Good morning everyone. I'm Beverly Cook. I'm the Director of Finance at Midwest Orthopedics at Rush. I do all their data analytics and benchmarking. We submit several surveys every year and AAOE is one of them. We also submit through the OrthoForum and MGMA. And I've been with Midwest Orthopedics for about 12 years and I've been doing surveys since I started there. So I kind of I'm pretty good at getting to the data. I've worked in several different systems as well. So I'm excited to be here to help you all figure out you know if you're having any struggles or anything. So how about if we just start by maybe going around the room to see where you're from and where you are in the survey and maybe like some struggles that you're having with the survey or if you are anticipating any struggles. We'll start up here. David Yoho, he's very important. You're the only one to bring to Orthopedics. I haven't touched it. Okay. Okay. I don't think the group is... I heard it's two years thick. I don't think they've actually ever submitted a 4 or 5 year survey. Do you ever buy the benchmarking data from anywhere to... okay. All right. I put my own analysis of what goes on. I figure we're going to show up pretty well in the survey as far as where we are on our status. Doctors never believe it. Right. They tell them it's all they want is more money. Why didn't I get more money? Yeah. This year you can prove it to them. Excellent. All right. Next row behind. Put this between you. Thanks. So we're from New York. We're from Spine Medicine and Surgery of Long Island. I'm the practice manager. I'm the director of operations for billing. And it's our second time at AAOE and I don't really... We haven't used the benchmarking survey. Yeah, we have not. Okay. So your practice has never had benchmarking results to work against. No. So you're going to do it this year, yes? Or you're just thinking about it? We're thinking about it. Okay. It's not difficult. We'll get you started here today. I'm Joe Larkin with Vail Summit Orthopedics. Terry, you and I met by phone last week. Thanks for your help. I'm relatively new to orthopedics. It's my second time here at AAOE. I work with Chris Greenman and this is near and dear to Chris's heart as it is mine. I poured through last year's data pretty thoroughly and I think as an organization, we're working on aligning our metrics so we can better, I think, leverage and contribute to the benchmarking survey. Great. It's kind of eye-opening, I find, when I look at my data against others because sometimes I think, wow, you know, I didn't think I'd do really well there, but we did. It's pretty eye-opening. Yes. Hi, I'm Amber. I'm with Suncoast Orthopedic Institute in Venice, Florida. This is my first conference. I have not started this at all. Same. Carrie Lynn Holt from Suncoast Orthopedic Surgery in Venice, Florida. We typically do this, but I'm the new administrator and I've never done it. Do you have any of the information from the prior years? Not that I'm aware of, but I could possibly search for it. Great. Good morning, everyone. My name is Tamara Lester. I am from Georgia Hand Shoulder and Elbow in Atlanta, Georgia, and I am new to this as well. So I'm here to gain some knowledge today. Great. Well, welcome. Hi, my name is Sandy. I'm with Dallas Orthopedic and Shoulder Institute from Dallas, Texas. I. What else do we need to say? I missed that part. I have four physicians in the group. We added originally it was just one doctor group. We added additional physician in the last five years. So we're rapidly growing. I have used benchmark before, but not very good at it. I haven't done the contributing part of it. So I'm here to learn. I'm Mike Piver. I'm with Gulf Orthopedics in Mobile, Alabama. It's the first time I've attended a conference. And so we have not done any benchmarking with a we in a prior life. We had done benchmarking with ortho form. And I will tell you that it was extremely challenging to get that data. So similar to the first gentleman, I have not looked at it. So I'm hoping that it's not going to be as challenging and that we can actually have some meaningful data. Yeah. I'm Ryan Greenberg is Michelle. We're Napa Valley Orthopedic. We attempted the benchmarking last year and I found it incredibly challenging. So I'm hoping to learn something that makes it not challenging this year. We did put in when we moved to the Excel version, we found that to be a lot easier. So we did one section that we put in, but then we don't we don't know what to do with it now. So kind of hoping to learn some tips and tricks. So, yeah. So what parts did you find the most difficult or challenging the non Excel version? I would get lost in what you guys were asking for, because you go to the next page and it seems like it was duplicating. So then I'd go back and I couldn't figure out where I was in the in the questions. And. Yeah, I mean, it felt like it kept we felt like a repeated, but then it was slightly different. And I was like, did I already do this? I just got lost in it a lot. So. Chris Roy with Summit Surgical in Hutchinson, Kansas, is my third conference. Came in here today just to learn more about the benchmarking. We try and use benchmark data all the time, whether it be in physician recruitment or trying to figure out. It's whatever. We're a little unique in that I'm on the hospital side of a smaller physician owned hospital, and I don't have access right now to practice data. So it makes completing benchmarking a little problematic. So just trying to figure out ways to work with those practice administrators to so that we can all grow from that data usage. Hi, my name is Heather. I'm from Black Hills Orthopedic and Spine Center. Lisa from Black Hills Ortho as well. And Tracy, we historically complete the survey every year. This is the first year that it's been handed off to me to fill out. So I have not looked at it yet. We do have all of the past data, so I'm hoping it's going to be a breeze. OK, great. And I just I just like data, so I tagged well. I'm Jill Hurlbut and Erica Hyman from Lincoln, Nebraska, Prairie Orthopedic and Plastic Surgery. I have done the benchmarking intermittently in the past and we do use it periodically, especially as a gentleman said to kind of reaffirmed our physicians that we're in a good place. And I'm just here to learn more about it and hopefully streamline my my data entry. Yeah. I'm Steve Lair, Mattis. I work at Riverside Orthopedic and Spine Center just down in Kankakee, about an hour and a half south here. This is my first conference. Our practice is about five, six years in the making. I am not too familiar with the survey. My one up is and the whole goal for me here was to learn more about it and try to work with them. All right. Hi, I'm Sherry Yates. I'm with Tennessee Orthopedics Alliance in Columbia, Tennessee. And actually, I think we have a company vendor that helps us do that, do the survey. I just from operation standpoint, want to see what else gathered and anything that I could do to help gather that information. And I'm Kadira Lafifi. I'm the clinic manager at Stoughton Health. I'm new to the conference and I'm new to the survey. Okay. Well, welcome, everyone. We have a good mix. We've got some that have never completed the survey and some that have have done it and are just looking to streamline. So what I heard from everybody is pretty much what we hear every year. You know, some people the difficulty of it. Some people don't aren't sure how to use it. I can just tell you my personal journey in the benchmarking back in 2016. You know, I've been at my practice for a while, had been the CEO for about four or five years, and we didn't do any benchmark. Our benchmarking was comparing ourselves year over year. Now, that's how we decided if we were doing well or we weren't doing well. And we'd go to the quarter meetings and I'd tell the doctors everything. And after one of those meetings that year, one of my young doctors came to me and said, well, how am I doing? You know, how am I really doing? I know how I'm doing against, you know, Dr. Jones down the hall. But how am I doing against my peers? And I really didn't have an answer for him. So I started looking at the different surveys out there. You know, there's there's, you know, MGMA was mentioned. You know, I found that to be a lot of hospitals, a lot of educational systems who have a lot of different problems than those of us in independent practice. I'm not saying that the AOE survey is not for everybody. It's just when I was looking for my practice, I needed more independent practice data. Of course, there's OrthoForum. I'm too small to be involved in OrthoForum or OrthoConnect. We've heard repeatedly the last couple of years, especially getting that data has been very difficult. So when I started looking around, I started into benchmarking. I completed the AOE survey, and then I came on to the council. And it was really eye-opening because if you don't have data to look at, not just yourself, but against other practices, how do you know if you're doing well? We have MRI. We thought we were doing really well, being very profitable. We looked at some stuff in the survey, and we weren't doing as well as others. So if you don't know nationally what's going on, or even hopefully if there's enough people in your region that are completing it where you can get some reliable information, it's hard to judge really how you're doing. And having those answers for physicians, like this gentleman said, you know, doctors, what are they trained to do? They're trained to follow the facts. They don't go in a room and guess and listen to opinion. They're going to look at the facts of what they see. And it's the same, at least in my experience with my doctors. When it comes to data, you can tell them until you're blue in the face. But when I show them the data, their reaction is tremendously different. And we use it in our practice, you know, at least once or twice a week doing things. We've used it to make decisions on adding new service lines like PT, neurology, MRI, rheumatology, podiatry. You can look at different things that maybe, you know, a doctor will go to a meeting, come back and say, hey, they're doing this somewhere. Have we looked into it? So we use it. You can get a lot of data. You use it when it comes to your own compensation. My compensation package is tied to our overhead based on where we are in the AOE survey. So I've used it more than once to increase my value to the practice. And you can do the same. Again, it's hard for them to refute if you have the data. So I guess what I'm saying is I was like you in 2016. I didn't know a lot. I was, you know, I was worried about how difficult it is. It's time consuming, yes. But it can definitely, with hopefully some of the tricks and the things that we're going to give you here, you'll want to participate. And, you know, if you can do the whole thing, that's great. If you can only do certain sections, the more data in those sections is going to help people. You know, some people don't have MRI. Some people don't have PT. So you don't have to deal with that. So if you can just get started and then maybe add a little bit