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Megan Walker: Hello and welcome to the Healthcare Online Podcast. My name is Megan Walker and I'm delighted to welcome Damien Adler, the co-founder of Power Diary, to our chat today. Hey, Damien, how are you?

Damien Adler: Hello good thank you Megan. How are you?

Megan Walker: Very well. This is a super exciting podcast where , Damien and I have met and we couldn't land on a few topics because there's so much to cover.

Damien has a wealth of expertise working with private practices. He's also a registered psychologist, so we've come up with some questions. We've got the background that we're going to cover first, and then we are going to put the lights on and rapid fire and see how much amazing content that we can cover to give all of you listeners terrific value in our conversation. So Damien, start off, tell us about you and for anyone who lives under a rock, tell us about Power Diary.

Damien Adler: I I'll give you the super truncated version. So, yes, I'm a psychologist. My wife is also a psychologist. We worked in the public system, then moved into private practice.

In those days, we realised there wasn't the right software solution. And long story short, along with my brother, we co-founded Power Diary. Power Diary is a software platform that really makes it a lot easier to run practices. So I think, as our audience would well know, there are lots and lots of moving parts and lots of things to manage in running a health practice.

And the idea is one simple online platform takes all that, simplifies it and brings a bit of order to the chaos.

Megan Walker: Beautiful. And just for those who don't know, what does it do other than diary management? Because I bet there's a heck of a lot.

Damien Adler: Yeah it does pretty much everything. So yes, diary management and all things that go with that like your automated billings and confirmations and so forth.

But it also does invoicing, it does letter writing, it does notes, it does online forms. You can process your payments. You can manage your wait list and you can develop automations to keep everything ticking along.

If you're doing debt collection and things like that, it will run all that for you. It'll generate all your statistics. So if you want to see how practitioners are performing and retention rates, things like that, it will do all of that. It will give you all your financial reports. It will tell you where your patients are coming from.

It will manage your referrals. It will track your session numbers. It will work out income against budgets. If patients have budgets and have funding allocated, it will track those. So it does the full gamut of things. And we try to look at what are the annoying, time consuming things of running a practice and then we try to use technology to simplify that. So things like writing notes, you can have templates and for writing letters to GPs. You can have templates that pre-populates a whole bunch of content and merges it all in. You can copy any previous clinical note into a new note. So you can just edit the parts if you want.

So we pretty much we look at all the things that kind of cause headaches or that people find time consuming, distracting and we try and simplify.

Megan Walker: Tell me the size of the practice that typically works with you.

What size are they? Where are they? What do they do? Tell us about your clients.

Damien Adler: So Allied Health is our primary focus. Think of psychologists, physiotherapists, massage therapists, speech therapists, dieticians, osteopaths, that kind of allied space is our core business.

We have solo practitioners all the way through to multi-location and franchise models where people are all over the place and have locations everywhere. So it really does scale to suit, whatever someone needs, it will grow with them.

We also have built in telehealth. We started in Australia as an Australian company. And then over time we went to the UK and we have a really good growing user base in the UK and in North America. So we're in Canada and the US and a bunch of other countries but they're the main sort of markets and the bulk of that growth actually happened organically.

People were using Power Diary in the UK and then started using it in the US. So now we have local support in those countries delivered by local people. So we have definitely grown over the years.

Megan Walker: And do you have a modest achievement in there that you haven't mentioned? It's something about the fastest growing ... do you want to tell us a story?

Damien Adler: Okay yes so I think what you might be alluding to perhaps is our G2's Best Software Award. G2 is the largest rating system for software companies.

And it's where people go on and rate software across all sorts of different categories. We are now rated the number one in the world which is amazing. There are practice management systems out of the US that are actually larger than us in terms of size.

But this is about the feedback from users around usability about the difference it makes to their practice and about our support.

I have to admit, we were even surprised in that you work away and do the best you can. And we saw that we were moving up through the ranks and then about 2023, we hit that number one spot. So cool. And it's really amazing and we're so appreciative, but our customers, that they get on there and make those ratings and give that feedback and we're very appreciative of what they do.

Megan Walker: Huge congratulations to you. Running any type of business and achieving that level of success, where it's based on user feedback is massive. So yeah. Hats off. I'm glad we got that out of you.

I was also going to ask you - what problem do you solve for your practitioners, clinicians, and therapists? But I'm going to ask it in a reversed way. If you took three of your features away from Power Diary, what would cause the biggest uproar among your current clients?

Damien Adler: I'm not going to say like the core booking function because I think that obviously has to stay.

But probably the client portal. So we have a client portal that allows people to manage their own bookings and manage even their own invoices and things like this. And the people can go on and pay, but still while giving the practice control to set all the rules around bookings and cancellations.

So it's not like handing over and allowing patients have free rein to your schedule and then feel like you've lost control. Practices can still control everything, but it just reduces so much admin time that's phenomenal.

Next I would say the online forms would be another one. Because online forms are a secure form that kind of gets sent out to patients. They complete that and you can customise, make whatever you want. And then the patient completes it and the information gets stored securely in their profile, but it also updates a whole bunch of the fields in the system.

