Cost Cutting Ideas for Small Practices, part 2

The first post in this series reminded readers why small firms have to come up with small but inventive cost-containment ideas to compete in competitive markets.  Idea #1 was to eliminate old expensive monitoring technology (security systems) and switch to inexpensive portable systems (smartphones with remote web cams).  Total estimated savings over 3 years (my wild guess):  $2600.

Here is another little cost-cutting idea for tiny practices.  

Little Idea #2:  Cut Out the Land Lines

Land lines are expensive in so many ways:  monthly fees; extra fees for additional lines; long-distance fees; installation costs; equipment costs of phones and answer machines; answering services, and — worst of all — having to dial “1” before the number.  What’s that about?  We used to need them to go online, which introduced other expenses such as modems and monthly fees with an internet service provider. Taken together, those are the accounting expenses. But there are bigger, if hidden, expenses to using land lines:

The Devil. What Was Alexander Bell Thinking?
  • They are not friendly.  Phones hooked to the wall make you come to them–usually running in vain to catch a call.  They refuse to leave the office, even in emergencies.  
  • They take up a lot of office real estate.  
    • Consider the maze of wires and the big box in a closet somewhere in your office, usually measuring on the order of a foot wide and 3 or 4 feet high.  That’s the price you pay for having a land line or two. 
    •  Consider the phones themselves.  They take up space on walls or desks.  Their placement is dictated, in part, by a/c outlets.  Their cables and wires get in the way, trip you up, or strangle the passerby.  
  • They are obtuse — a nice word for “annoyingly insensitive, unobservant, dull.”  Actually, they’re passive aggressives.
    • They have a lot of incomprehensible buttons that blink in mysterious ways, insensitive to your needs.
    • They receive and send calls with no thought of recording what they’ve done, unless you insist that they be observant.
    • They take important messages and sit on them, waiting for you to do due diligence and discover their little treasures. 
    • Their intercom systems are prehistoric: push a button -> ring -> push a button -> communicate -> hang up. Make a note.  Every time.
  • They are unintelligent.  Actually they’re just plain stupid.  
    • They don’t have alarms to remind you of things.
    • They don’t organize anything, even their own cords.
    • They don’t send you messages when you’re in with a patient or in a meeting.
    • They don’t keep a list of contacts’ phone numbers, much less addresses and other stuff.
    • They don’t take pictures or videos.  
    • They don’t have any apps at all.  Can you believe it?  What was Alexander Graham Bell thinking? They don’t navigate, schedule, browse, do email, take notes, translate, give you weather and traffic reports, Google, find the next Starbucks.
  • They are severely hearing impaired and hearings aid don’t help.  You can yell at a land line all day long and it will never follow a single command.  So much for voice dialing.
  • They are aesthetically unpleasing.  Actually they’re just plain ugly.  The one in the picture is a purse, which is clever but still ugly.

Low Cost Solution.  Toss out the land lines and buy some smartphones.  You’ll need one to monitor the web cam security system described in last week’s post, anyway.  Better yet, get one for everyone working in the office and set up a call-forwarding system to ensure that incoming calls from patients, referral sources, suppliers, etc., are handled in real time instead of a bunch of messages to handle every morning.  

Smartphones are everything land lines are not. The’ll do everything but swim and shower with you.  They’re all-in-one systems with connectivity that does not depend on wi fi– letting you talk to patients while you’re scheduling them on a calendar shared with the office; talk to suppliers while you’re tracking Fedex; take, store and send images (no more faxing and scanning!).  They’re sensitive and organized–keeping track of incoming and outgoing communications in an orderly fashion, reminding you of messages, helping you in every way you or they can think of.  They respond to voice commands and they have almost any app you can think of, including remote office access apps and super cool on-demand intercom functionality.  They counsel you with traffic and weather reports; give you information when you need it (OK, except for Siri, who’s probably genetically related to land lines).  As for security: they’re hard to steal because you can track them;  they’re easy to lock; and you can connect to work computers using a Virtual Private Network (VPN).  There’s bound to be a HIPAA objection of some sort, based on outdated technology in vogue when the regs were written, but I’m guessing the objection itself will be obsolete before it’s resolved.  For now, the only fly in the ointment is Medicare, which — as far as I know{{1}}[[1]]Please, somebody tell me I’m wrong![[1]] — still requires data transmission to go over a modem and dedicated line, but the expense is not much.  

How much does tiny idea #2 affect costs?  In accounting costs, I have no idea, mainly because I haven’t purchased or used a business land line system in almost 7 years.  But if you do use land lines, you can add up all the costs specified above and any yellow page advertising you do to figure your accounting costs.  Smartphones are only inexpensive if you sign up for expensive, multiyear contracts.  Prepaid plans may save money, depending on how you use phones in your practice, but the equipment cost goes up.  You will have to do the calculations yourself.  As we like to say in Economics, “It Depends.”

The Economic Cost is far higher.  You may have a hint of that from the mounting animosity directed against land lines in the above discussion.  The Economic Cost lies in the sheer, inexcusable inefficiency of old fashioned phones– add up all your foregone opportunities (aka opportunity costs) and your head will spin.  Thanks to convergence of communications devices, small firms can now position themselves as efficient, go-to offices that appeal to demanding, busy consumers.  They may be able to do this and reduce accounting costs at the same time.  Remember our old magic equation:  produce as long as MR – MC > $0.  Higher revenues and lower costs is the magic ticket.

Future posts in the series will suggest other smartphone applications to reduce other business costs.  Tune in again.

photos courtesy of View from a Blond and kitchy-kitchy- coo


About Holly Hosford-Dunn

Holly Hosford-Dunn, PhD, graduated with a BA and MA in Communication Disorders from New Mexico State, completed a PhD in Hearing Sciences at Stanford, and did post-docs at Max Planck Institute (Germany) and Eaton-Peabody Auditory Physiology Lab (Boston). Post-education, she directed the Stanford University Audiology Clinic; developed multi-office private practices in Arizona; authored/edited numerous text books, chapters, journals, and articles; and taught Marketing, Practice Management, Hearing Science, Auditory Electrophysiology, and Amplification in a variety of academic settings.