each year to where you get more and more comfortable, that would be great. So I guess now we want to dive in and start going through, Vicki. Do you want me to go over the resources and stuff? Yeah. All right, I'm going to advance through a few slides here. Oops, got there sooner than I thought. All right, so we have created a lot of guides and tools and resources for you to use as you complete the survey. So hopefully you've had a chance to look at this. If you go to our website at aoe.net slash benchmarking survey, it'll have a link to all these sources on there. But I'll give you the highlight here. You can also, when you get into the online survey, there's a link to those resources there as well. You might not want to print all these out, you know, like the data entry guide that I'm showing here. It's a long document. It's meant to be a question-by-question overview of what we're asking for, so those item-level definitions. Those definitions also exist within the online survey itself. So as you're completing it and it pulls up a question, you'll have those instructions that we have worked over the years to refine, to be as clear as possible what we're looking for in each section and each question of the survey. So that is a true survey guide. The next one we have is a cheat sheet. So this is a shorter version of that. It's really looking at the overall purpose of each of the sections to give you an idea of what we're looking for, what the information needed is, and what resources you might want to access as you're completing it. You know, some of you are in smaller practices and you will complete all the data because you're the person that has access to everything. In Beverly's case, he has a bigger practice, so there might be three or four or five people working on it because you have to get information from your human resources department and your accounting department and your practice management system, right? So all those data might live in a few different places, so we're trying to give you a clue as to who you might want to access or, yeah, which team members to ask for that information, what systems to pull reports from, that kind of thing. And then it also included a couple common questions related to each of those sections. So that's a great starting point just as you're preparing to complete the survey. And please do stop if you have questions. We want to make this as interactive as possible, so if I say something that's like, I looked at that and I had a question about something, please let us know. This next one is data sources and reports. So this is another one if you are going to your human resources professional in your practice and saying, here's what I need, there's a little bit of a, here's what I need from payroll, right? Here's I need the salary wages for all the employees. You're going to need the compensation data for your physicians, the W-2 forms, you know, all those things. So we have it kind of by section to try to detail which data sources you're going to need access to and what reports you might need to run. You guys have anything to add to that one? No, I just like Vicki said, everybody's in a different size practice, so everybody's going to be different. I mean, I've only got 80 employees. So what I do, I do everything, I am HR. So basically what I do is I just take out the W-2s and put them in stacks by what, you know, these are my extract texts, these are my front desk, these are my nurses. So that way when I have to go enter them, I have them all. And of course it gets a little trickier the bigger you are if you've got doctors that are, you know, they're drawing salary, they're getting K-1s, you know, they've got real estate income from an ASC or like in our case, our building is a separate entity that all the partners own. So that real estate income, you have to go get the K-1s from that. But it's information that is, if you're in a position like me where you're running the practice, you have access to everything. If you're in a bigger practice like Beverly, it's going to be a little bit more difficult. You're going to have to talk to a number of people. All right. So this is a survey checklist. So this takes each of the sections and that kind of itemizes what questions you're going to be asked or in the case of employee salaries, it tells you which positions we're looking for within each of those areas. For expenses, you know, what do we mean by medical expense? It gives you examples of what is included in there. So again, this is a checklist that you could give to other colleagues in your practice or you can use as you're working to complete the survey. All right. Go ahead. Kind of a little nuance on FTE. Our practice works four days a week, Monday through Thursday. Thirty-seven hours is considered full time. So in my mind, all my years with other places, 20, you know, 2,080 hours. It's pretty tight for us. It's not. Is there anything I have to worry about in the outer? No, we don't record hours in the survey. We do designate whether the employees are full time or part time, and then you just enter their salary. Because, yeah, like my practice, we're open five days a week, but I do have some that work. Like my MRI tech only works four days a week. So there is those kind of variances. So, yeah, they're full time for benefits and everything like that. Because she works 10-hour days. And I do have a few that work less than 40. So we don't record hours. It's just income. And if you designate them full time, part time, you know, if they're half time, you put 0.5, a quarter time, 0.25. Any other questions that come to mind? Okay. There is a frequently asked questions section on our website that you can check out as you have questions, like maybe before you send me an email saying I have a question. You can look on there. Some of the most, you know, this is an accumulation of questions I've received over the years. So it's a good starting point and it is set up so you can search some keywords, just start with a couple keywords and see if you can pull it up, review through there. So there's a lot of good questions and answers available. So again, our website is a good source of that information and you can always contact me. Data at aoe.net will get to me. So if you have a question and my name's harder to spell, you can't remember it, you can. Data at aoe.net is a good place to start. So, and we have a couple copies of the tools that I just went through here, so we could pass those around as we're working with you. If there's some questions, if you want to take a look at them, I do encourage you to download those. I also pulled out that these are all on the completing the survey side. There are also a lot of tools that we have for how to use the data. A couple of you said, well, I have the data, I don't know what to do with it, right? So we have some information about, you know, what are the, what's the overview, what are the formulas used, tips and tricks to maximize the results, and that's come from the Data Analytics Council over the years, is how do you get started, what you look at. And not just a single report, but you know, if you're looking at compensation, you also need to look at productivity. And if you look at accounts receivable, you might also want to consider your pay ranks, you know. So a lot of those reports work together and that's really what we've done there to highlight some of those things. Using your benchmarking data, we've had a lot of sessions like this at conferences over the years and webinars, so there are other education sessions available too for the recording, and you can always look that for the recording from the conference. You want, yeah. I'm going to pass these out to you in a minute. There's also a session on this later in the conference. This is insights from top performing practices. Every year we have a consulting group that goes through the data and they pick out certain metrics and pick out practices that are performing very well, and then those practices give their insights and how they've done things and what they've done to improve their practice. So I'm going to pass these out to you. I will say, aside from these resources, like Vicki said, reaching out to her, and then if she can't answer it, she will forward you on all the members of the council. There are nine of us now. There's nine members. We all are open and willing to get on phone calls and talk to people and share information and help any way we can, because like I said, it's really in everyone's best interest to get the best data possible. So I'm going to go ahead and pass this out. Yeah, I would really reiterate that. I've heard a couple of times that one of the barriers is, well, my practice is so unique that I'm not sure how I should enter that into the survey. Talking to the other council members can help in those cases. You have all practice sizes represented, a lot of different practice sizes represented in the council, and we can even connect other volunteers. So if you're concerned about how is my data going to affect overall results, we can connect you with the right council members, have that conversation and their perspective. It's not a perfect science in benchmarking, but your data is valuable and there are uniquenesses, but there's also a lot of commonalities, so it makes that data very useful. Terry mentioned that we don't have a minimum requirement for how much of the survey you have to complete. We do encourage you to complete all of it, obviously. We want you to complete as much as you want to have that comparison data, right? The power of the benchmarking results comes from your ability to compare your practice's data with the orthopedic benchmarks. So if you are interested in physician compensation and their productivity, then you need to complete the tier one to make sure you have all that information available. If you also want to look at detailed overhead, you know, how do different positions, employee positions compare to other practices? How do your expenses in a lot of different areas compare to other practices? You're going to want to do more of the survey, and that would be tiers one and two, right? You can see the details of what's included in those tiers there. Tier three really rounds out the survey, includes some of those, you know, less often used, but still important pieces. You know, there's some information we collect on the information systems you use. It's also, you know, end of career type of things for your physicians, call data, you know, recruitment data for new physicians, things like that go into that tier three. So you can decide how much of the survey you are able to complete and how much you are, you really want. So if you're just getting started and you're not sure, start with tier one and you can, on the line, you can customize it and you can change your mind. Like it's like, I'm not sure, so I'm going to just click tier one and I'm going to go through it. And, you know, maybe you're like, well, that wasn't so bad, so I'm going to do more. The next time you load the survey, you can click tiers one and two and expand that out so that you don't, you're not set on that selection at any given time. Questions