Originally published in Business Digest, January 1997

Just What the Doctors Ordered

by Kathryn Trudell

Billing with bedside manners. Practice management to enhance patient comfort. Training that supports medical practices and hospitals. Physician advocacy. These phrases describe the philosophy of MBA-Resources, a healthcare business management group whose mission and passion is providing a wide range of resources to free doctors to do best what they were trained for -- care for sick patients.

"Patient well-being is our bottom line even though we do not do direct patient care," says Sandra Bechtel, the founder, president, and chief financial officer of Medical Business Administration Resources located in the Mansfield Professional Building at 187 St. Paul St. in Burlington. "Our mission is to assist the healthcare practitioner in achieving and maintaining financial effectiveness, as well as increasing patient and employee satisfaction."

MBA-Resources -- MBA as it is known to its clients and employees -- is owned and managed by Bechtel and vice president/business colleague Lauren Parker. Founded in 1992, it is a professional consulting service that offers a wide array of customized medical management services to healthcare practitioners in private practice. During the last two years, hospitals have also used MBA-Resources in increasing numbers.

The phrase "Renaissance women" would not be an overstatement in describing Bechtel and Parker. They are a smoothly functioning team whose qualifications could easily be mistaken for those of a small crowd.

Their in-depth education and expertise covers a startlingly wide range of business, medical, and financial fields. The business has two main components: establishing and maintaining billing procedures for clients and medical business management consulting. Services available to clients include medical practice evaluations, practice education and management, personnel management, hospital-provider relations, customized billing, coding, electronic claims, claims follow-up, accounts receivable management, pre-collections, and reporting.

One of the most common reasons for a potential client’s first contact with MBA involves a financial matter, but in the course of addressing that concern Bechtel and Parker will usually become involved with a number of other areas in the practice.

Their goal is to assist the medical practice in taking care of patients in the best possible environment, from first contact through final billing. "When the physician doesn’t have to worry about the computer system, personnel issues in the office, or whether the billing is on schedule, he or she is free to concentrate on the patient. We assist in providing a calm, efficient, smoothly functioning environment for the medical practices with which we work. When a doctor isn’t worrying about office administration, he or she has more quality time to spend caring for patients, and that is our bottom line," Parker explains.

[photo] Lauren Parker and Sandra Bechtel head MBA-Resources in Burlington, which offers an array of customized medical management services to doctors' offices and hospitals. The women have expertise in both medical and financial fields, and enough degrees and qualifications for a small crowd. (Photo: Jeff Clarke)

Bechtel, who was born in Windsor, has three older brothers. Her father owned an oil business and her mother was a librarian. "Everyone in my family set very high standards for themselves as far as wanting to do anything well. My parents were trusting and supportive; they never pressured us."

Bechtel studied math and economics at UVM. In her junior year she entered X-ray technology, graduating in 1976 with a degree in education and an associate’s degree in radiologic technology. She worked in Boston as an X-ray technologist until she met her future husband, Henry, who is from Essex Junction. They have been married 18 years and have two children: Ethan, 14; and Nate, 11. They live in Monkton.

Shortly after her marriage, Bechtel returned to college to pursue a degree in registered nursing while working at the Rutland Regional Medical Center in the medical records department. After graduation she joined the Killington Mountain Clinic as a nurse and X-ray technician, later becoming an owner of the clinic in partnership with two physicians. Following this period, she took a position with the Rutland Regional Medical Center as director of the Radiologic Technology School.

Bechtel also began studying for an MBA at Plymouth State College in New Hampshire. In 1989 the family moved to the Burlington area so Bechtel could pursue a career that better utilized her management skills.

"I was hired by Vermont Radiologists in South Burlington to be the manager of that facility," Bechtel says. "I finished my MBA in 1991. I always knew I wanted to start my own business, but I didn’t know what it would be, other than the desire to combine business and medicine. While I was at the Rutland Regional Medical Center, I saw consultants helping hospitals through changes, but I seldom saw them working with the doctors’ offices. I decided to focus on the doctors’ offices. Having a medical background and a sense for patient comfort and care, I wanted to ensure that the processes that go on in a medical practice from a business standpoint affect the patient positively. Every aspect of patient contact and experience in a medical office is, in my mind, as important as the time spent with the doctor."

What helped Bechtel solidify her plans for MBA-Resources was the business plan she wrote for her master’s research project at Plymouth State College. "It took me a whole year to write," Bechtel recalls. "It detailed everything we do here."

Lauren Parker lives in Montpelier with her husband, Wes, and her two children, Rebecca, 8; and Emily, 6. Her husband is a network manager with Central Vermont Hospital. Parker was born in Darby, Pa., and her father, an IBM engineer, moved the family to Poughkeepsie, N.Y., one year later. Her mother was a teacher, librarian, and business woman.

