Tim Boyle – The Front Desk Problem: Why Good Practices Still Lose Money

Tim Boyle, Director of Sales and Business Development at Reva Global Medical and a former professional hockey player, joins Dr. Michael Jerkins to talk about the part of private practice nobody trains you for: the operations. His argument is that most physician-owned practices don’t struggle because of medicine — they struggle because scheduling, insurance verification, prior authorizations, and claims follow-up all land on the same overloaded desk, and every task that gets dropped is revenue that quietly disappears.

Tim makes the case for medically trained virtual professionals handling the clerical and back-office work, and where the line sits between what can be offloaded and what can’t. Dr. Jerkins pushes back on the operational logic with the question that actually matters: what do patients want? Not what’s efficient — what makes someone trust a practice in the first ninety seconds. Both land in the same place. Patients should be greeted by a person. Trust is built at intake, and you don’t get it back once it’s gone.

Should physicians still be opening their own practices? Which specialties actually have the margin to make independence work? And is the front desk the last place in medicine that should ever be automated?

Here are 5 main takeaways from our conversation with Tim:

1. Private practice wins by turning operations into a revenue engine

The episode shows that the biggest vulnerability to a practice is often not clinical care, but workflow leakage. When front desk work, insurance follow-up, and admin tasks pile up, revenue slips through the cracks even if the care itself is strong.

2. The best delegation is friction-based, not task-based

Instead of asking what can be outsourced in general, the conversation points to a smarter question: where is the practice breaking down? The best places to delegate are the spots causing the most delay or burnout.

3. Patients want continuity, not just automation

The discussion makes it clear that patients do not simply want faster systems — they want a smooth, reassuring experience. Human interaction still matters for trust, especially at intake, follow-up, and moments where confusion could hurt care.

4. AI works best when humans stay in control

Both speakers agree that AI can improve efficiency, but only when supervised by a person who owns the workflow and the compliance risks. In healthcare, “set it and forget it” is too risky to be a real strategy.

5. Independent practice may become more viable as operations get easier

A major theme is that technology and virtual support can lower the overhead of running a practice. That could make it more realistic for physicians to stay independent or start their own practice without needing a huge staff.

Transcript:

Dr. Michael Jerkins:

True or false: in ten years, no physician practice will have a human being answering the phone.

Tim Boyle:

False. I think that there are always gonna be people that are stuck in their ways, and there are always gonna be people that wanna keep it close to the vest and keep their practice close to home. But when you walk into the office and have that face-to-face patient care, that person’s gonna pick up the phone at one point during the day. It’s not like you’re never gonna pick the phone up.

MJ:

Welcome back to another episode of The Podcast for Doctors (By Doctors). I’m Dr. Michael Jerkins. Very excited today to have our guest, I think, our first former professional athlete on the podcast, to really talk about private practices, physicians specifically in private practice, and ways we can better support them. And we know how important the viability of independently owned doctor practices are. So excited to have our guest, and I’ll go ahead and introduce our guest.

Today, our guest is Tim Boyle, Director of Sales and Business Development at Riva Global Medical, where he helps private practices build virtual teams to carry the administrative weight of running a medical business. Tim spent nearly a decade in healthcare working with hospitals, labs, and private practices, and also played professional hockey. Tim, welcome to the podcast.

TB:

Thank you so much for having me on, Dr. Jerkins. I’m excited.

MJ:

So I think the first question that seems the most appropriate is: how do you go from professional hockey to healthcare? How’d that happen?

TB:

So this is a loaded story for sure. So I am an Irish Catholic. I grew up south of Boston in a town called Hingham. I am one of thirteen brothers and sisters, with our oldest sister being a doctor. So, through that 13, I—my older brother, who’s eight years older than me, was a professional hockey player himself. So obviously, as a younger brother growing up, I wanted to aspire to be like Big Brother.

I spent some time—I went to Union College and then spent some time playing professional hockey. And unfortunately, from professional hockey, I was injured. I herniated L3 to L5, cracked my S1. So hockey was no longer for me, so I had to figure out a different avenue.

