Why People Love a Doctor with a Family Practice Health care is the largest rising industry in the nation. With all of the specialists and various types of doctors, one still remains untouched and that is the General Practitioner who has a Family Practice. Why? People like to go to the doctor and see the same one on each visit. They have developed a relationship with the doctor rather than just another patient where the doctor refers from a stack of records or a chart. We want our family practice physician to ask us how are kids are doing and recall off of the top of his head why we were there last. The demand is evident for family practices and not just in rural areas; there is a high demand even in larger cities, maybe even more so. People like family practices because they are concerned with more than just your health. They try to provide care for your entire well being as a person. Doctors who work from family practices can offer many various types of care. They specialize in everything; they can treat you for a common cold, anxiety, or high blood pressure. They can treat babies, adults and the elderly. They are there each and every time that you visit the doctor. They are so predictable that you will even notice right away if he has a new nurse or receptionist working for him. The difference between doctors who run family practices and doctors who are part of a large practice or work from a hospital is that the family doctor may find out that you have cancer but he will give you a hug, hold your hand and tell you that everything will work out, even if it is likely that it will not. Other doctors state the facts so robotically and are on their way. A family doctor will send flowers to the funeral home when you have lost a loved one and some may even send you a Christmas card as well. They will remember when you come to see them that you are still having difficulties coping with the loss of your dog last year. They are real people and even with today's technology they can still bring back a Marcus Welby M.D. touch. They are not second class doctors nor are they last chance doctors that couldn't get into a different form of practice, they are great doctors who simply want to help people on a personal level but if something happens to come up and they believe that you need more help, they will refer you to a specialist, but you can bet that it would be one that they would take their family to. Family practices do generally require a longer waiting period than doctors with a larger practice but one good thing is that you can start a book while you are waiting and be assured that on your next visit you will be able to pick that very same book up and continue reading where you left off. When Your Family Practice Physician Retires You may have had the same family practice doctor for a great number of years and just got news that he is about to retire. You are beside yourself and are in a panic mode trying to even fathom who will be able to take his place. Because of the fact that family practice doctors are considered somewhat old school, it is likely this will happen one day. Your doctor will find someone to take over his family practice that he is confident in and believes has a good bedside manner. He will probably familiarize himself with the new doctor first and have him come to the office during business hours and watch how your doctor conducts business and possibly to see any interaction that the new doctor may have with the patients and staff. This process will probably begin months or maybe even as much as a year before your doctor's retirement. You will probably be notified first by a personal letter from your doctor announcing his retirement but it is possible that the first time you hear about it could be from rumor or gossip. You will have plenty of time to make at least one appointment with your doctor before he goes and he will value your opinion on your feelings toward the new doctor. The nurse staff will probably give you a good heads up too as to whether or not they like him, especially if they do not, as they will get a job somewhere else. If the staff stays it is a sign that you are probably in good shape. Remember, you have been dealing with the staff for a long time so they will at least give you an eye roll if they do not think you will care for him. Trust in your doctor, he is the one who picked him. Once more before your doctor retires, you should be able to have an opportunity to meet with your doctor while the new doctor is present and speak with both of them. This makes the transaction much smoother. After all, this is a huge transition for you and your doctor understands that. When it is time to schedule an appointment with the new doctor, you will at least know what to expect. It is certain that the new doctor will do all he can to make your visit comfortable. He will want to go over your chart and see what your past medical history has been. He is now your new family practice doctor, of course he will want to know. Be confident and if you have any apprehension, tell him about it. It may even take a visit or two before you will get to know him and be certain of a choice between stating with the new doctor and perhaps checking out the competition of other family practices in your area. Chances are that your new doctor has had a chance to scope out any weaknesses that your old doctor had and maybe he corrected them to make the new family practice even better than ever. Challenges of Family Practices in Today's Health Care System All businesses face challenges and struggles but with today's health care system and its complexity the challenges that family practices face are great and even numerous. It is often difficult to maintain viability. Just attempting to generate the understanding of a family practice can be a struggle in itself. There are many flaws in the health care systems that we have today. These flaws work in favor of family practice doctors if they are able to improve the results for patients. Family practices and family medicine in general are in need of a major overhaul. Family practice doctors will raise to the final victory as they display their deep concern for the patients overall well being. Family practices are unique and a specialty all of their own. However, family practice doctors have wanted to remain unnamed and unlabeled along with a class