After graduating from high school in 1975, Parker enrolled in a dental assisting school in Rochester, N.Y., graduating second in her class. After working for two years, she enrolled at State University of New York in Albany, graduating in 1981 with a major in psychology and a minor in business. From there she went to Stamford, Conn., accepting a job in public relations for Dental Associates of Stamford, but her job responsibilities soon expanded. During her seven-year tenure, the staff grew from nine people to 38. When the practice built a new office building, Parker researched and installed the computer system. "I worked closely with the office manager," she says. "I did all the training in the office for the front desk, reception, telephone etiquette, and seminars for the staff on patient comfort. We developed numerous internal and external marketing campaigns. I also served as general contractor for the new building."

Parker moved to Burlington in 1985, working at temporary jobs until she was hired by Breen Systems in Williston to market its dental software. Within a few months she began selling medical software as well, where she met Bechtel, who was considering the purchase of a computer system.

"Lauren was incredible," Bechtel recalls. "She was polished, intelligent, and very knowledgeable. I thought, ‘If I ever work with anybody, it’s going to be her.’ " The women stayed in contact with each other.

Bechtel recalls what happened next. "Lauren and I ran into each other at various meetings, and again when I was just starting my business. She was leaving Breen Systems at that point, and although it seemed like a perfect match it didn’t happen immediately. Lauren started doing some work with me while we had many discussions. We wanted to be sure. MBA was a business for about one month when Lauren became part of it." At that time Bechtel was sole owner, but after Parker joined the business they formed a corporation.

MBA-Resources opened its doors in the Chace Mill in Winooski in February 1992, moving to its current location nine months later. Says Bechtel, "We opened right after I graduated. I couldn’t use a business name with those initials unless I had earned an MBA degree. People actually ask me about that connection in the name fairly often. It helps people remember the name of our business and connect the two areas that are our focus.

"Healthcare providers and business people are different types of people," Bechtel points out. "Our desire is to help practices bring the two specialties together."

Parker echoes Bechtel’s philosophy. "We often work with major financial operations, computers, software, billing and coding, etc. These things seem not patient-related at first, but we make sure they are based on the ultimate welfare of the patient. For example, if we are setting up a protocol at the front desk, the focus is on the patient."

Bechtel and Parker stress they and their business are a team. "Sandy and I do everything together," Parker says.

Bechtel agrees. "When we go into a doctor’s practice or hospital on an initial consultation, we always go together. If their needs are in the billing, coding, and reimbursement areas, Lauren has the expertise. If their needs are clinical or financial, that’s where my strengths are."

In addition, both women have strong human resources backgrounds. They are equipped to help practices create more effective and caring patient-provider relationships as well as handle employee and personnel issues. Their own business relationship has worked so well they are often invited to address other groups concerning their success.

Karen Mitchell, the practice manager for Associates in Orthopedic Surgery in South Burlington, attests to their effectiveness. "I attended a Vermont State Medical Society meeting where Sandy and Lauren did an excellent presentation.

"At the time, our own practice was undergoing tremendous growth," Mitchell says. "We needed a local consulting firm that understood the area and the needs of a medical office. We worked with MBA for well over a year. They came in and assessed every aspect of the running of our office, right down to the job descriptions. They presented an extremely thorough report to the physicians, then helped us with all the changes. They stayed with us. They didn’t just drop a report on our desk and leave."

MBA has four employees, three of whom are full-time: Deborah Frazier, billing account manager; Stephanie Thayer, billing manager; Patricia Bremer, billing assistant; and Linda Dillon, part-time bookkeeper. The business is expanding. Deborah Guilbault was just hired as an office assistant, and interviewing is under way for an office manager.

"We are a family here. We all work together," says Frazier. "The atmosphere is very supportive. Lauren and Sandy have given me opportunities I never would have had otherwise. I never stop learning."

Bechtel and Parker have come a long way from their earliest days of cramped office space and borrowed computers. In 1996, MBA-Resources processed $7 million in physician practice charges that, when combined with the consulting portion of the business, resulted in $750,000 in gross charges to clients. They work with more than 100 doctors in a wide range of practice specialties, and a growing number of hospitals. The demand for the services they provide has been so great that the partners are exploring the idea of franchising MBA- Resources nationwide.

"Sometimes the smallest gesture makes the biggest difference," reads a wall poster in the office. "That’s our philosophy in dealing with people," Bechtel remarks. "We know we offer a great service. We used to worry about a large corporation coming into the state and swallowing us up, but that fear has lessened as we have become more established. We love working with people. We think we offer a unique mix of services in Vermont, and we care about our clients. Lauren and I receive tremendous personal satisfaction from what we do."