So I got into the medical space, starting in the technology space, so reimbursement software for labs and hospitals, and then went over to PerkinElmer selling laboratory equipment. And how I got to Riva Global Medical is actually a very funny story.

So I was, like I said, a former professional hockey player. And our founder, Bob Lachance, also a former professional hockey player. His older brother played in the NHL just like mine. So we have a lot of connections here.

So coincidentally, we were having a phone conversation around the time I was talking to my sister about her struggles at her primary care practice and just what Bob could do to help those struggles. And I came over to be the Director of Sales at Riva Global Medical just because of that personal story and how I could figure out how to help my sister exactly. And I know this can go out through the whole industry.

So I’m here to serve, and I’m happy to be here. And we’ve had some fun in our first six or seven months doing it.

MJ:

Very cool. So follow-up is, if you had thirteen of you, oldest sets the standard of being a doctor, what happened to the rest of you guys?

TB:

Okay, so you want me to fire down the list?

MJ:

You said one of you is a professional hockey player, so you had to live up, but then one of you is a doctor, but zero of twelve.

TB:

Oldest is a doctor, so doctor. Then we got a real estate mogul, owns our own brokerage. Then we got my oldest brother has autism, so he’s the light of our world. He makes us smile every single day.

Then we got a brother who is a priest who was ordained in the Vatican over in Italy. My brother does fashion and retail in Boston on Newbury Street. He’s a big, big upsell guy on that. I have a sister that’s a teacher.

I have a sister that works for the Archdiocese of Boston. And then I have a younger brother who’s a golf professional down in Florida. And then a sister who plays country music in Nashville. Country and a little bit of alternative.

MJ:

I bet Christmas and Thanksgiving’s pretty fun.

TB:

Yeah. So I just had my first baby girl, but that is number thirty of the nieces and nephews.

MJ:

Congrats.

TB:

Thank you so much. Thirty.

MJ:

That is something. Speaking of private practices, your pediatrician, I’m sure, of the family is doing a good job. You’ve seen so many different perspectives and healthcare specifically. What are some of those things that specifically you see for physician practice owners who are coming to you? What are the questions they have when you talk to them?

TB:

Yeah, so they’re usually coming to us to try to alleviate a pain point. Whether they’re having a lot of people come in, they’re having a tough time with that front desk management, whether they have an AR backlog that’s building up.

So what we do at Riva Global Medical is we act as consultants. We’ll take a step back and we’ll ask, what are some of the pain points that you are dealing with? Is it missed calls? Is it patient scheduling? Is it collecting on reimbursement?

Because, as you know, as a doctor yourself, there’s insurance reimbursement. It’s a funny game in the healthcare industry. So being able to maximize that reimbursement is huge for practices because you’ve already done the work, and it’s just acting on claims.

To answer that question and bring it back, we work as consultants. We look to see where the biggest struggle is. We’ll work to fix that problem by working alongside your staff with a medically trained virtual professional to help delegate all of the clerical work.

So any clinical work, patient care needs to be handled by the doctor and people that go to school for years and years and years to handle that patient care. All that clerical work can be delegated.

So thinking about a practice’s workflow along the whole workflow, from front desk management to back-end billing, if you think clerical tasks, that can be delegated. So all of those clerical tasks are the conversations that we typically have with these doctors.

Is it the reimbursement that you have to deal with, or is it just getting patients in the door?

And if you’re a specialty practice or an IVF practice, is it making sure you have that touch point the day before so you know that that seat’s gonna be filled, that appointment’s gonna be filled, so you get paid out for services rendered instead of having to chase down people?

MJ:

When you say delegated, are these human beings? I’m just curious on, like, how much you’re utilizing because obviously that’s a huge buzz in the healthcare space of what are humans going to be doing in the workflows, what are AI agents or other kind of technologies going to be doing?

But in your case, you guys have, sounds like, virtual professionals that do things like even front desk and stuff like that. Is that fair?

TB:

Yeah, so I can give you a very full high-level of what we do here at Riva Global Medical.

MJ:

If we could, I would love to hear more. Even—I know I’d love to obviously that. I just want to hear from your perspective because you see so many practices. I think it’d be helpful to hear from you, your perspective, on what in general are the physician-owned practices right now struggling with? And, like, how are people being successful in general at using virtual assistance? Because I’ll be honest, I don’t know much about it.