So when you are, you know, collecting information. All that gets populated.

So it just means that all that is done. You don't have to have people typing in and updating information manually. So I think that would be one. Another one would be our SMS communication system is second to none. So we have the normal appointment reminders, which you'd expect, right?

But we also have when people reply to SMSs, we automatically update the status of the appointment so people can reply, confirm, and or cancel if the practice allows it. And then automatic things can happen based on that. So we can notify the practitioner, hey this person cancelled and so forth.

But we also have two-way SMS chat. That type of interface that a panel opens up so you can have this rapid back and forwards with patients. So when you're thinking about scheduling or moving appointments or, reminding them to bring their referral from their doctor, you can actually just quickly message them and have that go back and forwards and all get stored in their record as well. So you're complying with all the record keeping obligations and so that reduces admin time. Like if you try and play phone tennis - you can't reach them right away. You leave a message. The us right away, oh, for a cancellation, you know, you ring up and leave a message, the person doesn't answer and then they ring you back and you might not be able to answer the phone. They they leave a message and you still haven't filled that spot.

Whereas if you message and say, hey I've got a spot do you want it. Or hey I've got a cancellation do you want to move up? 

Megan Walker: That's fantastic. All of that back and forth, what a waste of time and I'm so delighted to hear you offer electronic forms.

I know we had a big assessment we had to do in our family and it, the form came in post, we had to fill it by hand. We were asked to scan it, send it back. Thank goodness we had a home office. But how many people have that level of technology that very few would have printers and scanners and, yeah. You know, and then repeating that information over and over again.

Megan Walker: Now have you got a glass of water there Damian? 

Damien Adler: I do. Right here.

Megan Walker: You're on the spot here. You've got huge amounts of wisdom around all aspects of owning and running a practice, you've had a successful practice yourself as well. So let's run through a few of these questions in relatively rapid fire. So the first one I'm going to ask you is how can practice owners increase the value that they offer team members or contractors who are working with them without increasing the amount of money that they're paying to those contractors?

This is an interesting one. I've got a client who says I'm having to pay more and more and more for my psychologists. They're pricing me out to the point where I'm actually not taking home an income because I'm paying them so much that I'm not earning anything. But I know if I don't do it, they're going to leave and go to my competitor.

Damien Adler: Yeah okay so what do we do? The first thing is, I think is a mindset thing around this, in that if your focus is on wanting to attract or retain people just by pay, what you ultimately end up doing is attracting mercenaries. And you know, the mercenaries are going to go where the pay is highest.

And if that is their primary driver and they're going to go to a competitor simply because the payer is higher and nothing else is important to them, then you've got a mercenary there. And I'd rather have mercenaries elsewhere and not in my practice. Right?

Because there will be no loyalty and no commitment. It will just be about the money. Now it's not to say money isn't important, of course you've got to be within a reasonably competitive range, but that definitely is often a long way from people that are paying top dollar and just trying to attract and siphon off, right?

So first thing is if people threaten to sort of go elsewhere, have a good look at it. Bye-Bye. I think that often people find that the reality of being elsewhere is there's a reason that they're having to pay top to retain, right?

So I think first of all is getting that thinking. But in terms of what you can actually do is try and think of your practitioners as customers and identify what's important to them as a customer. So look at it from their perspective and what we typically find is there's a whole lot that they don't like to do.

The annoying parts of running a practice.

Typically people have a picture in their head of what being a practitioner is going to be like. They picture being in a room providing treatment to a patient.

But they don't think about or realise the paperwork and the admin and that's a reality that comes with running a practice.

 So if you can deliver that idealised vision of what being a private practitioner is by taking away as much of the annoying stuff as you possibly can.

Have good admin support, manage debt collection, deal with the legal stuff that comes up. Handle complaints that come up - all these sorts of things.

Strip all that of way and provide that kind of service where they can come into work, do the thing that they always wanted to do. If you do that you'll find you're 80% of the way there.

Megan Walker: I was just going to add to that ... also communicate the value of what you are taking off them, because I know a lot of situations where someone will go, well, I want to earn the whole amount. I don't want to just earn a portion, so I'm going to go and set up my own shop and then not realise all of the hidden costs that they were being saved.

Absolutely. So when you join us, here's the table. We will take all of this off you, which will save you and get some of that reality. What are your thoughts about that?

Damien Adler: Totally. And in fact there's a real value creation here too, because if you're in a group practice you can do all those things more efficiently than someone can do by themselves. So for instance, a group practice may have a bookkeeper who does a lot of stuff, but that's really expensive if you're on your own.

So you can genuinely create value here where you can provide that for cheaper than what they can do it on their own.

 Another aspect is the sort of support you can provide around the practitioners. So clinical decision making, difficult interactions or patients that might be challenging, risk scenarios that come up, right? These are the sort of things that play on practitioners' minds after hours that they worry about. You can create value with a team atmosphere where you can escalate an issue.

So if there is a problem or a risk scenario that pops up, the practitioner can debrief and get immediate consultation with colleagues or with a senior person to create support and a safety net around you that you don't get when you're on your own. 

