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You are here > Home > Reading Lists > Medical Leadership > Physician's Guide to Survival and Success in the Medical Practice The Physician's Guide to Survival and Success in the Medical Practice The Coker Group; The American Medical Association 3-Ring Binder: 400 pages + bonus CD-ROM Size: 8.5" x 11" ISBN 1579477801 9781579477806 AMA Press April 2007 (click below to check the very best available price for this loose leaf manual and CD-ROM set) Recommended by the American Medical Association, this comprehensive reference guide details the day-to-day operation of a medical practice offering tools and techniques for managing personnel, finance and operations, marketing and promotion and risk. Up-to-date coverage of electronic health records and other technologies are also included. This resource is organized with these content areas: Managing Personnel Labor and Employment Law Employment Process Compensation and Benefits Compliance and Regulatory Finances and Operations Operation Management: Managing the Staff Budgeting and Forecasting Managing Medical and Administrative Expenses Information Technology Managing Managed Care Insurance (Third Party) and Managed Care Contracting Developing an Insurance Contracting Strategy Recruiting and Retaining Physicians Practice Marketing and Promotion Ancillary Services Risk Management / Managing Risk Buying, Selling, and Owning the Medical Practice Practice Buy Buy-In/ Practice Buy-Out Purchase and Sale of Practice The Physician as an Employee Numerous tools are also customizable and easily printable using the companion CD-ROM. This user friendly three-ring binder format also offers may forms, checklists, evaluation and assessment tools. The sections of this loose-leaf manual are briefly described here: Overview of Section One, Managing Personnel: For employers in the healthcare industry and for employers in general, one of the most important elements of success is having good employees and excellent working relationships. The greatest asset of any medical practice is its practice staff to support the physicians. Hiring and maintaining a reliable staff requires a working knowledge of employment laws and the application of policy and procedures that motivate and improve productivity. With skillful personnel management, medical office professionals can expect to have a harmonious workplace where each employee works as a team member for one purpose: providing quality patient care. Competent personnel management goes a long way to ensure that the employees will attain satisfaction and enjoyment from their jobs. With sound management principles in place, the risks of both employee discontent and patient dissatisfaction are reduced. This section provides guidelines regarding many policies and procedures relating to the structure of the practice staff. These guiding principles are generally applicable to all practices and can be tailored to the unique size and practicalities of the specific practice. The information in this unit will equip personnel decision makers to accomplish these objectives: Understand and adhere to employment laws; Prepare staff job descriptions; Manage the employee application, interview, selection, and training process; Set up and maintain accurate personnel files; Establish policies and procedures; Conduct performance appraisals; Administer employee compensation and benefits; Handle employee terminations; Develop an employee handbook; Develop a procedure manual. Overview of Section Two, Compliance and Regulatory: This chapter, a section unto itself due to its vital nature for today’s medical practices, provides basic information of which practice managers should be aware and provides a guideline to follow in ensuring compliance is maintained by the practice. The chapter highlights such issues as Stark Laws and anti-kickback statutes, plus government reform as it relates to physician reimbursement. Also, the chapter provides a usable table of contents for a compliance plan (a must for physician practice). Finally, a section explores the intricacies of HIPAA and the most recent updates that interpret this regulation. Overview of Section Three, Operations and Finance: Trying to separate and determine which is more important, operations or finance, is like trying to decide which came first: the chicken or the egg. That is, a practice cannot effectively manage one without impacting the other. Although operations and finance are distinct and have their own interrelations, they cannot be considered mutually exclusive. A manager cannot expect to make changes in financial performance without making changes to operational performance, and whenever the manager changes operations, odds are it will have some impact on the financial performance of the organization. For example, suppose a practice is having a cash flow issue in that too much money is going out and not enough is coming in: clearly a financial problem. In this case the practice manager has two options: increase revenue or decrease expenses. So after appropriate due diligence, the manager realizes that the organization is overstaffed in terms of benchmarks both on a full-time employee basis and a percent of revenue basis. After further, more in-depth due diligence the manager determines that the practice’s salary scale is competitive and within market parameters, so the problem has to be the number of staff. If staff are cut from the billing and collections department, the practice may lose efficiency, which could lower the collections rate. If the manager cuts clinical staff, this will lower the number of patients the practice can serve, thereby adversely affecting revenue. Clearly, this “financial” decision cannot be made without first addressing the “operational” aspects of the decision. Conversely, from an operational viewpoint, the manager notices that the organization is losing a significant amount of money from a particular third-party payer. Because the current billing and collections department is maxed out on its workload, the practice manager will need to hire another person. This seemingly good operational strategy raises financial questions: How will this hire affect the practice’s financial performance? Will this person be able to collect enough (ie, generate enough revenue) from the payer to cover all of his or her employment expenses, or will the cost of the employee just bring down financial margins still more? This section helps leaders effectively balance these questions and make prudent decisions. Overview of Section Four, Information Technology: Recent events in American healthcare policy and legislation have had a crucial impact on healthcare providers. Portable electronic health records (EHR) for all citizens are supported by both political parties, and legislation is likely to be required to meet this goal. Meanwhile, EHR systems are numerous, disparate, expensive, difficult to implement, and incompatible. Practices are understandably hesitant to risk investing in systems that are so much in question and a significant number of practices that attempt the conversion from paper records to electronic files