TB:

Yeah, okay, perfect. So just to give you an idea, these are medically trained virtual professionals that are outsourced from the Philippines, all being in their office. It’s not a call center or anything like that. So they’re HIPAA compliant. We run system audits all the time.

But to answer your question, for physician-owned practices, the biggest thing would be the front desk management, where you’re handling phone calls. So if I bring into a daily life of my sister’s office, per se, this is hypothetical, but this is just a day in the life of her practice.

So you walk in as a patient and you have that front desk manager. So in a smaller practice, that front desk manager and medical assistant might be the only staff that this physician-owned practice has.

So when you walk in the door as that patient, that front desk manager is also in charge of getting reimbursements for insurance, making sure all patients are scheduled, calling out to patients to make sure all the prescriptions are filled.

So if you walk in as a patient, right, and that person’s on the phone, especially with an insurance company, which can take up to 40 minutes, those calls take forever. That front desk manager has to hang that phone up, handle the patient, and then go back and restart that phone call from the beginning.

So that is a huge pain point for offices because they’re missing out on revenue because they’re not able to chase down those claims because they have to worry about the patient in front of them.

Where, if you have a medically trained virtual professional, you can worry about that patient care, handling, checking in patients.

But all of the rest of the back end—reaching out to patients, making sure they come into the office for their appointment, filling their scripts, getting reimbursed, calling the insurance companies—all those tasks that are currently being handled by that front desk manager in person can then be delegated, like I was talking about, to a medically trained virtual professional.

And what makes us special is a lot of ours are even registered nurses that are over in the Philippines, but they have medical experience, two to three years of medical experience, either in the billing, in the whatever niche, whatever part of the workflow that you are going to be using them for. So they’re going to have experience.

You can really trust this professional to work alongside your team as just another part of your team.

MJ:

What are the things that your doctor practice owners are, I guess, most eager to give up or delegate? And what are the things that they want to hold on to maybe a little too long?

TB:

What we’ve found is that the biggest delegate, like the biggest job that our VAs have helped practices with, especially the physician-owned practices, are that insurance verification, insurance claim prior authorizations.

It’s getting that money in the door. You just make sure that you’re collecting on all revenue for all services that you’ve rendered.

So for us, like, the biggest pain point that we can fix is getting that money in for you. So a lot of our practices have seen where you have a reimbursement rate of 93% usually, right? If that’s the average.

You could be using some AI tools or SaaS systems to try to bring that up to close to 100%. But when you add the help of our VA alongside your systems, we bring that rate, that reimbursement rate, up to close to what, like, nearly over 99%, just under 100%.

So when we have that story and we talk to these doctors’ offices, when we basically tell them you’re gonna be able to be paid out for all services you render, that’s usually what they jump on first.

But then that patient schedule and just making sure all appointments are filled. If you have any AR backlog that you need to try to collect on before timely filing, so you don’t have to write off those claims, that’s a big one because that’s a lot of work that’s just sitting there and that VA can go to town and just dial, dial, dial and collect revenue that way.

But it really is a case-by-case basis. It’s what’s going on in your practice and what can help.

For instance, in some states, Medicare and Medicaid is bigger than in other states. So, like, that reimbursement process might be a little easier than in some other states.

So it is a case-by-case basis, but to long-winded answer your question, it’s around that reimbursement rate and making sure that the patients are showing up to their appointments.

MJ:

Yeah, that makes total sense. Especially, I mean, revenue, right? I mean, like, that’s the most important piece in the back office.

But I’m curious, what are the doctors saying, “Hey, I just—I just think this is too much. I don’t want to delegate this. I really want to keep this in-house.”

What are those tasks that you’re kind of encouraging the physician, “Hey, actually your time’s better spent doing X, Y, and Z,” but they just wanna hold on? ’Cause we like to have control generally as physicians.

So I’m just curious on what trends you see. Some of the—

TB:

Patient communication. So when they want to keep it closer to the vest, it’s the—so we provide medical scribes. So we could be in-office with you on a Zoom call providing a medical scribe.