about that? And one thing that is helpful is once you complete the survey the first time, the next year, your information is going to pull forward a lot of your, you know, your doctor demo. You're not going to have to enter that every year. You just may have to change it if, you know, if someone left or if you had a doctor at the practice. So the more times you do it, the easier it gets. Okay. Does everybody have their survey link and or downloaded the Excel version? All right. Does anybody not have access to their link? A few of you. All right. So at some point when maybe when Beverly and Terry are talking, I can come around and help get that information to you if you have your computer so that you can see what we're talking about as we're going through it. Definitely want to make sure you have that link before you leave today. And you can see that there are a few options for Excel. There is a complete Excel version, right? So the ideal for us in terms of data controls and your ability to customize your survey experience is to do it online because it's been built in a way that allows that customization and allows us to really, you know, have, you know, the minimum and maximum data limits and things like that. So the accuracy is best in the online experience. But we know a lot of your reporting and the format that you get the data out of your systems is more consistent with an Excel format, which is why we also provide an Excel version. They map very well. They map very well together so we can get your data in. So if you complete the Excel one, you can go to the site listed there to download the Excel file to your computer. You can complete it and then you can either send it via email or you can upload it at portal.aoe.net using your email address that you have in your membership record and then upload it into that system. And that's a secure password protected site and we'll download it and we'll map your data directly into the survey. So go ahead, question. We use the Theta. So what if I just go to a Theta and just make reports and upload that? You can, you pull the reports and then you'd have to, you pull the, populate that into either the Excel version or, you know, enter it into the online survey. Do you have anything to add to that? No. Okay. Yeah, I know everybody's systems are different, so the reports, but yeah, there's too many different EMRs, practice management systems, out there to have one way to ingest all that data. So there are compromises providing these different versions of the survey to make it as easy as possible. I think we did tier one last year, email to an Excel version. So then when we go back this time and we go to the portal version, that information will be in the portal version and we can just continue doing it. Yeah, really all your text-based responses, you know, so if you entered, you gave us all your individual physicians and their like identifying information, their FTE status, their specialty, things like that, you'll have a record for all of those physicians already in the online survey. And then you'll go and edit their information for the productivity levels and compensation and so on. Yeah, that's a huge time saver. The fee? No, no, no, it's all free. Yeah, so it's a free download so that you can have access to it and start working on it on your own. So yeah, freely available. Yeah, so you know, when the data submitted to AOE, it's coming to me, you know, I'm the data person, you know, on staff. So we have it and that the Excel version, the portal.aoe.net is our data portal, and it is password protected, secured, upload, we'll download it securely, and then we'll map your data into the online survey. And the only time your data is combined, combined and aggregate with other participants, you will have the ability to see your results in comparison to that aggregate, but no one else will see your data, individual data. So it is very confidential. Yeah, by October 1st is always our goal. There's been a couple years we've missed that, but last year came out towards the end of September. Yeah, so there's a little lag. So, you know, we try to be as aggressive as possible and balance that with giving you the time to complete it. So the survey is due on July 15th, and that deadline is important in order to, we need at least a month, month and a half to do the reports and then the Council reviews them to make sure that, you know, validity check on the data, does it make sense, you know, are there any outliers affecting the data, things like that, that we need to resolve before we publish the reports. And that... Your data is based on the fact that they are doing the surgery and for the surgery and surgery and all of that. It's based on, when you talk surgery, it's based inpatient, outpatient cases. And but it is, you can drill in and divide by specialty. You can, yes, you can divide by specialty. Yeah. So when you report and then you report your productivity data and compensation for a physician, for each individual physician in your practice, and you identify a primary practice specialty for that physician. And then that's what we use to give that by specialty data. And just since we're talking about that, we'll talk to touch on a couple others, the types of things you can filter through the data, you know, specialty, years in practice, number of providers. Like, you know, if you're a four provider group, you may not want to be compared to a 30 provider group. So you can drill in and look at just practice is your size. You can look by revenue level, you know. Location. Location, you know, state or region. So there's a lot of filters built in that you can be as broad as you want and look nationally at just, you know, because we all have that doctor, all he cares about is what's his over here compared to everybody else in the country. But then you do have some specialists who want to know how they're doing. So you do have that to be as broad or as narrowly focused as you would like. Well, we have sessions every year. There's one Sunday morning. Beverly is speaking at one on utilizing the benchmarking survey. Yes, maximizing the return or maximizing the value of benchmarking through participation is the title of that one. Another session you can, not to plug all our sessions, but another one that is to watch for secrets from top performing practices. So the a few of the practices that are highlighted in this handouts agreed to be on a panel and they're going to talk just, you know, really how they've used the data to improve their performance and lessons learned throughout their practice is not all about the data. It's just really, it's a great session to learn their tips and tricks, lessons learned through some of the things they've done within their practices. And then a discussion about how the data has played the role in those decisions that they've led to. So those are the two that you could also look for. Yeah. Okay. So I just typed it in the top, download Excel template. Okay. I type that in. So then I got this on my computer. So you're saying I can just start filling in the data here? Yeah. As long as you've downloaded it to your computer. So you don't want to enter it right on line into the, you need to make sure it's downloaded. Yeah. Okay. Yeah. So you're saying you can just, and then when? Once you complete the survey that you've downloaded, then you can go, you can, if you're comfortable, some people will are willing just to email the, as an attachment, the survey to data at AOE.net, which again, I will take. And then I will say that securely, and we'll do our mapping that way or portal.AOE.net. You, you will have your username will be in there already. So you should do your email address that is associated with your AOE membership. And then you can use the reset your password function to retrieve your password. And then you can go into upload that information and I can walk you through where that upload section of the site is. Yeah. In the back. You know, in my experience, like I said, MGMA tends to be more hospital-based and more like university system-based, not so much independent practice. So it really depends what practice setting you're looking for. That's, you know, MGMA and AOE both cater to all three of those groups. But we have found, and Beverly could speak more to this because she does the MGMA. I have found the AOE data to be more in line with independent physicians. Yeah. So MGMA definitely has more hospital data than not. They do have filters now where you can filter out the hospital data and just look at independent physician-owned practices. However, some of those metrics just don't have values because they just don't have enough volume to support that. And I do know that many times my physician, my executives will tell me they want the AOE or OrthoForum data because it's all, it's more applicable to the way our practices run and the data just is more sound. All right. Last thing to point out, we did add a new feature this year, which is if you want to do a hybrid of the Excel and the online survey, though, you know, I believe there's, you know, all the different sections have their own challenges in terms of the data entry, but the volume, especially for larger practices, if you have 20, you know, physicians and then, you know, 40 providers, that's a lot of line by line data entry. You can choose to upload those provider sections, the provider compensation and productivity in an Excel file. So there's one for physicians, a tab that includes both PAs and NPs, and then another one for your therapists and your athletic trainers. So you could just do those three sections in Excel, provide it to us, we'll do the data, you know, the mapping of the data in, and then you can complete the rest of the survey online. So that is another option to try to facilitate some of the repetition and some of the challenges some people reported with the online survey. All right. Do you want to tell them about the incentives? Yeah, if I can remember that. So we do have some incentives available for participation, and those are based, we really want to encourage those of you that have not participated in the past to participate. And so again, you can go to aoe.net slash benchmarking survey and see kind of what those are. But you will get, you have a choice of a discount off of next year's annual conference or a gift card. And the level of discount and gift card depends on whether you participated in the survey previously or not. So if you're new, you'll get a little bit more and it tears down. And we also like to encourage participation in the survey prior, so we can start building those reports, which helps facilitate those reports getting to you sooner. So if you complete the survey by June 1st, you'll also get some access to educational sources, courses that we have available. So be encouraged, you know, it was really helpful to us as a council and me as we're developing the reports to have that data to base those initial versions on before we finalize the results. And also when you participate in the survey, you get free access to not only the online results we have in the AOE data portal that allows you to customize the results, you also