will ultimately fail in the process. On the other hand, between 15% and 20% of US physician practices in have successfully made the transition to EHR, and more consider it daily. The difference between success and failure lies within the practice itself: its self-discovery, preparation, leadership, and management. This section addresses various aspects of information technology relative to successful implementation of EHR systems for the medical practice. This section helps you manage the transition and technological improvements in your practice. Overview of Section Five, Managed Care: This section’s chapters address managed care from different perspectives. The first chapter defines managed care’s current role in the physician’s practice. The second chapter addresses a suggested approach for the practice in contracting with managed care entities. It will help you decide your strategies and approaches with contracting as well as manage your ongoing relationships. Overview of Section Six, Recruiting and Retaining Physicians: Practices inevitably have to consider the question, “Should we add another provider?” Many factors apply to the decision for whether the timing and situation are amenable to expanding the practice through adding a provider. This section addresses many of the factors that must be considered by an individual physician or group prior to begin this process. The goal of the section is to illustrate many of the factors involved in successfully evaluating how, when, and why the practice should add a provider. And, if the practice decides to do so, what should be done to recruit a physician and retain him or her for the long-term good of the group? Physicians/practices recruit for many reasons: transitioning patients, expansion plans, call coverage responsibilities, competitive forces, financial opportunities, to name a few. This section helps you clarify your reasons, expectations and goals for expansion. Overview of Section Seven, Practice Marketing and Promotion: A contracting population base, constant competition for referrals from other colleagues, loss of income with the decreasing Medicare reimbursements, or managed care that moves existing patients to another healthcare provider are all reasons to look for ways to market the practice effectively, efficiently, and economically. Those physicians who maintaining a high level of clinical skill and marketing savvy will truly find themselves equipped to practice medicine in an ever-changing environment. In this section, practice building means the employment of external initiatives to develop and maintain an image and to get the word out through ethical promotion of the practice to attract new patients. It also means taking extraordinary care of existing patients through internal initiatives. Many concrete concepts and down-to-earth strategies are addressed in this section. Overview of Section Eight, Ancillary Services: One of the major challenges that physicians and other healthcare providers are confronted with in today’s environment is payers’ reductions in reimbursement. This matter affects myriad initiatives within the practice and causes the need for developing new strategies. One such new strategy that has gained popularity is the development of ancillary services within the traditional medical practice setting. This section explores the definition of such services and delves into opportunities, operations, and overall impact that these services have on medical practice and the healthcare delivery system at large. Using the information provided, you will be equipped to make key decision regarding the addition of new services to your practice or clinic. Overview of Section Nine, Risk Management: The proliferation of medical malpractice litigation continues. Lawsuits are filed frequently, often imposing stinging monetary penalties upon providers. Even when courts dismiss claims as unfounded, disputes consume and exhaust substantial time and money. Further, the emotional toll that such lawsuits take on a physician and his or her practice is immense. Physicians must protect themselves, their patients, and their employees through a proactive program of risk management. An effective program of loss prevention is twofold, emphasizing both risk management and quality assurance. They must instill a defensive mindset in every employee of the practice to reduce the likelihood of malpractice litigation and to enhance the patient’s perception of quality care. This section strives to help physicians develop a loss prevention program. This section addresses all of the major ways risk management affects the practice. Physicians will be able to set in motion protective measures to reduce exposure to litigation from patients, employers, or other sources. Overview of Section Ten, Buying, Owning and Selling a Medical Practice: The most common financial transactions arise when an owner wants to sell a medical practice or a provider wants to come on board as a partner. Unlike a valuation of a publicly traded entity such as a retail store, there are no publicly traded medical practices. Some of the more common other reasons to obtain valuations are for tax purposes, dissolution purposes, marital dissolution settlements, joint ventures, and practice mergers, to name a few. The purpose for the valuation dictates which methodology to use and the end value. There are standards as to how a valuation should be completed. The valuation should provide a general overview of how the entity operates and goes into some depth about how the calculations are made and the assumptions that were used. In valuing an organization for partner buy-in, the valuation expert considers the value of the entity as a going concern. The valuation expert must try to predict the future using historical operations, current operations, and understanding about the future of the industry, the market and the entity itself. In addition to learning the value of a practice at the time of purchasing or selling one, a physician has many other concerns at that critical juncture. The types of assets necessary for a successful practice are listed, and the overall process is outlined. Also reviewed are ways the practitioner prepares patients for his or her impending retirement or termination of the practice. This section also compares various payment and compensation incentives for all levels of practice staff. It explores the reasons physicians choose to become employees or independent contractors rather than manage individual practices. Some healthcare settings reviewed and discussed include employment at insurance companies, instruction at educational institutions, being part of an HMO group, and consulting. All of these opportunities and others are described, as are the types of roles, responsibilities, and contractual terms that accompany the professional’s employment. Recommended by the American Medical Association, this comprehensive reference guide details the day-to-day operation of a medical practice offering tools and techniques for managing personnel, finance and operations, marketing and promotion and risk. 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