That has been difficult for us because that is a patient care process. And I know you just said revenue is the most important thing.

Yeah, we would say patient care is the most important thing, and then revenue would come second. But, like, if you’re—

MJ:

To be clear, I just want to make sure everyone in the audience knows I believe patient care is a cool one. What I said was, in the back office, that’s the most important thing, is generating the revenue.

As a physician, I took an oath. It wasn’t to revenues; it was to treat patients and the whole Hippocratic Oath. Just wanna clarify that. So that’s not a viral clip.

But sorry, I didn’t mean—

TB:

And so, all of the audience listening, that is my mistake. I apologize.

Why I bring that up is patient care, when you’re dealing with a doctor, you’re talking to a doctor, is great. But when you have the one thing—even for me, to be completely transparent with the audience—when you have a tablet there with someone’s face on it, just looking at you, taking down notes instead of having a medical assistant in-office, that might be less of a homey environment, less of a comfortable environment, because it’s like, who is this person on the screen taking all of my information?

It’s not so much on the back-end side of it, where we’re not so much patient-facing, right? Like, anything that’s patient-facing, patient care, even though medical scribe is clerical, right? That is clerical work.

But you need to be involved with the patient and be talking back and forth with the patient because even when I go into the doctor’s office and I see a medical assistant, that medical assistant says, “Hey, hello, how are you? Dr. Jerkins is gonna be in in a minute, but I just have a few questions for you.”

Those questions being asked by a tablet is a little bit difficult. For us, more difficult to sell.

I am trying to encourage it because it just puts time back into your people’s day, but I understand the trust factor in the patient care of giving your patient the best experience.

MJ:

I want to talk about this more, if that’s okay, that piece. Because there’s a ton of discussion now in the healthcare space of what work will AI be doing? What work will humans be doing? And there’s all sorts of aspects and complexities there.

But one of the things I like to think about or like to discuss, because I don’t think it is discussed, is what do the patients actually want? Right? Like, you can have somebody that sells a tool and builds a thing and says it can do this, that, and the other. But at the end of the day, are we asking the patients what they actually are comfortable with?

And you bring up an interesting point, which is on intake. So I’m a patient. Do I want, even though it could be super efficient for the doctor in the practice, do I want to punch a thing on a tablet or speak to a tablet or talk to a person? Do I want to talk to a virtual assistant versus an AI agent? I don’t know how you feel about that. Obviously, you have a bias, just like I probably have a bias, but I mean, do you think patients really want that?

TB:

I think that the patients want patient care and they want to feel comfortable. So, I mean, there’s levels to it. There’s layers to it.

When you walk into a doctor’s office, I do believe firmly that you need to be greeted by a human being. And especially with COVID, as you know, with the COVID testing, they had to find out ways to make this as efficient as possible and get people in and out of these lines.

Like, especially if you’re talking about a state like Florida, and you look at those—so I’m from Boston. The Boston Red Sox spring training field was a COVID testing site. The line is three miles down the street for people to get tested, swabbing out. So they needed to find ways to be more efficient. So they used technology.

Years down the road, now this AI is coming into play. People are going to be more efficient everywhere they go. I think the patient’s going to want the best experience possible, to answer your question. So that is going to take a mix of both.

I think if you have the best systems in place where you’re using AI, a medical virtual assistant, and your staff, that patient experience is going to be the greatest possible because you’re not going to let anything fall through the cracks.

When things fall through the cracks, that’s when you start to get the patient’s experience to go down. And, for instance, if you have a patient that gets a bill at the end of the day when they shouldn’t because they’re covered and that was just an insurance gap, that’s something that’s going to hinder that patient’s experience.

So obviously the patient doesn’t want to see a bill at the end of the day, but I believe if they saw what was going on in the back end, they would just want whatever is gonna make their experience the best.

And for doctors’ offices, especially privately owned practices by doctors, it’s difficult to hire staff. It’s difficult to have a lot of people in-house because I don’t know what state you’re in, but the minimum wage is growing year over year. So to try to get people in-house, it’s difficult.

You can do more work, be able to be more efficient, create a better patient experience without having the higher additional overhead. I feel like that’s a great solution. So, I mean, that’s why I firmly believe in what we do.

