reviewed standards, then interpreting the MBS would not be as complex, difficult and potentially financially fraught as it currently is. All people want is financial certainty so they can plan.

The issue will remain one of concern for practitioners and practices until the medical and health profession collectively addresses it.

You can do something about this, by understanding the risks and responsibilities and challenges under the present MBS system.

Please complete our MBS complexity survey and read the High Court application which will help you better comply with the law.

Keeping the family in family practice

We all know about the importance of continuity of care to patient health outcomes, not to mention GP job satisfaction. We also know that building strong relationships with patients is the foundation that allows this to happen.

But how does your practice approach this? Do you rely solely on doctor-patient rapport and good quality care? Or do you look at the entire patient journey and the role it plays in how your patients feel about your practice?

There are many ways of systematically building patient loyalty – and these can be found both within – and beyond – the consultation room.

Think about your patient. What can you offer them beyond the primary purpose of the consultation?

If you’re thinking about sustainability, then thinking about how to build a loyal following among families is an important consideration. And what better place to start than building a relationship with parents?

This will depend to an extent on your location and the associated demographics. But if you do have the opportunity to reach out to parents in every way possible, then you most certainly should. They are the bedrock of family practice and if you focus your energies on them you – and they – will reap the rewards.

rogue-river-funny-coffee-mug-thanks-mom-i-survived-novelty-cup-great-gift-idea-for-mom-mothers-day-wife-or-parent-i-survived

This busy time of year is a perfect opportunity to increase the level of engagement with patients who are parents. So how might you do this? Here are three things to try:

  1. Lighten their load

One of the key problems patients report is getting good quality information. And if you’re a mum or dad, good luck wading through the endless parenting advice factory. If you, their trusted partner in health, can point parents in the direction of trustworthy, evidence-based, easy-to-follow information, you’ll save them precious hours and they will thank you for it. Have your ‘goto’ parent resources at the ready and be quick to articulate how they can help.

Here are three top homegrown resources for parents – you’ve probably heard about them but how often do you and others in the practice use them as a referral tool? Patients sometimes need help navigating their way around health information online. Pointing them to trustworthy information or downloading helpful articles or resources, can help improve health literacy and make everyone’s life easier – and these are Government-endorsed and commercial free.

  • raisingchildren.net.au is a free, Australian Government-funded, evidence-based parenting website that covers all bases from pregnancy and birth to raising teens. It contains articles, videos and family friendly resources on hundreds of topics on child health, development and behaviour. And it gives parents plenty of tips and tricks to try. It’s also accessible for patients with disabilities and from diverse cultural backgrounds. Information is updated regularly, tailored to different ages and stages and rigorously assessed by subject matter experts and a scientific advisory board. There is also an active Facebook community associated with the site that parents might find useful.
  • Health Direct (healthdirect.gov.au) is a public company funded by the Federal Government and most Australian states. It aims to use technology to give consumers the tools they need to manage their own health. As well as phone help lines patients can use 24/7, its website contains a health topics A-Z with ages and stages information. It also has a blog with interesting articles on health.
  • Better Health Channel (betterhealth.vic.gov.au) is fully funded by the Victorian Government and offers up-to-date plain language content. It’s a great goto resource for parents with health questions who might be waiting for an appointment with you or a specialist and need further information or reassurance. Like raisingchildren.net.au it has a quality assurance process for its content and uses subject matter experts.
  1. Think laterally about starting conversations

Think of, and plan for, ways to start conversations with parents about family health issues – and I’m not just talking about the consulting room. What are the common areas you see regularly where being proactive will improve family life? Nutrition? Sleep? Managing behaviour? Talking with teens? There will be some that resonate for you. Think about how you can create touchpoints across the practice that highlight these issues and prompt conversations.

  1. Demonstrate your family friendly credentials

What are you showing on your waiting room TV? Are there likely to be programs that make parents squirm? Do you have a sad looking set of children’s toys that never rotate? Or do you instead have an inviting story corner that might jumpstart a conversation about the exponential benefits of reading to children every day? Is there anywhere breastfeeding mums can go to get a little privacy if they’d like it? Where can people park strollers or prams? Think about the hassle it can be for parents to get their kids to the doctor. What might make the whole experience easier – and more welcoming – for them once they’re there?

Simply taking a walk through your practice with a mother’s – or father’s – hat on might reveal things you’ve never considered before. But you might be surprised about the benefits that thinking outside the box will bring.

We think these are some great ideas for your Practice and would love to hear your feedback.

  • Declaration: raisingchildren.net.au contributed to the content in this column

2019 Health and Life 30 under 30 Awards and Achievements

To see our team be nationally recognised was one of our  proudest moments in 25+ Year history.

A client Dr Nick Vhlachoulis who inspired this post texted David Dahm

 ‘Hi David. Congratulations. You must be very proud.’ I said ‘It is pretty cool to be quite honest. More than money or anything else but especially to people like you guys who give them a chance. We all had a part to play.’ 

We were really punching above our belt and beyond. 

The competition was tough playing against billion-dollar accounting and consulting firms and being judged by senior veteran peers. This was an amazing effort. 

 These were for our four moonshot projects:

1. Live national medical practice benchmarking

2. Doctors Pay (Service Fee) Calculator 

3. Specialist advice in the healthcare sector 

4. International Healthcare Standards and Ethics Board

i

Congratulations to: 

Ashely Tudo Accountants Daily 2019 Public Accountant of the Year

Christian Verbi Specialist Consultant

Mark Di Fabio Specialist Consultant and 

Jonathan Markey Tech Innovation national finalists! 

Ashely Tudo Accountants Daily 2019 Public Accountant of the Year

Public Accountant national Award Winner Ashley Tudo being interviewed by Accountants Daily.

Thanks to everyone especially our amazing clients and Health and Life Senior Associate Nick Tsoulakis. Thanks to  Jonathan Lee who looked after us during the Award week. All staff and supporters should feel proud of this remarkable achievement.