get access to the results ebook that provides the data in a PDF form. And a lot of members say they like that because they can print it out and have it on their desk. Physician ask a question and once have an idea about a benchmark for something, they can flip right to that resource. So we have that as another way to get it. So you get free access to both of those reports and also the opportunity to talk to a consultant from Doctors Management about your results. They can be, they'd be really helpful on how do you use the data that you've got back. It's just a 30-minute free consultation with experts from Doctors Management to help kind of get started and give you some initial action items based on your data. Okay, questions? All right, I'm going to turn it over to one of you, I think, because the next several sections are really working through what data we're looking for in each of the sections. You know, the first couple will be pretty basic, you know, demographic information, but then we can talk through the various sections. And those of you that don't have your survey link, if I can come around with my computer and help you get that on your computers, if you're interested, you just let me know when you see that I'm done. I can kind of get that set up as we go through it. And again, we're meant to this, we want to workshop with you a little bit. So if you, when we talk about a section, if you have a question about that, you know, your system or what reports or, you know, talk a lot about allocating to various service lines, things like that, where it can get tricky, please, let's just have that conversation when we do it. So that's why we're excited to have the pre-con, because we have a little more time to do that than we would in a typical 40, 45 minute session. So that work? Okay. I'm going to redo it. Terry's going to do it because I have to admit I've never done the online survey. I have 50 physicians and 250 like mid-levels and therapists. So I always do the spreadsheet. It just is so much easier for me. So Terry's going to go through because he's an expert. Oh, thank you. Online entry. So the first section you're going to come to is the one that all of our doctors care about the most, and that's their compensation. So that's what a lot of this is geared toward, is toward getting good information. One thing I will say we've just started doing, you know, when you bring in a young doctor you're recruiting, you really don't want to show them your books too much, at least not in our case. But we do show them where we are in the survey so they get an idea of how the practice is performing. So we've found it very useful, and we've actually had some candidates tell us they really like that because a lot of practices, like I said, you know, they're going to tell you everything's great, but they might not share the data with you. Nothing's worse than getting a doctor in for a year or two and then they decide to leave because you've invested a lot of time and money in getting them up and going. So that is one thing we've started doing recently, and it's really worked well for us. So, you know, the provider compensation and productivity, it's going to look at your physicians, both partners and employed physicians. I know a lot of us have employed physicians, maybe some subspecialties like podiatry, rheumatology, even some neurology, some people that maybe aren't partners in the practice. Obviously, PAs becoming more and more a part of practices everywhere, and, of course, nurse practitioners. So this section is going to look at all your providers there. Now, if you have PT and DME, that's going to come later. They're providers, but that's going to come in a different section. You know, so you're going to look at patient visits, you know, the number of new patient visits, the number of total visits they see in a year, and that's going to include, you know, your global, your follow-ups and things like that just to get an idea of, you know, because you've all got those doctors, you think they're working really hard and then you show them the numbers and they're really not working as hard as they think they are. So you're going to look at visits. That's also very helpful. You can get some things. I know some stuff was on. Does everyone here get Collaborate or participate in Collaborate on the AOE website? That's a tremendous place to go for resources. I know recently there was some talk on there about, you know, number of surgeries per new patient visits. A lot of clinics like to look at that. So that is one thing from the survey we get by looking at that. You know, some of us, I don't have any more, but some of us do have doctors doing IMEs. So those are included in there as well. The number of injections, you know, this has been, this has confused some people in the past, I'll be honest. We're looking more for, or the survey is looking more for like VSCO-type injections. You know, we had some people enter in their Depo injections and we were getting very, you know, skewed numbers. You know, we don't really track those because, I mean, that's not a high-ticket item in terms of cost. If you do a lot of them, but we're looking more at the VSCO with all the talk recently on VSCOs and reimbursement for that. So that's what we're looking for when we talk about injections. Obviously, surgical cases, like we talked about, we're looking for inpatient, outpatient. And we're looking for cases done in a hospital inpatient, hospital outpatient, and also ASCs to kind of get an idea, you know, to kind of know where the profession is going. We've got to be able to look ahead and see, you know, more stuff obviously is shifting toward ASCs. It's interesting to follow that trend and see if it is trending like we all think it is. One thing that, again, causes some confusion in surgical cases is you need to make sure you're pulling specific patients. We have some people who pull just all their surgery codes. Well, if you have a person who put four codes on one patient, you know, you're going to have, you know, one and a half surgeries per new patient visit, which is so we're looking for unique patients when we're talking about surgical volume, not the number of procedure codes. And you also kind of got to tease out because some fracture charges fall under surgery and some practice management programs. So you need to pull those out too. You know, obviously, unless it was something that went to the OR and had to be manipulated or something like that, your fractures done in the office, we're not looking for those in surgical cases. Work RVUs, this all depends on your system. My clinic does nothing based on RVUs. We don't track them. We don't use them. My managing partner tells me he can't spend an RVU so he doesn't care what his RVUs are. So that's just my practice. For some practices, it's very important. I know if you're hospital-based, probably everything is based on RVUs and your doctor's compensation is based on that. So that's just one of those things that's going to vary practice by practice. So obviously collections, when we're talking collections, we're looking for just the collections that they generate for their professional services. You're not including anything they make on PT, MRI. You're going to back out their DME because there's a separate place for that. So you're looking for basically their E&M, their surgical injections, fracture care, things like that. And also you're going to back out their DME because that's going to be, if I didn't say that, that's going to be captured in another section. And if I could just pop in here for a sec. All of these are defined in the online survey as you're going through. So you'll have, you know, when you get to those sections, there's a definition for each of these. So you can then go into your practice management system and understand what filters you need to enter to pull the data correctly and accurately so that you can get the right numbers to put in here because you're not going to remember all this when you get home. So just know that all the definitions are in there and it's easy to find and then you'll know what data to pull. And we can even help you here if you have access to your practice management system. Like I've used Athena and NextGen, I can come over, I can help you, I can show you how I do it. And then it might help you to be able to do it. Yeah, what's your case? I pulled the numbers for 2023 on surgeons. And I know what you're saying because, you know, I'll be a whole list of CPT codes. One CPT code, a whole bunch of charges. Yeah. And I'm like, and I see all of these. I go, you couldn't possibly have seen all these patients. Obviously, it's three or four CPTs equals a patient, a counter or surgeon case. Yeah. So then how do I figure out what that is? Well, that's going to depend on your, like my practice management tells me, it tells me the number of units, but it also tells me the number of cases. So I may have a guy who did 100 cases, but there may be 400 CPT codes. So it pulls out the unique – it should be able to pull out the unique number of patients. So I need to go back to the fee. Yeah. It's a different question. I can tell you. It's in Report Builder. You can filter for your surgical codes and your surgical locations. And then you can pull claim IB. Okay. Yeah. Let me look it up. Sure. All right. Very good. But, yeah, so that has created a lot of – we as a council sometimes sit there and say, how is this number possible? Because you may have a hand guy. He may do six codes on one procedure. A hand guy? Yeah. He smiles? Yeah, and he's going to pay $800 for those six or seven codes. So, yeah, that skews the number. So we definitely want to be cognizant of that. Yes. If you have Epic for an example, you have all this information in Epic. Can this be degraded? No. Like we said earlier, because there's so many EMRs, it would be impossible to – because not only are EMRs may term something the same, so it would be too hard to map. That's why we give you the different options of being able to – you know, you're going to have to pull the reports and then enter it either in the online version or the Excel version. Hold on. Yes. But in one patient, maybe they have. Mm-hmm. We're looking for just the one patient. We don't want all 10 codes because that's going to make it look like 10 different surgeries and it really was one. Yes. For injections, we have key measures that we go to. We only go to those two injections. I think we just asked for joint – it defines it in there as joint injections. Yes. Because that's – you know, I know that's very common, a lot of people doing those. But, again, that's going to kind of vary widely. Like we do a lot of prolia injections at Mikelin. We do a lot of bone health. We don't include those in ours. So it's just those viscose. And really that's because it's become such a hot topic, you know, who's doing them, who's not. Is it trending up? Is it trending down? Just trying to give people some accurate information. Again, compensation, you know, depending on the size of your practice, that can be a little bit difficult because, you know, you've got W-2s for your providers. You may have K-1s for – you