But to go back to the question in itself, it’s just, I think a patient would want what’s best for their experience, right? If I’m the patient, I just want: how am I going to be taken care of to the best of my ability? Nowhere to go after next steps, right?

We find a lot of gaps in practices with next steps, whether it be with medication you gotta go get or—

TB:

When the next appointment’s gonna be, what are the follow-ups gonna look like. But it’s just—I feel like at the end of the day, it’s just what’s gonna make the experience the best for the patient.

MJ:

The next steps are always tough, right? Because as a physician, I saw the patient maybe fifteen, twenty minutes, and then I need to go to the next person. I might already be behind.

It’s hard to sit and make sure their appointment schedule, they know where to pick up their medicines, they know when to follow up, when to message us back. I try my best to go over that in the clinic, but you need some support with that to follow up and reiterate and pull the levers and actually getting some of that stuff done.

But again, that one helps patient care if you can have follow-up, but two, it also helps you have revenue because you’re making sure that that patient actually does follow up and you’re able to continue managing their care.

But the thing that’s tricky is, like, how much of that should be a human being? How much of that doesn’t have to be a human being?

And it’s interesting, even your example of, like, when I walk into a physician’s office, you firmly believe there should be a human being that’s there. I agree, but it’s very interesting to see what will that be like in 10 years? Will we just have different expectations? I don’t know. I’d like to think that we’d still have humans that greet us.

But at the grocery store, I almost always go to the self-checkout line.

TB:

Yep. Yep. Like, going back to your point of rushing, right? Like, having to rush through the patient. You gotta get on to your next patient, but you’re dealing with the paperwork with this patient.

When you have to rush anywhere, that patient experience is going to be worse. So just taking your time through it, knowing you can take your time through it, it’s going to reduce burnout, too, for both doctors and people working in your office as well.

You’re not going to be having to chase down as many different hats. So, I mean, it’s big for the patient experience.

But to your point of not knowing where things are gonna go down the road, I mean, kiosks are everywhere now. I hope and I pray that we keep face-to-face patient care because it’s so important.

You need to be—trust. Like, that’s the first point of the patient care, and it’s gotta be trust. You gotta shake someone’s hand, know it’s a human being, especially with all the AI that’s out.

MJ:

Yes.

MJ:

I agree, right? I mean, I think medicine and healthcare in general is a human endeavor with a human service. It doesn’t mean that humans have to do every part of it. It just means that it needs to be human-centric, in my opinion.

If there’s tools that allow us to make patients healthier and more efficient, that’s great. But at the end of the day, I think humans—and I could go on and on about this. Like, the studies are, and they show AI being able to pick up a diagnosis better than the human doctors, but as you know, it’s not like when I go walk into a patient’s room and they have abdominal pain, they hand me a sheet of paper with all their exact data neatly written out and all of the information and vital signs and previous labs and imaging. Like, that’s not how it works.

We’re people and interacting with other people, and the data inputs are messy and complicated and counter each other, and they go back and they say something a different way.

Like, computers are not—and the AI interface is not ready for that, in my opinion. So that’s why there’s really no good real-world studies of these in actual patient encounters to show that they’re better, because it’s super complicated and they just haven’t done it yet.

That’s—I know that’s not a question, but it’s more of me just going—

TB:

I can build off of that, too. Like, that—it’s a lot. We went to HIMSS this year in Vegas, and there were a lot—I mean, I would say 90% of the conference was new AI, right?

And a lot of this AI—and AI is, one, inevitable, and two, great. If you want to be more efficient and you can use it the right way, it is gonna help your practice for sure.

But a lot of these different companies that we were walking by are preaching this “set it and forget it” model. It’s like, you can just put this in. And when we’re dealing with HIPAA, like, that’s ludicrous to me.

So when you have AI, you need someone that is gonna run the AI. You can’t just set and forget when it comes to patient care or patient information because down the road—and this is not a promise, but I can almost guarantee that something’s gonna go wrong.

AI does make mistakes, and we’ve seen it time and time again.