of other specialists and physicians. Another big challenge and probably the biggest is the fact that family practice doctors have yet to gain the respect that they deserve. They are sometimes looked at as second rate doctors especially within their academic circle. Although it truly is a specialized field, it is generally not supported nor endorsed. Family practices and family practice doctors need to gain recognition and support because they have truly been the medical backbone for centuries. Today, many people believe that family practice doctors are old fashioned and not equipped to handle newer medicine. That actually holds no weight within the medical profession itself. Family practice physicians are experts in their own field. They handle common complaints, diagnose acute and chronic conditions, they promote health and prevent disease. Prior to the skyrocketing insurance premiums that doctor's had to pay because of so many lawsuits; doctors performed some surgical procedures such as tonsillectomies, appendectomies, child birth, and other simple surgeries. No longer do many family practice doctors provide these types of surgeries and have to refer them out to specialists but can often provide the follow up care. Another challenge that today's family practice doctors face is the aging population and the "baby boomers". These people make up a large majority of patients that are dependent on family practice doctors. Issues with Medicare arise as well with these challenges. Further, work is being done to make family practices more attractive as options available rather than focusing on what family practice medicine or doctors used to be able to provide they need to look into the future and see what family practice physicians will be able to better provide in the future. Although family practice physicians have some difficult challenges to face with the health care system of today there are also many rewards as well. The relationships that doctors are able to establish with their patients and their families, the ability to offer the best in preventative care, flexibility and security, and being able to observe and assist in all facets of life are just some of the rewards that family practice offers to some doctors who are just not willing to compromise the true meaning of quality. Support Staff for Family Practice The right staff can make a measurable difference in patient experience, office morale and the family practice bottom line. When preparing to set up a family practice, it is important to determine who will be needed and what tasks they will be performing. A small family practice can often operate with no more than one nurse and one office employee. With this method of management, tasks are less defined. Everyone pitches in to do whatever is needed at any given time. The physician is as involved in clinic maintenance as the supporting staff members are. A larger, more complex family practice may require more support staff and a greater division of duties. With this method of operation, duties are more clearly defined and there is much less blurring between who and what. Office Staff for Family Practice Reception. Reception duties are a must. Someone should be responsible for greeting everyone who comes in the door. This person is often the one responsible for creating patient charts, setting appointments and collecting payment for services. In a small family practice, reception duties may be shared between one office person and one nurse position. Coding and insurance. Unless the family practice is operating on a cash only basis, coding and insurance filing and follow up are vital. Incorrect coding can cost the practice money it deserves. The filing of insurance claims, getting pre-certification for procedures and verifying receipt of payment can be time consuming. Many family practice's employ someone whose only duty is to manage claims and billing. Medical Transcription. Medical transcription was once a costly process involving the hiring of someone specifically to transcribe all patient visits and other related dictation. New electronc family practice software has eliminated this position in many clinics. All data is entered onto computer as the patient visit takes place. A well chosen electronic medical record software can be one of the family practice's best investments. Office Management. The mid to large sized family practice often benefits from the presence of an office manager. The manager may be involved with every step from reception to billing or may oversee all divisions. Smaller family practice setups may not require a dedicated office manager. Those considering hiring an office manager should decide how much support staff is going to be necessary. Office manager duties may consist strictly of overseeing staff and practice administration or may instead consist of performing a wide variety of duties from reception to billing to payroll. Family practice staffing may require no more hiring than one general office staff member and one medical staff member. Large, complex family practices may hire an army of staff including separate individuals to handle appointment setting, reception, billing, coding, medical records, and more. Services provided by the family practice will be one of the determining factors of how many staff members and what type of staffing will be required. One mistake that many medical clinics tend to make is hiring more staff when patient volume is up and letting staff go when patient volume is down. Proper staffing and a system for handling everything from the moment patients enter the family practice until they walk back out the door can make it possible for fewer staff members to handle any amount of patient volume while maintaining quality of care, patient satisfaction and a healthy bottom line. Rising Liability Insurance Rates Hurt Family Practices It is becoming increasingly difficult for family practice physicians to even obtain medical liability insurance let alone afford it. More and more insurance companies are deciding not to underwrite any medical liability insurance. Literally, in most states there are only few who will offer it. The increasing rate of malpractice lawsuits is to blame for this. Juries are awarding multi million dollar settlements and it is forcing many doctors to close the doors on their family practices. The problem