know, I'm an S-Corp, so my guys draw a salary on a W-2 and then a bonus on a K-1. So you're going to have to pull those. Your real estate, again, or ASC earnings might be on a different one. My ASC is a joint venture with the hospital. So I don't – and the doctors are individual investors. So I don't see that number, so I just don't report on ASC. I just leave that one blank. Hospital pay, you know, that's – a lot of times that's call pay. That's been a big discussion on Collaborate a lot of the time. That is in the survey. And I will tell you that my doctors have used the AOE survey to negotiate higher pay call from our hospital. So it's in there. And it's based – you know, it's broken up by trauma level. So, you know, obviously your higher trauma centers, they're getting more. So that is a useful one. The doctors like to know what pay-for-call is going on. So just on the right is just kind of what it looks like in the online version. You know, you're going to enter the basic information. The initials are just to help you identify them, you know, down the road. I believe it asks in there for, you know, number of years in service because, obviously, a sports medicine guy in his second year is probably not going to be making the same as a sports medicine guy in his 20th year. So it is important to know those kind of things. And those – a joint guy the same who's building his practice isn't going to be at a compensation level of someone who's been practicing 20 years. So anybody have any questions on compensation and productivity? That's, you know, again, that's every doctor's most important topic right there. Yes. No. No, just this goes in general. That's something we could look at. And although the way it's trending down, I don't know if it's – if it continues to trend down, I don't know if that's something we would even want to – If I could go back to like you have a different for the MD versus media. The DO versus the PA slash it can be – We have, yeah, physicians because the DO is a doctor. So we have the physicians and then PAs and MPs are broken out separately. Fellowship. We're in the physicians. If you have fellows like we do, they're also listed in the physician section, but you can identify them as fellows. Sorry. Continuing on that. Yeah. So, again, there's the – this is just an example of the instructions you can get by going to one of the helps. You know, when we're looking for new patient visits, those are the codes you basically want to pull from your PM program. You enter those codes, you pull them. Your total patient visits, you know, you're going to pull everything. You know, it includes, like I said, your globals and your things that you're not going to reimburse for, but you want to know their volumes. Surgical places, again, reporting the number of patients, not a count of CPT codes. And then gross charges and net collections. You know, the Incident 2, if you're billing like that, we don't – our PAs all bill directly, but that's going to – Incident 2 is going to come in your PA and MP section. And then your in-office ancillaries, again, like we talked about, are going to be reported differently if you have those. Any questions? No? No. No, you're fine. That's why we're here. Well, if it's a different problem. Established patient? I'm sorry. Yes. You filter using the code. Yes. Okay. Because we do have a consult. We do have a new patient with a new – a new patient means – I'm sorry, established patient with a new problem. Right. And you have a follow-up. So we do have a post-op and we have a pre-op. We have those, too. Those are like the appointment types. So what I do is I look at the claim level detail to pull the data. Because you're looking at – you need the codes. Because sometimes a new patient will come in, but it can't be billed as a new patient for whatever reason. Maybe they realize they were just here two years ago or we have several specialties that you just can't bill a new patient if they saw someone from a different specialty. So I always look at claim level data and I use the codes that were billed. So like the new patient visit is a 99201 through 99205. So regardless of what the appointment type was, I always use the claim level data. Yes. I do it by the same way. I pull my reports by the codes. Now you get into your therapists. That's your PTs, your PTAs, OTs if you have them. You know, your athletic trainers. In some states, your athletic trainers can bill in physical therapy. In other states, they cannot. So, again, you're going by their type, which one of those they are, their years of experience. Because, again, that makes a difference. Their FTE status, again, that goes back to if they work halftime, you're going to enter them as 0.5. If they work 20 hours a week, they're going to be 0.5. If they work 10 hours a week, they're going to be 0.25 and just kind of go from there. And this is just for billable providers. Yes. Like we have ATCs, but we can't bill for them where we are. So we don't have ATCs in here. But some practices do because they can bill for them, but we can't. So we would not include them here. Yes. PTs and PTAs come through CORA. Just pretend CORA doesn't exist. So we use the partner with Athletico, and I would get the data from Athletico and include it. So it just depends what access you have. You have access. But it doesn't matter. No, if you have access to the data, I would include it because it's great data to have. Yes. Because it's good to have and it's not going to affect you when you're looking at physician compensation. So when you get an ancillary income, again, that's a separate area. But it will help you see like the number of therapists per physician, you know, those types of metrics. If you can include that data, you'll have access to more metrics. Yes. And you'll get like, you know, the number of units per visit. You know, obviously, the higher you're trying to get as close to four units per hour, you know, as you can. So you should be able to get all that because that is included in the survey. So, you know, you can enter their base compensation, bonus compensation, and any other compensation. And, again, the cheat sheets kind of define all this for you and help you pull all that data. Practice administrative is one that's important to a lot of people in this room because that's how we all get paid. So we do have it. You can list your title. Your base salary. The bonus and benefits. We do ask for gender. You know, I think we had a thing yesterday that said 51 percent of the administrators, I believe, are female. Forty-nine percent are male. This was based on data a couple years ago. So we do ask for the gender. You know, the professional certifications, if they have any, you know, if they're through NGMA or anything like that. So highest level of education, obviously. These come into play in the filters when you're trying to justify to your physicians your salary or the fact that you may need a raise. You know, like I said, it's nice to be able to go in and say, well, this is what administrators at other practices my size, our size, are being paid. And this is another one, like I said, I have used this personally with great success to justify my role and my compensation. So very important for those of us in this room. Our doctors probably wouldn't think so. Any questions on that one? Sorry, I should have asked before I moved on. Now, this is the one that, you know, we get a lot of questions about this on Collaborate. You know, what's the average salary for a front desk? You know, what's the average salary for an MA? This is another reason why the more people we can have participate, the better, because my dad in Alabama is greatly different than the information just 90 minutes away in Atlanta, Georgia. You know, I don't have to pay what someone in Atlanta has to pay for a lot of this. So that's why it's important to get more people to participate so you can get accurate data. But it is also good to know, you know, just kind of make sure you're at least in line with where things are. So you've got your revenue generating staff, obviously, in orthopedics, PT and OT, DME, and other ancillary. You know, you may have MRI. You may have, like I said, podiatry if it's considered an ancillary, pain management if that in your practice is considered an ancillary. You know, you've got your PAs and your NPs. This data is going to pull forward from, if you entered it in the compensation section, it's going to pull forward into this section. So this may be where some people were saying they saw repetitiveness. You'll see this also with the physical therapy. It comes up a couple times. And I know that happened to me when I was doing it. I'm like, I already entered this. Is this the same? So I know what you're talking about on that. So and then you're going to look at your PT and OT staff because, obviously, if your PT is generating revenue, you don't want to lump them in with your office staff that's, you know, maybe not directly generating revenue or not as involved. So in our practice, you know, our PT receptionists and all that, our PT billers, they're all broken out of the orthopedic income or orthopedic expenses and they're expensed under PT. That's gonna depend on how deep into it you wanna get based on your practice. If you have the ability to go in and say, well, how we do it at our practice, I'll just tell you, if PT is 10% of our total collections, then PT is paying 10% of the business office cost is being expensed to them. Really, it works out as a wash because if it wasn't being expensed to them, the physician's compensation from PT would go up by that same amount, but their expenses would also go up. So it's kind of a wash, but it's good to know so you really know what your PT is making and what it's costing you and it's not getting lumped in with other things. Hope I didn't lose anybody and confuse people there. So MRI is the same thing. With our MRI staff, we wanna make sure that we're allocating expenses to them. Otherwise, it's gonna look like MRI is really profitable, but there are costs associated with it. So you go through that. Your athletic trainers, again, only if they're able to bill for services. Your clinical support staff, obviously, you've got your x-ray techs, MRI techs, therapists, DME, other ancillary, and that can run the gamut again on practice from RNs all the way down to just MAs and nurses' aides. So it breaks it all down by that. Yes. Is there anything in the form that talks about, again, your athletic trainers, outreach programs, and referral, these kind of things? No, we do ask later about athletic trainers and if they work in outreach, but no, we don't have a method in there to track that because, again, I think that's gonna be very, very greatly by practice and it'd be, you know, that's something really to track internally, but yeah, I see what you're trying to find, you know, are your ATs working as hard as ATs in other places? So, you know, we're always looking to add things, so if that's something that we need to look at in the future, but again, that kind of comes down to your practice management, too, if you're able to track that. Like, we track it, we have to have a special code that