And when you’re dealing with HIPAA, I don’t think you can ever have just AI in place without having someone run that exact AI tool itself. It might just be one person, but you still need the human touch behind it.

MJ:

Yeah, do we fly airplanes with just on autopilot and no humans in the cockpit? Yeah.

TB:

Yeah. Yeah. No, we do not. Tesla got a little scary with the self-driving cars, but I still never will get in one of those. That’s not happening.

MJ:

You know, I did get in a Waymo once, and it was disconcerting. I didn’t really have a choice. There was no other car we could get, and it was in Phoenix, and they were everywhere. It was bizarre. If I had a choice, I would not do that again. It might be unpopular for some people.

TB:

Like I said, I grew up in Boston and they had that Big Dig, so the roads are going every different way. I don’t think they can drive in Boston, so I—I haven’t seen many of which is nice.

MJ:

That’s true. And Phoenix is on a nice grid. It makes sense. It’s not like that everywhere.

So I’m curious, as you see what can be delegated, what can be automated, what is a job in a medical practice that doesn’t exist yet, but you think will exist in the future? That’s a really tough question, by the way.

TB:

It is a tough question just because, like, my brain’s going in so many different directions. But, like, the first thing that popped up to me is social media management.

That makes sense. Getting patients through social media and having a dedicated LinkedIn, Instagram, social media person to try to find patients and to promote your practice, to make you look like it’s a fun place to go, if that makes sense.

And it’s a unique and it’s a tough question to answer because there are so many different avenues in the healthcare field. It’s evolving every day, and there are new things that come into place, especially with this new AI stuff.

So it’s tough, but, like, just off the top of my head, that social media management and, like, trying to grow practices via social media tools.

MJ:

When you see physician independent practices growing, is there increased interest that you’re kind of picking up on in the market of doctors hanging up their own shingle?

TB:

I mean, that’s why we’re here, right? If you can delegate all these clerical tasks that we’re talking about, the revenue comes in, and you can run a practice with just a medical assistant, front desk manager, and a doctor.

I’ve seen it happen. And we have clients that do it.

So being able to delegate all these—that brings in revenue. You’re being able to collect on all services that you render. That’s gonna bring in—and I don’t wanna speak for everybody, but I haven’t spoken to many practices that can collect on 100% of insurance claims.

And if you aren’t taking insurance and you’re a self-pay practice, are you having someone reach out to put on payment plans to see if there’s different ways that they can pay, just to work with those patients?

So, I mean, it can happen everywhere, but that’s my long-winded answer to it.

MJ:

Yeah, I mean, it makes sense to your whole point of there’s increased abilities for doctors to get more efficient running a business. So, in theory, as far as the organization goes, it’s never been easier. Obviously, there’s issues with insurance depending on specialty and all sorts of things.

But we see it too, of doctors that have worked in the employed model, and they’ve never really had anybody walk them through what’s possible or not possible. And not everyone that comes to us or talks to us ever opens up their own practice or buys into a practice. But a lot of them do, and they just don’t know where to go, quite frankly.

There’s not a really great—it’s not like dental, right? Dental has people in dental school talking to you about owning a practice. You rotate with people and shadow or associate with people who own their own practice. But in medicine, the people who train us are academic. They’re in academic medical centers. They train us in med school and a residency. And then we don’t really get a lot of exposure to entrepreneurship in medicine, especially on, like, practice ownership.

So I think people are just starting to see, like, maybe what’s possible. Definitely is challenging in a lot of ways, but I think the interest is there. And I think we’re also finding out that giving patients better choice can drive down costs, and practices that are owned by doctors can do that.

TB:

Yeah. And at the end of the day, as much as, like you said, you go to school and you go to a lot of school, right? But when we look at a practice, it is a business at the end of the day.

And we find ourselves consulting a lot here with people, with different practices, because they don’t, like you said, they don’t necessarily know how to run the operational side of the business, right? And they don’t know what the best SOPs are.

So for us, it’s been big that we’ve been able to consult. And when you add this medically trained virtual professional, we’re continuously consulting with you to find different gaps where you could collect more revenue.

Because you’re not going to start being like, “Okay, I’m going to add a VA here for front desk management. I’m going to have someone collect over here. I’m going to have someone be a medical scribe,” that we were talking about before.