is concurrent with other problems; doctor A closes his family practice so all of the patients rush to doctor B, now Dr. B is on overload and his patients are unhappy because of lengthy wait times and the vicious cycle continues. It has already been obvious as most family practices no longer deliver babies due to the ever rising costs of OB insurance. Also, most have stopped performing any surgical procedures because they simply can not afford the insurance premiums. This does not work like auto insurance either, regardless if a doctor has had a malpractice lawsuit against him or not, the premiums remain the same as well as whether or not the carrier will even write the policy. This is certainly posing a problem for family practice doctors or doctors in general who have to limit the scope of their services. Doctors are literally becoming afraid of assisting high risk patients because of the consequences and ramifications that could follow. If something does not change soon what will happen is people will not be able to get health care when it is most needed and it is due to two factors: availability of liability insurance and affordability. Another result from this is that most family practices who were always about to receive discount health insurance reimbursements such as Medicaid and such, no longer can because they can not simply afford to. Liability insurance companies simply claim that there is zero stability in the market of liability insurance due to the puerile lawsuits and the astronomical awards that juries are handing out. This is causing family practices and doctors everywhere to watch every move that they make to avoid being sued. It is further raising medical costs because a doctor is running countless and sometimes unnecessary tests to ensure his medical security. All of these possible unneeded tests take money away from those who really need medical treatment. Now guess who ends up having to foot the bill for all of this? The government and the taxpayers. Then, this process affects employers because they no longer want to provide employee insurance or cut the insurance that they do offer because rates climb so high that they can not afford it either. The only foreseeable way to get the system back on track is to begin with eliminating the numerous amounts of petty lawsuits. Beginning with this will perhaps get the system back on track and instill some validity back into America hence, achieving the ultimate goal which is to provide everyone with quality health care and instill the values of family practice. Repositioning Your Family Practice For Future Growth The whole system of health care is becoming more and more complex with the exception of family practice doctors. There are doctors or specialists that are committed to treating just cancer or just the heart but family practice doctors are committed to treating the whole person and nothing can be more unique than that. Because of the grim image that has been given to family practice doctors many medical students are turning their back on the possibility of entering the family practice field. In order to keep up with the times and for upcoming generations to invest their trust into family practices, the entire basis of family practice may have to be remarketed to them. Although many family practice doctors believe that it is unethical to allow themselves a marketing budget and solicit themselves they are going to have to enter a new facet in order to draw the new generations into the belief that family practice is not second rate health care. Baby boomers have visited the same family practice for decades but many of the following generations refuse to consider it. Many family practices rely on word of mouth to build up their patient population but in order to capture the new generations and allow family practice to refuel in an attempt to advance into the future; some strategic moves will have to take place. Start off with seeing what is going on with your competition, the community as a whole, and their expectations. Review patient records and have patients fill out short surveys while they are waiting and allow them to remain anonymous. Family practice doctors are going to have to recapture their patients and potential patients in order to ensure future growth and stability. It helps if your family practice has been longstanding in your community and has a good reputation. Where are your strengths and weaknesses? Review your cancellation rates, staff turnover, and scheduling procedures. See where there may be room for correction or if it is fine the way that it is. Look at the demographics of your family practice and see where your patients are from, are they mainly male or female, children or adults? All of these are things to consider when deciding which avenue you will pursue when marketing your family practice. Find out how your patients perceive you and your family practice. Why do they come to see you and are these needs changing at all? These are the questions that need to be answered so that you can move your family practice and reposition it for greater strength. People will then come to understand that only family practices offer health care for the entire body. You have a major advantage so go ahead and use it. Compare a family practice to that of a Walmart or Meijer or any one stop shopping. They offer everything. In rare cases, you may have to go to a specialty store for something rare. A specialist is comparable to going to a meat market, a place that has quality meats but if you are looking for anything else you will have to make another stop. Analyzing it that way will make it easier for your patients to see that running to a bunch of different doctors doesn't make sense. Recognizing and Accepting Family Practice It has been a long time coming but family practice physicians are finally making the way to the front of the line. It has been a long struggle attempting to gain status quo. That was never really what they wanted, what they wanted was to make a difference and for it to be known that they care. Family practice doctors are unique in a manner that they can take care of boys and girls, men and women. They are very convenient and offer quality care without having to visit many different doctors. It can not be argued that family practice doctors specialize in the long term and quality care of their