Because That’s How We’ve Always Done It

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By Erin Cammarata
Erin Cammarata

When I am hired for a consulting job, I always ask my client why some tasks are done a certain way. More often than not the response is, "Because that's how we've always done it." These simple words can be the greatest roadblock in the path to your success. And yet this answer excites me because I identify it as an opportunity for change and growth.

A lot of times the tasks that get this answer are those we don't think twice about when performing them, such as entering patient demographics into a software system, receiving payments from insurance companies and patients, ordering office supplies, etc. The person who completes these tasks every day has grown accustomed to doing them a certain way. Human beings by nature are creatures of habit and cling to routines. If it's not broken, don't fix it. Right? Wrong! There are many different paths on the road to success, so why not try to find the one that gets you there the quickest? Performing tasks in the most efficient and effective ways is one of the keys to growing a successful business. How many of the daily tasks in your operation are not serving your growth and/or your success?

I would like to highlight an example I came across recently. This particular O&P practice was a contracted provider for ten insurance companies. Five of the contracts were set up for the practice to receive payments via electronic fund transfers (EFTs), and the other five were set up so the practice received payments via paper checks in the mail-because that's how they've always done it.

Let's look at all the tasks involved with receiving a paper check versus an EFT.

Paper check:

  1. Wait for the check to arrive in the mail. This process alone adds at least seven to ten days to your claim getting paid.
  2. Open the envelope.
  3. Tear off the check from the remittance slip.
  4. Sign the back of the check.
  5. Fill out a deposit slip.
  6. Drive to the bank.
  7. Make the deposit.
  8. Drive back from the bank.
  9. Record the deposit in your accounting software.


  1. Log into your clearinghouse and look at the claims that were paid.
  2. Log into your bank account and verify the EFTs that were made (while you were sleeping).
  3. Record the deposit in your accounting software.

I don't know about you, but I cannot see a logical reason why receiving a paper check would be an option.

efficiency graphic

This is just one example, but how many daily tasks do we perform because that's how we've always done it? The trick is to identify the task, no matter how small, no matter how long we've done it, and no matter who is doing it, and ask, "Why are we doing it this way?" Asking the question is key to discovering opportunities. Asking the question should not just be the responsibility of the boss; all staff members should ask this question during their daily routines.

Twenty-five hundred years ago, the Greek philosopher Heraclitus of Ephesus wrote, "The only thing that is constant is change." The idea here is that change is going to happen, so keeping up with it is a good thing. Constant reinvention is essential to the long-term success of any practice. So are you ready to take a look and see what has stayed the same over the years? Several years ago I began using the term "the adolescent years" to describe why O&P practices need to change their business models as they grow. A practice with 15 or 20 or 30 employees can't succeed using the same business model it did with a staff of five. It's easy to get lost in the day-to-day routine, but, like teenagers growing into adults, we can't spend our days doing the same things we did when we were 17 years old.

I hope you take this concept back to your practice and have your staff ask these questions over and over during their day: Why am I doing this task this way? Does it fuel our success?

Erin Cammarata is president and owner of CBS Medical Billing and Consulting. For more information, contact .