What you’re going to do is you’re going to say, “Where’s my biggest pain point?”

Okay, I am having trouble scheduling patients because our front desk manager is just completely overwhelmed. Okay, I’m going to add a VA there. And that way, we’re going to be able to book double the amount of appointments that we were before because the workload just expanded.

Or if I have someone chasing out these insurance claims, you’re going to be able to do double the amount of the insurance claims, right?

But what happens is they find that first niche, they find out it’s successful with the help of a virtual professional, and then they go, “Okay, where’s another gap in our practice where we can find revenue?”

And that is how we make practices successful without adding additional tasks or adding additional overhead. You’re just finding ways to be efficient in collecting the revenue for it.

Yeah.

MJ:

Very cool. We normally end the shows with true and false. So how this works is I say a statement, you tell me if you think it’s true or if you think it’s false and why. I say it’s rapid. It’s almost never rapid, but we’ll try rapid fire.

All right. The first statement: true or false, ten years from now, a higher percentage of physicians will be in independent practice.

TB:

True. And why? Because of all of the technology that is coming into place to be able to run the operations efficiently without having to handle, like I said, all that additional overhead or adding tasks and stuff like that.

There are definitely things that are getting more efficient. There are different ways to become more efficient. So that is why that answer is true.

MJ:

Are there specialties that you see that being more true than others? Like certain specialties where you’re seeing more of a—which specialties are that?

TB:

Specialty like IVF fertility. So, higher reimbursement tests. So think of anything, any practice that is going to have high reimbursement tests. If the test costs a lot to run, then those practices are going to have to be reimbursed on every claim because if it’s a ten-thousand-dollar test that they’re trying to be reimbursed for, and not just a two-hundred-fifty-dollar office meeting, that is going to be more important.

So those specialty clinics are going to be big time. IVF, if you have dental implants, like those different practices, that’s a big one. But if we’re gonna keep it to physician-owned practices, it’s specialties for sure, or higher reimbursement test practices.

MJ:

Gotcha. Makes sense.

True or false: the new generation of doctors are more entrepreneurial than previous generations.

TB:

I feel bad answering that, not as a doctor, because it’s like listening to this, being like, “Who the heck is this guy gonna tell me what?” But I would say true just because of what we grew up with.

The technology is more relevant now than it ever has been. So I would just have to defer to true.

MJ:

Okay. True or false: in ten years, no physician practice will have a human being answering the phone.

TB:

False. I think that there are always going to be people that are stuck in their ways, and there are always going to be people that want to keep it close to the vest and keep their practice close to home.

If they don’t want to expand, they don’t want to run it, they want to do, like, for instance, my sister’s primary care practice, right? Like, a lot of her patients are her friends and her neighbors. And she is a very innovative person. But for other people that might have that same type of practice, that might be a little bit more difficult.

And then, to our point that we were talking about earlier, about when you walk into the office and have that face-to-face patient care, that person’s gonna pick up the phone at one point during the day. It’s not like they’re never gonna pick the phone up. The answer there is easy: true.

MJ:

Okay. Well, let me ask you: true or false, patients want to engage with virtual assistants.

TB:

True. Patients want to be left alone for the most part, unless it has to do with educational pieces, right? You have your prescriptions ready. Go pick it up here.

Or you just had an appointment. You get a call the next day from the virtual professional asking how everything’s going. And then, at the end of the day, if you have the virtual professional and they’re calling you, not asking for a bill, they’re just asking how your time was and how your experience was.

Rather than having to talk to a front desk manager who’s trying to collect on bills or anything like that, they’re gonna enjoy the process.

MJ:

Especially if it’s fast, right? Like, and they’re not having to wait on hold, like you said, to someone who’s also on the phone with the insurance.

Exactly.

TB:

It’s real-time, right? They’re on call, and it’s not AI-sounding. Like, if you were to go on the internet and you would look up someone who has an AI voice, these are real people, right?

And so they’re gonna be able to talk to you with a real human touch and really have feelings for you. So I think it’s gonna be a smooth process, but that definitely, rather talking to a virtual professional rather than an AI or a machine-operated thing.