patients. They can recognize and treat your physical problems as well as your emotional problems and maybe better than someone else who does not have the special bond with you as your family practice doctor does. Advertisements have been everywhere, on billboards, in magazine, and in articles that chant about being smart and making sure that you see a specialist in regards to your physician. These are the types of statements that cause people to question the quality and performance of family practice physicians. The entire medical circle needs to recognize that family practice doctors went into this type of practice well aware of what they wee getting themselves into. They knew that they would never get rich, never be admired, or ever get the respect that they so deserve. They have the education and are by no means second rate doctors. Family practice doctors are some of the finest that medical school has ever put out but it was their passion and caring that brought them to where they are. Family practice doctors get to know the real you and everything about you. Imagine calling the doctors office to ask a question, odds are that the nurse will tell you that the doctor will call you back after hours. But when he does call he actually remembers who he is talking to, he can put a face with the name and maybe even ask you some questions that a specialist would never ask. Why? Because to them, you are another patient, another file. Do not think about going to see them without your deductible or your checkbook. Family practice doctors are more likely to tell you not to let money or the lack of it stop you from coming in if you need him. There is a difference and it is so very huge. Family practice physicians need to be accepted as well as recognized as a specialist for that is truly special when you can deliver a baby, take out someone's tonsils, medicate a patient for depression, update a woman's diabetic medication, remove a wart, and stitch up a kid who fell off of his bike all in one day. This is the true meaning of specialty and the very reason that we count on our doctors. Family practice doctors fell off of the band wagon some time ago as the modern and savvy specialists came to the forefront but since, something very important has happened and that is that they have now resurfaced back into the front of the line again. Open House Benefits in Family Practice Holding an open house to celebrate events, changes or milestones in a Family Practice can be an excellent means of increasing patient base and community awareness of the practice. Why Hold An Open House? Why hold an open house? There are plenty of reasons for a family practice to hold an open house. Relocating to a new location, adding a new procedure or new piece of medical equipment to the practice, completion of a remodeling project, achievement of a particular goal or milestone, addition of staff or an anniversary are all excellent reasons to hold an open house. Who's Invited to the Family Practice Open House? In order to determine who to invite, it's important to determine the purpose of the event. If the purpose of the family practice open house is to announce and celebrate the addition of new equipment, anyone who could potentially benefit from the use of the equipment should be invited. For example, the addition of equipment relating to cosmetic beauty procedures could mean inviting area women to the open house. If a new physician has joined the family practice, invite potential patients who could potentially benefit from services as well as current patients who can spread the word by telling friends and family members about the new physician. Don't forget to invite local leaders and dignitaries. When Will the Family Practice Open House Be Held? Set a date in advance for the family practice open house. The date should be far enough in advance of the event to allow time for taking care of all of the preliminaries. Allow an open window of time of at least two to three hours for the actual family practice open house. This leaves room for attendees to drop in throughout the time period. Don't forget to take work into consideration. If many of those invited work, set the open house time for hours after work so more of them can easily attend. How Much Will the Family Practice Open House Cost? There are several variables involved in hosting a family practice open house. There are invitations to create, print, address and deliver. There's a menu to do (finger foods and refreshments, possibly cake), and advertising, including the selection and ordering of any promotional products, to be done. The cost of each of these will have to be taken into consideration. If the open house is to be held during what normally would be regular office hours, how much revenue will be lost? How to Advertise the Family Practice Open House It will be necessary to advertise the family practice open house. Using advertising methods and media that fit both the occasion and the community will yield better results. Signage in the clinic, ads or flyers in area newspapers, and announcements on community radio are good methods. Wording Family Practice Open House Advertisements The family practice open house advertisement should do more than just announce the gathering. It should also state the reason for the event, along with place, date and time. Be sure to include information about any promotional items or services that will be provided. Holding an open house can be an excellent means of promoting the family practice. Paying careful attention to the targeted market, the reason for the event and the best methods of advertising to reach people will help ensure a well received event that produces the desired results. Office Management and the Family Practice The right office manager can help a family practice thrive. The wrong office manager can result in loss of clients and have everyone in the practice ready to commit homicide. How do you find the office manager who will be a blessing to the family practice instead of a curse? Office Manager Duties Before interviewing prospective office managers, consider what you need from them. What duties will the office manager be responsible for performing? What will be the office manager's role in the family practice? Office Manager as Administration When the family practice is a large or complex one with a large number