get entered on all their referrals in so that we can go and easily pull that data. They get a billing code of AI added so we know that's an athletic injury and we can go pull it and that tells us all the ones that were referred by our athletic trainers. So, you know, you've got your medical receptionist, secretaries, you know, if you use transcription, if that's not, if you don't have Dragon or if that's not something you're outsourcing, your medical records, even if you're outsourcing it, you're going to enter that cost in the expense data. And then your business operations staff, obviously. That's all pretty straightforward, I would think. Any questions? Anything, Beverly? No. You know, taxes and benefits, you know, sometimes this, again, you're going to have to, you may have to get with HR, you're going to have to sit down and figure out, you know, not all my employees get health insurance. I got to, you know, I know what my insurance cost is per employee, but I'm going to have to sit down and figure out how many have the insurance. So you're going to have to have access to that. You know, how much any benefits are going to vary. Some people may not offer life and disability and those sorts of things. So, again, that's pretty straightforward. That's just, you know, whatever you're spending on each employee for their benefits and, you know, retirement and things like that. So, you know, your expenses then, your general expenses when you get out of, you know, obviously for most of us, our biggest expense is our staff. I mean, you look at your P&L, it's not hard to tell that. But you get into your other expenses, you know, your rent on things like your facility maintenance, your utilities, medical equipment, medical supplies, and drugs. Technology, obviously is a big expense for all of us. And you see there, outsource services. A lot of us outsource our IT. Then you've got your marketing and other, so you may be outsourcing your marketing to an outside marketing firm. So you want to make sure to capture that. You know, your office costs, you know, supplies, mailing, you know, furniture, equipment, you know, all the basic things. You know, and this is going to be as easy or as difficult as your P&L. You know, my P&L is all of six pages. So it's not that difficult. I'd hate to see Beverly's P&L and what her accounting department has to deal with with their number of employees. So that's just going to be, you know, kind of vary on your practice. And just how comfortable, you know, I look at my P&L, you know, every month. So I'm comfortable going through and knowing where things fall. If you're not that comfortable, you may have to do a little investigation and say, well, where does this fall on my P&L? Where is this expense at? So. So my P&L is, as Terry alluded to, it's quite large. I have a ton of lines on there. So what I've done, and it was painful the first year, but I mapped it. I mapped it to the fields that I needed for the AAOE survey. And then the next year, all I have to do is map the new lines. And that made it a whole lot easier because then I have just a simple income statement that I can just plug those numbers in for this. And it is, it's so much easier. But that first year was tough, I'll admit. But it's a lot easier after that. Hey, Terry. Yes, sir. In our practice, we've got a number of third-party relationships. In some cases, they take up all of the administrative support and are part of the business. In other cases, it's shared. Example is that we have rollover fund support. And we have certain routine available at busy times. In those busy times, we have a third party that also follows. Yeah, we've eliminated, for example, the front desk and chief position as a result. Billing is an example as well, where there's more support. How do we kind of consider those costs that might previously be considered compensation for support versus professional resources? Well, they're going to show up in your outsource. I mean, you're going to put them in your outsource services. Where you're going to see that is really when you start looking at your overhead, because I'm assuming you did it because it's cheaper and easier. We would share that, but really it was more for quality service. We were just lacking some flexibility. In these partnerships, you have some flexibility that we didn't have. So that was really different. We reduced how many we sent. Yeah, so your comp's going to go down, but your expenses are going to go up. And if it's about the same, it's going to be a wash. You're going to see it in your... Some doctors, old school, still like to go by the number of employees per full-time physician. You're also going to see it in your staff costs as a percent of revenue. That's a big one that, obviously your staff costs is going to go down as a percent of revenue, but your expenses are going to go up. But that's, yeah, any outsource things, like we outsource accounting, legal, that all gets recorded in the appropriate section to try, because you're trying to get as true as you can number on your overhead. Any questions? So this goes into physician expenses. Obviously it's more than just their compensation and their bonuses. You've got their retirement expense, their payroll expense, their health insurance. In our case, we directly allocate their liability insurance because it's a captive, it's an investment. So they're going to get that money back when they retire. So it's a benefit to them. So that doesn't get expensed to the practice, that gets expensed to them directly. Again, some of this just depends on how your practice operates. But I think we're all pretty familiar with our expenses. You're going to find as you do this, it's all information that you look at and have access to. You just might not be looking at it and have access to it all at one time, which is what you're doing with this. And then you're going to get this. It's going to come up and it's going to show you what you entered and it's going to give you a little bit of an income statement. So you can kind of see while you're doing the survey if something looks out of line. Maybe you got a result that you didn't think, but it's going to tell you what your orthopedic revenue was, your MRI, PT. It's going to tell you what your expenses allocated to those different service lines are. And then what the physician expenses are. Obviously in PT and those, you're not going to have physician expenses, but that should get you a net income, give you an idea from the survey. And again, like I said, it's kind of a data entry check, see if you have something that's kind of way out of line. And then you can also kind of compare it to your income statement and your P&L. One thing I'll say, and this came up last year a lot, doesn't matter if you run your financial year, we have people ask, well, what if my year doesn't run January to December? What if we run, you know, June through May or excuse me, July through June or something like that. It doesn't matter as long as you're consistently entering for a 12 month period, really doesn't matter how your financial accounting is set up as long as you're being, because if someone's on a January to December, that's 12 months. If someone's obviously on a July to June, that's 12 months. As long as we're getting 12 months of data, it should all be compatible or comparable. You know, pay our mix. A lot of us like to look at this, see where we're at in terms of, you know, is our area higher in Medicare? My area, we have to do a lot of Medicaid because to take call at the hospital, you're required to see Medicaid patients. So my Medicaid's probably a little higher than some people. My worker's comp is lower than a lot of people because we don't have a lot of industry where I am. So it is good to see kind of where your payer mix is, you know, comparatively again, with people across your state, across your region. So, you know, that's all stuff that's going to come right out of your practice management system and then your billing system stuff. You probably, like I said, look at all the time. You're just going to be looking at it all at one time. You know, accounts receivable, obviously everyone likes to look at their AR, see how you're doing, see if your staff is being efficient in turning over. So it gives you a very good report on that, looking at different things. You're the accounts, you're the financial person. Do you have anything to add here? No, it's just like our DAR is usually really good, but the volume of AR we have is not. So some metrics might be really good and some not, but it's pretty eye-opening just to, when you compare yourself to other practices, it's like, wow, you know, it's great. So that like the zero to 30 days, you'll need to know the insurance and the patient at each one of those levels. And I know like in our NextGen system, we couldn't see the patient balance versus insurance, but in Athena we can. So some PMs you might be able to see that and some you might not. But yeah, that's just, you know, like I said, it's good to have, it's good reporting. Kind of like I said, to see how efficient you are in turning over your AR. Absolutely, I mean, if you're heavily on United or, you know, just like unfortunately a couple of years ago, you know, everything was skewed because of COVID. But yeah, if you're on an area that's heavy United, knock on wood, luckily Alabama, we don't have that problem where if you are, if you're not familiar with Alabama, 85% of the commercial payer in the state is Blue Cross Blue Shield. So as long as Blue Cross was up and running, we were all, we were good. To affect our Medicaid, we don't get our Medicaid remits, but definitely if you see a lot of United, and I do, United's my biggest Medicare Advantage plan because they have the state retirement system. So all those state employees are on it. So I think you're definitely going to see some of that have effect. So you're just going to kind of have to maybe look at your payers. You'll still be able to look at your payers that weren't affected. You know, like I said, luckily we didn't have that issue. So, but yeah, and we see that things are going to skew numbers at times, things out of our control. Hopefully that'll be cleared up sometime soon for all of us. You know, ancillary services, again, the main ancillary services that most people report on are x-ray, MRI, CT, DEXA, if you're doing a lot of DEXA scans in your imaging. You're not in imaging, you know, PT, OT, a lot of DME, you know, orthotics and prosthetics. You know, some people have prosthetics in their DME program if you're a big clinic. So you may have that kind of stuff. And then obviously if you have an ancillary or an ambulatory surgery center, just, you know, kind of, again, trying to know what the landscape is, you know, how many are physician owned, how many are partnerships, you know, just so you can kind of tell your doctors, well, this is what the flavor is across the country right now, so they can kind of be prepared for what might be coming. And obviously want to see if total joints keep trending up in the ASCs, you know, it seems like CMS is adding, you know, new procedures every year that they're allowing to be done