’Cause when I call it—it could be anywhere. I could be calling the deli, and if they had an AI-operated, “Press one if you want to order a sandwich. Press two,” I’d be like, “Let me just talk to a person.” I’d never—exactly. “Give me the operator.” That’s the point I’m trying to make.

MJ:

Just get zero. Overnight.

MJ:

Yeah, and it’s funny, right? I mean, like, we want efficiency until we don’t. And, well, we want an efficient access to a person that can help us, basically. That’s why mash zero, I guess.

All right. Appreciate your time. We always ask last question, too, is what is one thing that you have recently changed your mind or opinion on? It can be about medicine, healthcare, anything, even outside.

TB:

I can keep it on topic. I think that AI is going to be efficient in healthcare.

When I first started my role here and I first went to these events at HIMSS, especially, I was more scared than anything. I was like, “This is not gonna work. There’s gonna be a lot of breach. Then there aren’t gonna be any human jobs.”

I don’t know if you’ve seen the movie—it’s a Will Smith movie, I, Robot.

MJ:

Yeah.

TB:

I thought of AI a lot like that. And then once I got starting to work with it in my space and our company, I’ve realized how efficient it can be if you do have the human touch, the human side of it.

So I’ve changed my stance on AI, especially in healthcare. And that’s honestly been over the last year or so.

MJ:

Yeah. I mean, I tend to agree that it’s inevitable to make things more efficient. I also tend to agree that, like, we probably overestimate all of the things it can do.

And when you really step back and think about who are the ones telling you all of the things it can do, it’s the people who are selling you the technology.

And then I think all of us listening have used AI, and it’s been sometimes great, and other times you’re like, “This makes no sense. And obviously, you have no idea what you’re talking about.”

And I think the question we have to ask ourselves is, would we let that machine autonomously take care of one of our family members? And I think that’s no, right? At least for me, and I would never, ever recommend that for a patient.

And that’s, like, ultimately what people are arguing is, like, “Okay, our doctor is going to be obsolete and this thing is going to take all of our jobs.” Like, okay, go to your AI, turn on voice mode, and try to reason with it about a complicated problem and see how—

TB:

That’s a good—

MJ:

There’s a video of a guy who is holding it up and he’s talking, telling it, and he says, “Hey, I’m underwater. I’m gonna go up to the surface.”

And, like, “Yeah, just make sure you do it really slowly.”

And he’s like, “Okay, I’m gonna take a deep breath. Is that okay?”

And they’re like, “Yeah, just take a deep breath, nice and slow.”

He’s like, “Deep breath underwater.”

And they’re like, “Yep, deep breath underwater.”

That’s what I mean. Like, yes, it’s really good at writing things and making things more efficient and scheduling things, but ultimately what it really is doing is predicting what the next word should be based on its previous data sets, right?

It doesn’t mean that it’s good at actually reasoning, and it doesn’t really reason.

TB:

Doctor language, too, especially. Like, they’re not gonna be able to understand what you’re saying when you have doctor language. It’s just—it’s not gonna happen.

There is no avenue for a set-it-and-forget-it for this AI. You’re always gonna have to have that human touch, human running it.

MJ:

And patients, I’m not convinced want that anyway, even if it were available.

TB:

I don’t think so.

MJ:

Well, this has been great. Sorry, hopefully I haven’t been too preachy. Appreciate you spending time. And where can practice owners find more about you and how you help practices?

TB:

So I’m on several podcasts. I have a LinkedIn page myself. We have RivaGlobalMedical.com. We’re also on LinkedIn and all socials. But just my number’s on there. Feel free to reach out to me if you have any questions.

Like I said during this podcast, we’d love to work as consultants. Take a step back and just work with you. Learn where the gaps are and see how we can fill them.

MJ:

Awesome. Well, thank you so much for your time.

TB:

Thank you, Dr. Jerkins. I really appreciate it.

MJ:

You can catch The Podcast for Doctors (By Doctors) on Apple, Spotify, YouTube, and all major platforms. If you enjoyed this episode, please rate and subscribe. Next time you see a doctor, maybe prescribe this podcast. See you next time.

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