of support staff carrying out individual roles, the office manager's main task is usually that of making sure everything runs smoothly and every task is covered. This is especially important when separate staff members are covering appointment setting, reception, billing, etc. If one person isn't getting the job done or isn't performing the job right, the whole system is affected. In this type of family practice, the office manager keeps an eye on the pulse of the practice, making sure everything is working properly while handling any issues that arrive, from staff issues to disgruntled patients. It is vital that the individual hired for this type position be able to multi-task, to work under pressure, to be able to mediate when problems arise, and to properly exercise their authority if necessary. The best office manager as administrative aide candidate can perform any task in the office if necessary and is capable of training, encouraging and overseeing other office staff members. Some office managers handle payroll and other financial duties for the family practice. If this will be the case, the potential office manager should have experience in payroll and the tax issues that affect operating a family practice. Risk management is another task the family practice office manager must administer. Keeping up with applicable local, state and federal laws, taxes and regulations and maintaining family practice compliance is part of the job. Insurance and legal issues such as malpractice must be monitored. Office Manager as Support Staff In the small family practice, the office manager may be the only staff member aside from medical staff. In this situation, the office manager fills every business office duty, from reception to accounting and payment of taxes. This type of office manager is well rounded, able to multi-task and comfortable both with computer related duties and tasks involving interaction with patients. From greeting patients and others who come through the front door to signing for equipment that comes in through the delivery door, this type of family practice office manager can handle any situation that arises. Finance and Family Practice Management Family practice financial duties including accounts payable/receivable, payroll and the budget may be administered by the office manager or the office bookkeeper. Practice administration is often handled by the office manager. If the office manager is not performing financial duties, he/she is responsible for overseeing those who do. Again, the size of the family practice is usually the first consideration when deciding who to assign financial related duties to. Human Resources and Family Practice Management Hiring and dismissing staff, overseeing staff activity, creating employee manuals, managing employee benefits, employee files and employee accomplishment is usually handled by the family practice office manager. Marketing and Family Practice Management Office managers, in the absence of a dedicated marketing manager, may perform all tasks related to advertising, community relations and building the practice. Qualifications of the Family Practice Office Management Candidate Specific qualifications usually vary in accordance with the size and complexity of the family practice and the expectation of the physicians involved. A college degree is usually a prerequisite. Certification as a medical office manager is a plus. Certification usually guarantees a certain amount of training in the required skills and tasks. In some cases, practical experience is as valuable as a degree. Once the expected duties have been determined, along with desired qualifications, the search for a family practice office manager can begin. If using a medical staffing agency, it's possible to have the agency interview potential candidates and refer only those who meet select criteria. The right family practice office manager keeps the practice running smoothly. Choosing the right candidate is a decision that should be made with careful consideration. Medical Record Systems for Family Practice Many clinic and medical care facilities can tell horror stories about computer software glitches and human error in record management systems that should have lightened the load but instead made it almost unbearable. This result is often due to specific mistakes or areas of ignorance on the part of those who chose and implement the system. Fortunately, there are steps that can be taken to avoid such an outcome. One of the criteria of a successful family practice is the existence of practice management methods that work. What will the Family Practice Medical Record System do? If a family practice is to work well (and profitably) it is important that everyone involved carry their share of the workload. This applies to equipment as well as individuals and departments. The first consideration in medical record system management is in determining exactly what is expected of the equipment. How many patients does the family practice serve? How many physicians are part of the family practice? How many records will the system need to process? What tasks will be involved in the management of the family practice patient and business records? What information will be managed? Who will be using the Family Practice Medical Record System? What members of the family practice team will be using the program? Will the system need to support multiple users at the same time? Does the system process information quickly and automatically? Will there be any 'down time' while the system updates or processes information? Will the system be accessed at one physical address or from multiple addresses or locations? How many workstations will be required? Will the system have to be hard wired or will a wireless system work? How many users can access the system at the same time? If the family practice is a large one with several physicians seeing patients simultaneously, can office and nursing personnel access the system at the same time? Can information be processed for multiple patients at the same time? Family Practice Advanced Medical Record Software Issues Will the system need to be accessed remotely (from the hospital, from home, etc.) at all? Can more than one patient window be open at the same time? For example, can personnel have two windows open for John Doe, one for entering prescription