Sharing knowledge, debriefing, education, case conferencing as a group creates a better atmosphere and lifestyle.

 Megan Walker: You've created such a beautiful mentally healthy workspace that has enormous value. It hasn't cost you any hard dollars. It has costed time, but then it's reduced your retention if you keep the right people and nurturing them.

Damien Adler: Absolutely. And it provides such a contrast. If people do leave, they'll go to a high paying competitor but then realise all those wonderful things you're doing and they took for granted.

They will realise how stressed they are - doing their own debt collection and admin.

Damien Adler: And it's the same when someone joins you that has been often bounced around  a few practices that have really bad kind of vibe about them and then they go this is heaven. I'll never leave.

Megan Walker: You're in such a good position to look over the fence into thousands of different practices. What do you think are your top three recommendations to create a really efficient, streamlined practice? 

Damien Adler: I think it would almost go back to the things I was talking about before about the kind of client bookings and getting as much of the admin automated. So using client bookings with online forms to collect information efficiently and securely. I would also put into that automating payments where you can get people paying via credit card online.

It just takes out so much headache and speeds up that front end, the reception area. Paying online the claiming process, say if they're doing a Medicare rebate, you can just click a button and it submits all the claims and everything.

 Megan Walker: Brilliant. Oh, so good. And I think as we are getting tight on time, we need to do a part two, Damien, if that's okay with

Damien Adler: Sue we can do that. Absolutely.

Megan Walker: But something that I hear a lot about when I talk to my own therapists and clinicians and practitioners, is really different opinions around no show policies. So let's talk about this and then I'm going to get you to explain to people how they can find out more about Power Diary and get started with you guys.

But I've seen things like, oh yes, we're going to charge them the full amount. We are going to give them a 72 hours notice period. We're going to give a 24. It seems to be so inconsistent. Have you got a view on no show?

Damien Adler: I do. And it tends to work well. So depending on the practice, the thing is to have a 24-40 hour (business hours) cancellation policy. To offer telehealth as an option instead of cancelling.

Have it clearly articulated at the start in writing with context around why it is important. Then reinforced throughout.

 The way I view it is that people are buying time when they book an appointment and time is perishable. It is not something you can return.

 And essentially when you book an appointment, the closer you get to the actual appointment time, that capacity to reuse that time is rapidly diminishing, right?

So yes, all those things happen in life that it's not just someone can be bothered turning up. We understand that but that's a risk that the patient takes, not the practice. When you book an appointment time, you are assuming that risk because the alternative is that you have to charge so much.

And everyone else has to pay a lot more to cover the income from those shows. And that's not fair. It really should only the people who are unable to attend their appointments, for whatever reason, should wear the cost of the cancellation and that's just part of life.

The same as, oh, I got called into work. Okay, that's fine. But you've made a decision to prioritise attending work versus your appointment. That's okay, but there is a cost attached. It shouldn't be a matter of passing that to the practice.

Megan Walker: Interesting. So good. Okay. I love it. I love the fact of talking about time as perishable and whose responsibility is it.

We have got more to cover but I think we'll put a pin in it there because you and I are great talkers. We've got things to talk about with personal boundaries, separating self-worth when we are charging, thoughts on expanding the practice and diversifying. And I've even thought of just another one of NDIS charging and non-NDIS client charging.

We could go on for days. Let's park it there Damien because you've imparted so much wisdom. I love what you've said about increasing the value for team members and changing the conversation from money based. I love your efficiencies for streamlining operations. I mean, if you can get all of those cogs moving through automation and technology, what a breath of fresh air and your thoughts on no-show policy have been so helpful.

It's such a good reminder to get out of that space of this is not a free service that our clients are offering to the community. These are businesses that have to run profitably.

 Megan Walker: Tell us your final thoughts about running a proper business and charging and not letting money get in the way.

And then we must wrap up. Tell us how can people get in touch with Power Direct? Over to you.

Damien Adler: I think that when you look at it broadly, you need practitioners to be in a good mental space to do the work that practitioners do, right? And you extrapolate that. It needs to be in a position where the business is running as a business.

It's generating income and profit. It's not causing financial stress. It's not encroaching on the practitioner's life, whether you are the practice owner or you're the practitioner providing services. So my thinking is really about practitioner wellbeing is where it all starts and ends. Because you can't provide a good service in a sustainable way if practitioners are not happy and in a good place.

Megan Walker: A damaged product isn't it? They are the product. If that, they're the product that's damaged, then the whole business has nothing to sell.

Damien Adler: Yeah exactly.

I think in terms of Power Diary, people can jump on our website, www.powerdiary.com and they can learn a little about us. We've got a whole bunch of blog content on there too. We go into all different areas of running practices and how things you can make things more efficient, not just based around using software, but actually other areas as well.

Megan Walker: Thank you so much for what you do and the business that you run. Obviously you care very deeply about your clients and their success, and then the impacts that they're making in communities with positive healthcare. So thank you so much for sharing some of your golden nuggets that you've accumulated over the years, and we look forward to seeing you soon.

Damien Adler: Thank you.

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