in that. So definitely, again, it's good to not only just to look at data for your practice, but you can see a lot about where orthopedics in general as a whole could be going and things that you need to be, have on your radar and need to educate your physicians on because you don't want them to be blindsided. Physician recruitment. This is, again, I heard someone say about recruiting physicians, you know, what is the starting salary right now for an orthopedic surgeon? You're competing with a lot of hospitals, a lot of, I think, Dr. Baer, who's, if you don't know him, he's a great guy. He's a physician in Atlanta, past president. I think he said that the current number is 60% of guys coming out of school are going into employment models. Not so much the partnership track. So that's what you could be competing against. So it's good to know what the starting salary is out there. You know, what kind of signing bonus are you offering or is being offered? If you want to stay competitive, you know, are you offering moving expenses? Some people do, some people don't. So, and you know, do you have a hospital willing to assist? We, you know, we have a good relationship with our hospital. They do help us in recruiting with some upfront stipend money and then helping get physicians in. So do you have that? And again, that's all in the survey and you have access to it to help you make some informed decisions. Yeah, and I will say this is one of the biggest or the most requested metrics from my admin team. They want to know, you know, because we're looking to hire a new physician, you know, we're hiring free this year. And I was asked to provide, you know, joint, hands, scores, like what are the starting salaries for the Midwest for these physicians straight out of school, you know, out of fellowship. So I was able to go to AAOE and get that data and it was super helpful. And like I said, that's one of the most asked metrics or benchmarks from my practice. I would agree. We're going through that right now as we look at recruiting and, you know, because for some practice, smaller practice like mine, it's been four or five years since we recruited and the landscape is completely different. So you need to kind of know where things have gone. Additional survey sections. These are just things that if you can complete them, they're great to know, you know, square footage, you know, how much square footage is being used for OT and MRI and CT. If you're looking at building a new facility, you may want to know what you might need looking at size-wise, nothing be worse than spending a couple million dollars to build a building and find out it's not big enough once you get moved in. So obviously a lot of resources for that, but this is a good one as well. You know, end of career, that's becoming a big one for a lot of people. You know, how are you getting doctors out of your practice? You know, how do you have that difficult decision with the guy who's slowing down and doesn't want to slow? Yeah, he wants to slow down his practice, but he doesn't want to slow down his draw. So, you know, how do you go about that? You say, well, look, this is what the industry standard is right now. This is what's going on. So that's an important one and then how you handle it. What's the retirement age? Well, a big one, when can they come off of emergency and group call? That's a big issue in a lot of practices. You know, and then the call data, very important. A lot of doctors want to know, I get asked that one a lot, probably yearly my guys want to make sure that we're still in line with where we need to be for, you know, the emergency room. Trauma, you know, some places will pay hand trauma separately, you know, because that's a very difficult field to find physicians in. And then the levels, obviously, you know, I told you it varies by what trauma center you are. And then we do want to collect information on, you know, what EMRs are out there, you know, what accounting software you use. Those are just administrative things to help people. You know, you see stuff on Collaborate every day. Hey, who's using ModMed? Hey, who's using Athena? Let's just give this an idea of that. And then some of the government affairs data, you know, who's participating in MIPS? Are you participating this year in the alternate pathway? Are you doing traditional? Things like that, just again, trying to stay on top of what's kind of going on in the profession, what are other people doing? Because if you kind of live in a bubble and you just worry about your practice, obviously you should worry about your practice, but if you're only looking at your practice, you might be missing on something. So we do ask for things like that. So back to the resources. So anybody have any questions on any of the sections and just kind of what's the data that's required and kind of where to go and get it? Well, I've been doing this a few years. I've done a few talks on benchmarking, so. But I was as scared as anybody, like I said, that first year. I mean, it's, again, but it's all data that you have and you look at, you know, or you should be looking at. I mean, so it's just a matter of taking the time to sit down all at one time. I don't do it all. I mean, you know, it takes me probably a couple of weeks because I do it a little at a time. So it's just knowing the data to pull and knowing where to enter it. That's all it is. It's not like you're making up the numbers or you're having to, I hope you're not making up the numbers or you're not having to go out and get things that you don't have access to. It's just taking the time and sitting down and entering it from what you have. And if you have questions, you refer to one of the resources or reach out to Vicki or any members of the council, you know. You know, we're not on the Data Analytics Council because, you know, we just like to get together once a month. We all have a love of data and we know the importance of the data if you want to stay competitive and stay ahead. So that's why it's important to us. And we do these sessions because we want as many people to participate as possible because the data is only as good as what we get. And it's, you know, it's tremendous, can be a tremendous asset for your practice. Yeah. So- It's too likely to make up our P&L. I think we'll have to do better. Yeah. And I mean, I have probably a hundred reports that I pull for all of my surveys every year. So I just go through, I spend like three days just pulling reports and I look at what I did last year. These surveys don't change much each year. I don't think AAOE changed at all from last year. So, you know, you're always pulling the same data. So like I have my filters on each report so I know what to do. It's just wrote. I just go in and I just pull it and it's there and it's ready and it's filtered and it's pivoted and I just copy paste. It's much easier. And if you're in a smaller practice like I am, well, you're probably already doing everything. I mean, a lot of that you probably looked at at the end of the year. You probably looked at volume. You probably looked at payer mix. You probably already have that report. You may have thrown it away since then or shredded it, but you know, you've already looked at compensation, you know, cause you probably did your fourth quarter bonuses or however your physicians are paid. So you probably had a lot of it already. It's just the time to take down. And again, I understand the confusion, some people not knowing where do I pull this from or what's the right number here, but that's why we're here to help and that's why these resources are out there. Any other questions? Yes. Yes, each year you'll have the opportunity to go in and edit it. You know, maybe a guy went part-time so you can take them from full-time to part-time. You can take them out completely. You know, maybe they went on sabbatical or something. You take them out for a year and you bring them back. So yeah, once you've done it once, it's all in there in the future. What do you do with the time that the physician has gone? Have them all ready or sit down? Reduce their FTE. If they're gone a long time? Like I do, like if they go on sabbatical, if they go on maternity leave or something, I just reduce the FTE. But we do ask in the survey the number of days they worked a year. Do we still ask that? What? I think we may have just added that back in. Yeah, I think we ask, you know, but again, like Beverly said, you would just reduce it. If they were out for three months from maternity leave, then they'd be 0.75. So, you know, if a guy went out, God forbid he had something happen, he had to have surgery and he was out, which, you know, they're humans just like anybody else. They go skiing, they go do crazy stuff and they get hurt. So again, you just would reduce it. I mean, I'm not talking about when you do, you know, just 0.25, 0.50, 0.75. I mean, I sit down with my payroll summary at the end of the year, the same one I have to send to my 401k actuary. So I've already got their number of hours worked. I divide how many hours they worked by 2080. And if it's 65%, then they're 0.65 FTE. So. All right, I'm gonna turn it over to you, Vicki. I'm just gonna say, I think that, you know, that was the overview of the survey. And I think, you know, we have 45 minutes left for the session. And it'd really be great to connect with each of you, you know, starting with, if you don't have your survey link, or you have an app downloaded the survey, or if you wanna download it and look at it with one of us, let's use the next 45 minutes to do that. If you have any questions, some of you had questions about reports and what those would look like. I could try to pull a few reports up and, you know, walk through those with you on an individual basis. Just what, you know, I'm sure you have some questions that you'd wanna ask one-on-one and not necessarily in front of the big group. So we're happy to use the remainder of the time just to do that to your benefit. If you wanna get in online and get your survey link, we can get started. If you have your computer and actually do some of those sections together, enter a couple of providers, whatever would work for you. So that would be the vision for the next 45 minutes or so, if you're willing to stick with us here and ask those questions. Definitely wanna make sure all of you have access to the survey before you leave. So if you don't have that link or the Excel file, please come see me. I can help you get all that information and then Beverly and Terry can help you answer some of those questions that might be very specific to your practice. Or if you think there's any barriers to your successful participation, now would be the time to let's talk through that so that we can support you in the best way we can. And like Vicki said, we do have, unfortunately, we don't have enough copies of these to give everybody, but you're welcome to come and take a look at it. If you'd like to take some pictures with your phone, you can. These are the cheat sheets. They're available online, but if you just wanted to have those now, you could certainly do that. We'll be here to help you any way we can. What would be the check-in code? Yes, the check-in code is 511216. There should be a check out. Can you advance the slide? Sorry. There we go. That's the check out code. That's not in there. That's different than what's... So ignore that. 511216. That's the check-in. Yeah, so there should be a check-in. Oh, I'm sorry. 