information and another for flagging test results? Miscellaneous Family Medical Record System Issues Can the program grow with the practice and be updated as necessary or will time and practice growth render it outdated? Can multiple patient windows be open at once? What kind of support is provided? Can support be reached immediately at no charge or will support be hard to reach? What kind of reputation does the company that created the system have? What kind of learning curve is involved? How long does implementation take? Family Practice Data Storage Issues Can patient information be accessed by a variety of means? For example, can the patient database be searched by name, age, diagnosis, zip code, etc.? If a single patient should end up with multiple charts, how easily can those charts be easily and automatically combined into one family practice chart? Can users of the system run queries and print reports showing the query results? There is no perfect family practice medical record system. There are some systems that are better than others. Knowing what is needed and what can be expected of the family practice software, along with what can be expected of the system can aid in choosing the right system. Marketing the Family Practice Successfully marketing the family practice can be done by several different methods. The best methods are those that fit the practice style, the community or city the practice operates in and any that show measurable results. Internet Marketing for Family Practice The Internet is becoming more and more available, even in rural areas. Every family practice should have at least a webpage, if not a website, representing the practice online. The website should reflect the style and tone of the family practice. Practices where younger patients are seen will probably want to use a younger style in web design. For practices focusing more on older or even elder patients, the website tone should probably be more classic. Ideally, the family practice homepage should be simple and to the point. Added pages can target the different age groups, different treatments offered, and other such divisions. This way, the page about pediatric treatments can be more child friendly. Teens are a class unto themselves and pages targeted toward teen patients should include more technology, even video or audio. Every page of the website should include not only contact information but also a signup form for viewers to provide name and address in return for free health information and inclusion on the family practice email newsletter. Email Marketing for Family Practice Family practice newsletters can sent out regularly via email as well as being available in print form in the facility. Regular newsletters can contain health information, clinic news, customer news and appreciation information, games, trivia and more. The newsletter should be specifically targeted toward those who will be receiving it. The tone should reflect the tone of the practice and the style should fit the community as well as the market. Family practices may wish to encourage user generated content by allowing comments and/or encouraging visitors to post tips, healthy recipes, etc. Newspaper Marketing for Family Practice In addition to standard newspaper ads, health information articles and blog excerpts linking to the family practice website or blog can be used. Newspaper readers who pay little attention to ads are likely to read articles or blog excerpts. A weekly column is another good way to market the family practice in local and area newspapers. Professional Publications Published articles and information in professional publications is a good way to build credibility and professionalism. Notice of such publications can be posted on the family practice website, blog and in newspaper announcements. Community Participation Family practices can greatly increase visibility by participating in community activities. In addition to joining appropriate clubs and organizations, clinic staff members can speak at area schools and daycares, participate in community fund raising events, parades and holiday celebrations and even sponsor community events. Providing tours for young schoolchildren can help ease the fear of physicians and medicine in young minds. Providing tours for older students who are considering careers and college is a good way to interact with the community and encourage education. Branding Publications The family practice can have standard health information booklets printed with the practice logo and give them away in the clinic, at the Chamber of Commerce, at health fairs, and other venues. Community health fairs are an excellent way to come in contact with potential clients. There's a multitude of ways and means to market the Family Practice. The best ways are those that fit the tone and style of the practice and fit the community or city where the practice is located. Marketing styles should blend well with the targeted population. Take the audience into consideration when looking at marketing methods. Making the Most of The Family Practice Website More and more people are becoming comfortable in using the Internet and many now have Internet access at home. A well designed family practice website can serve as an introduction for the practice and an advertisement of services offered. Family Practice Website as Introduction The appearance of the family practice website is crucial. Viewers will judge the practice by the appearance of the web pages. The website should match the tone of the clinic. If the family practice sees only adults, the website should reflect that. Crucial information to be included on the family practice website includes location, hours of operation, telephone and fax numbers, directions, and information about the services offered. If the practice is a cash only one, this should be noted on the website. Including a signup box for a free family practice newsletter or health report will encourage people to take the time to submit names and addresses. A signup form should be prominently displayed on every page of the website. Staff information in the form of photos, short biographies and job titles or descriptions can personalize the website. A smiling face goes a long way in starting a family practice/patient relationship. Some family practice websites include news and notes pages where news regarding the practice is announced as well as news regarding patients. Community and school achievements are a good way to promote area goodwill and advertise the practice. Do be sure to get permission before posting photos. The decision to use full names versus first names only will depend upon the area and the family practice. Ads and Links on Family Practice Website The issue of ads and links on the website should be addressed. Ideally, there should be no ads on the main pages. The website is, after all, supposed to be promoting and advertising the family practice. This said, offering a page where patients who use the practice can post a link to their business may be a good idea. Consider sponsoring a community page of some type and encourage anyone from the area to use the page. Links that lead to health information regarding general health or the specific issues addressed by the family practice can prove to be useful. Patient education can be integrated into the website via an informative section of the website or links to such information. Including a frequently asked questions area on the family practice website is a creative way to provide information while promoting the practice. Include a form to encourage website viewers to submit questions or comments. Family Practice Website as Shameless Clinic Promotion The family practice website should include physician credentials and accomplishments along with those of support staff. If staff have contributed in some way to the community, this information should be on the website. If the practice contributes to community activities, charitable or other such activities, this information should be on the website. Consider adding links for donations to charity. Maximizing the Family Practice Website The family practice website can be an important part of building the practice and maintaining it. Make the most of the opportunity. Showcase staff members, clinic and community activity, blog, announce news and hold contests. Include a signup form on every page, encouraging Internet surfers to sign up in exchange for free report or other item. Include the family practice website url in all advertising on and off-line. Making certain that your Family Practice doesn't grow out of Control Word of mouth spreads the fastest. If a family practice doctor is good enough, people will wait sometimes for hours to see him. However, as word spreads about a doctor so do his patients. If he doe not have such a great bedside manner then he will likely lose patients but if he does he will likely gain patients which to an extent are a good thing but can also overwhelm the doctor, his staff and his patients. Family practice doctors have a reputation for wanting to help everyone. Those who call in for a same day appointment are served just as someone who scheduled their appointment a month ago. Sometimes it is impossible to move them to another day or to switch them to a new provider. However, family practice doctors do need to recognize that they can only take on so many patients effectively. If a family practice doctor is going to consider the numbers of patients that he can effectively manage then he will need to discuss with his patients what it is that they expect from him or her and what makes them happy and satisfied. The family practice doctor also needs to confirm his workload and see what hours he can put forth that works best for him and his family. Estimate in hours of surgery and hospital visits and so forth. Factor in the time allowance and see how time is humanly possible to complete the schedule. The average doctor/patient visit is or should be about 10-15 minutes. Some doctors or nurses have the habit of scheduling 3 or more patients for the same time block which simply will not work. Based on a 10-15 minute time interval, it does not take a rocket scientist to figure out that the doctor should schedule four appointments per hour but might be able to get in five. Anymore than that and he could easily get behind schedule. If a doctor with a family practice finds that he has taken on more than he can manage effectively then he will be left with no choice but to cut down on his list of patients. Annually, patients move away, pass away, and change insurance providers which naturally can cut the patient list. Doctors can also close their acceptance of new patients for a while. Another possibility is to remove patients who miss many scheduled appointments and do not see the doctor regularly. The absolute number of patients that a doctor should have is the largest amount that he or she can care for effectively. That number can vary with time and there is no way to put an exact count to it. If everyone involved is happy then the doctor has probably the right amount of patients. However, if he finds that patients are waiting too long, he is cutting their visits short or running back in forth between rooms, and then the number may have to be readjusted. He does not want to few or too many but with a quality staff and dedicated persistence it is likely that the doctor will find his happy medium.
Implementing Office Systems in the Family Practice When setting up the family practice, some essential services, including telephone, mail, answering service and medical transcription will need to be addressed. Family Practice Telephone Systems The family practice telephone system is vital. When evaluating potential telephone systems, there are a few key considerations. What rooms will phones be required in? How much automation is preferred? Does the system need to send automated calls to patients reminding them of appointments or scheduling issues? Does the system need to play music or present health information while callers are on hold? What about wireless systems? What about hands free systems? What about caller id, voice mail and long distance services? High speed Internet services will not require an extra dedicated telephone line. If high-speed services are not available, one telephone line will be required for Internet. Once the requirements of the family practice telephone system are identified, it's time to go shopping. Innovations in wireless technology have resulted in more and more practices using wireless products. Choosing an Answering Service Family practice personnel cannot be answering telephones 24/7. It's important to choose the