203721. I'm sorry. 203721. If you're applying for AAPC credit, this code is 88598GSE, and the GSE are all counted. So again, if you're applying for AAPC credit, 88598GSE. The check out code is 203721. So if you don't say, thank you very much for coming. Those of you who are new attendees this year, I see a lot of you. Welcome, or we're grateful to have you. I hope you'll have a good show and be back to join us in the future. And those of you who are returning and haven't done the survey yet, I hope you'll at least give it a try. We really would like to have as many people participate as we could. So thank you all again. We'll be here. If anybody wants to stay, we'll help you work on it. We'll answer any questions you have. Go ahead, Greg. Bringing up his computer. Can you turn it on? Right. Yeah, it's like, what am I even doing? Yeah, that's it. It's done some stuff, so just move on with it. Hey. Hello. I actually attended one of your training on financial report online one time. I remember I sent an email to you because our practice size is very similar. We are also on cash basis, you know, unlike other practices. We don't work on work RV. So that's why I reached out. So the size we have grown from one doctor to four and then added in-house physical therapy. It's becoming a challenge for me to run the numbers. So I was going to see if you have sample report that you present to them. Cause I find that it's so, those numbers may be important to me, but my physician is like, okay, I can care less about that. I just want, they want to know about if they take home promises. That's about it. But then there are other factors. Like you can go in, like, you know, work RVU is sort of important just because you get to compare the national average, but they can care less, the office visit. Of course, these days nobody wants to work or they want to pay. It's all about how much they're taking home. Yes. And for some guys, it's not even about the dollar amount, at least in my group, they care about their own business. Like if I tell a guy, your overhead is 45% but you're only taking home 50 cents on the dollar, he might be happy as he thinks 45's a good number. Right. Whereas if I tell him, you know, you're taking home 70 cents on the dollar, but your overhead's 60%, he'd be mad at me. Right. I know exactly. I see. So like, how do you, do you guys normally meet as a group? We meet, see, we meet every quarter. Okay. And every dollar, cause we're an S corp. Yes, we're an S corp too. So every dollar that comes in from January 1 to March 31, shows that it's either going out as an expense or revenue or compensation for the physician. So, but now, cause you added PT, how we break the, we do PT separate. We expense it all out and then whatever's left gets split, you know, it's ancillary income gets split. So are numerous physicians like, they have an equity, I assume, in the practice? We don't do, like they don't buy in, there's no buy in. Okay. And all they get when they leave is 85% of their receivables per session. So we don't have, like you have to buy, you know, they have to buy into the building. That's a separate. Okay. Okay. That's a separate entity. But even like the MRI machine, you don't, and usually if you don't have any claim to it, cause you've made all the money while you were. Right. You've built out the services, right? Okay. No. So yeah, there's no, like I said, there's no equity. It's in all models. Again, it's just, if you retire December 31st, you're going to get 85% of whatever comes in for you for the next 16 months. As you've already paid expenses up to December 31st. Okay. So you're not going to be building any expenses going forward. You just, we're keeping 50% to cover the cost. Someone's going to sit there and post the I missed. Yeah. But you're talking about 85%. That is their next collection. After it exists, right? After. The only, they get 85% off the top. After they, for six months after they leave. Oh my God. That's, what a deal. That's 15% equal. I see. To pay. That's not normal operating. Yeah. It's a daily collection. You know, we, right now, only one position is the owner. So 100%. Okay. So, are the other ones partners? No, they're associated. They're only the employees. Okay. So that's it. All mine are partners. Oh, okay. So everything. So everybody has equal right? Or, so whenever you guys add in more doctorate, it just dilutes the, I guess. No, there's nothing. There's nothing to buy into. They just come in and they start, they get put on a contract. As an employee for two years. And they just start, you know, drawing, based on, you know, they're in the same compensation model as a physician, which is, we take your collection. We minus your, your share of expenses. We have free expense buckets. We have direct expenses, which is their salary. We have a variable component that's based on production. And we have a fixed consumption, because you know, the rent is the rent, whether you're Disney world, or you're seeing patients that you're going to pay your share. I mean, you know, so. The variable that I includes a staffing payroll, because that's the highest. Well, it depends on like, they didn't say what, where did they get the medical, for us, our medical assistant is a fixed expense, because they share, they all have an MA, but when they're not in the office, their MA is working somebody. So they're shared. So, but like, when we get to the billing office, that is based on collection. You are 10% of, like I said, with our PT, if you're 10% of collection, you're paying 10% of the business office costs, which you're using more business office costs than somebody else. Okay. So. Then how do you. It's a complicated. Do you pay? Joe can tell you, because I just sent him our, was that? Spreadsheet complicated? I'll look. That's spreadsheet. I've let her, yeah. I worked with him on something else. I sent him how we do. Yeah. Oh, I was, that's why I think that your email got kicked back. Maybe I didn't write it down correctly. So yes, I was looking for that. Cause we, right now it's hard to also, cause we, we have four songs. One is a specialty and shoulder to our scores. And then one is actually DPM. So then they're, where they are in terms of their salary is very different also. Yeah. And see, like I said, with yours only being all employed, that's very different. I know. I'll be happy to send you the spreadsheet. That would be great. Do you have a card with you? Terry, I just want to say. Yes. So yeah. I see. But in terms of the share, is this, do you guys face it off? Like the deal charges? We don't do anything on chart, everything's on collection. On just based on collection. Yeah. Cause you can't, you can't spend a charge. You can only spend the money that comes in. So based on how much they collect, if they collect more, that means their production is, but that's like previous. Yeah. But they're see, but their expenses, we, if we do all their expenses from January through March, but only collections January through. Now there are going to be some collections that come in later, but that's just, it just rolled over. Okay. And that's why when you get to the end, you get your collections for six months. Oh, I see. Okay. And we don't do that with ancillary because technically, if you came in January 1st as a partner, some of the collections in January are for chart, are for work that you want a partner for, that you get a cut of it. Cause every player has to be equal in that model. But at the end, when you're not a partner, there's going to be money come in that you will respond for that you don't get a cut up. That makes sense. It's going to wash. It's going to wash out. Okay. I see. But if you, if you email the other third. I do. Are your doctors happy with that model? Yeah. My doctor loved that model. Cause it rewards the doctor if you work and penalize. We, you know, we were big on, you know, if you come in and work harder, you can do well, but you have to come in and ride the coat rails. You know, our fixed overhead is actually moving us there. So if you're not working, you're going to pay the bill. But I'm on, I can probably send you my email. Okay. Yeah. Oh, that would be amazing. Yeah. But no, I love the train. That's why I was like, okay, that's my, cause last year we went through the owner of the practice, we went through a kind of a decision, whether we should still continue doing cashless or we call those accounting accrual. But then we tried to do it for six months. Gosh, that's confusing. Yeah. You're, you're, you're paying on imaginary number. I mean, we didn't, we didn't implement. See, that's why we don't pay on target. We pay on dollars in the door. Let me, let me pull this up. Okay, fine. Let me see. It's just an Excel shell spreadsheet that shows how we come to our compensation. So you basically, me was all the doctor together. Everybody knows that everybody's a number. That's actually a good idea. Okay. We do. Cause again, they're all departments in our case. And they, do you mind sending me a copy of how you guys structure this like physicians employment? You don't have any interesting to our employees, our physicians and all. Really just heartbeat. So they get to take home. Really? Look at what you tell them. Yeah. That's what we're, it's a blended model. Cause we have some fixed and some pair, but we take, you know, they take home on average about 60 cents a week. So our overhead runs about the same. What's your email? That's amazing. Sandy, S-A-N-D-Y. Yeah. Yes. Yes. 60. That's actually, so your overhead is. Yeah. Well, that was our answer last week. Okay. So, do you guys have your own MRI? I'm sorry. We own MRI. We own a BD. Okay. And a BA, you're considered an ancillary income. So if you get a profit from that, you'd split that. That mid-level part is tricky. So we used to have just one PA for the doctors. The one that's really busy. We haven't done mid-level as a share, cause they didn't like the idea though, when I presented to them. Cause like the protocols are different, you know, between shoulder and sports guy, even treating the shoulder. All our PA's are shared, all four. And then how do they, do they just spend time with each physician? They see their own, they, two of them work in the OR. There's always two in the OR. Okay. Usually, sometimes three in the OR, cause between the ASD and the main OR, there's always one in clinic, seeing their own clinic, seeing bone health and doing that. But any profit from that, it's split equally among the four. Okay. So I just sent you that spreadsheet. Thank you. Feel free to ask me questions. Thank you. You're welcome. You mind if I take that copy?

Beverly Cook

Director of Finance

Midwest Orthopedics at Rush

surveys

data analytics

performance improvement

medical practices

accurate data entry

interpretation

practice management

benchmarking

industry standards

physician compensation