right answering service to represent the clinic. See what service other physicians are using. Check references and reputation. Some hospitals provide answering services. It will be necessary to define answering service criteria. What constitutes an emergency? What about calls from family members? How much information should the answering service get in addition to a telephone number? The more specific the details in what is required of the answering service, the easier it is for the answering service to meet those requirements. Handling Mail While email and faxes are often used for correspondence, standard mail is important. A small family practice may find it sufficient to simply purchase stamps in the beginning. As the practice grows, however, the mail volume will too. Postage options include the United States Postal Service online mailing and shipping as do services including Stamps and Endicia. Various companies provide postage meters. Pitney Bowes is one of the best known. For packages, large and small, the UPSP online mailing and shipping service is available. Independent carriers include DHL, UPS and FedEx. It is necessary to use a street address with independent carriers. They do not deliver to post office boxes. Medical Transcription Medical transcription was once an issue of sending dictation to be transcribed either in the clinic or outsourced to someone in the area. New developments in family practice computer software and electronic medical record software has eliminated the need for transcription in some clinics. Since family practice staff, including office, nurses and physicians, input all information directly into the computer at the time it's done, patient records are always current. If medical transcription will be required, decisions must be made about whether to employ someone to take care of it in the family practice clinic or outsource it. If using a medical transcription service, it's important to check references and reputation. It doesn't hurt to ask other physicians what service they are using. Some services are vital to operating the family practice. Reliable telephone systems that handle all required tasks, a quality answering service, a convenient and affordable mail handling system and medical transcription are just a few of those services. Goodwill in Family Practice Success Goodwill is not just the name of a well known charity. Goodwill, in terms of valuing a medical facility or other business, is an important, intangible asset that can play a huge part in the success of a family practice. We've all seen them. They're the person at the business that everyone enjoys seeing. The one person patients at a family practice may stop by to chat with even when they aren't ill. They are well liked, well respected and well known in the community. Sometimes they have enough personality and charisma to make up for the office crankpot or employees who tend to be rude. Often they are the principle force in the business as well as the driving force in the success of the business. What is goodwill? Some professional appraisers define it as an overall talent, attitude or condition. It includes the ability to interact very well with people, to attract and hold clients and is usually part of the makeup of respected, well known members of a community. Family practices can have practice goodwill attached to them. Practice goodwill is a term used to describe a professional entity that bears the same characteristics as someone with professional goodwill. Practice goodwill is defined by several family practice characteristics including excellent location, a respected reputation, and often is applied to a business that has been operating for some time. Practice goodwill isn't created overnight. It takes time to build a relationship with the community, with patients and with other professionals. Once developed, practice goodwill is an excellent characteristic for a family practice to have and one that directly affects the bottom line. If the family practice is one of goodwill, patients are more likely to tell others about the clinic in a good way, other physicians are more likely to refer patients and to speak well of the practice, as are general professionals. The location of the practice is good if not ideal. Professional goodwill is a characteristic demonstrated by one or more family practice staff members. Many different talents and skills and circumstances can affect professional goodwill. Most staff members who possess goodwill in a way that actually increases the value of the family practice get along well with everyone inside and outside the clinic. They have a good reputation and are considered trustworthy and reliable in the practice and in the community. Goodwill can rarely be measured in dollars and cents. It is measurable in that if it were to disappear, the family practice would suffer. Family practice clinics that do their best to hire the type of employees who generate goodwill will go farther and last longer in the community. Practice goodwill can be developed as can professional goodwill. Smart clinic administrators recognize the value of goodwill both in the practice and professionally in staff members. Hiring staff members who appear to be able to develop goodwill characteristics or who have already demonstrated them can be good for office morale and for the bottom line. Family Practices and Medical Malpractice So many people have filed medical malpractice lawsuits against their doctors that is has affected and had serious implications for family practice doctors in particular. Patients have sued their doctors mainly for lack of or a delay in proper diagnosis, maternity practices, negligence in trauma care, handling issues in a time conscious manner, providing care without consent, and failure to refer out patients who require specialized treatments. Most of the malpractice cases stem from a failure to diagnosis a condition that is already existent. Sometimes this lack of diagnosis comes from the family practice doctors who are under extreme stress. The biggest problem that results from this is the lack of identifying it in the first place. Family practice doctors work chaotic schedules that are extremely conflicting and have been viewed as almost superhuman. Recently, the dust has settled and now researchers are seeing that super humans do not exist and it is possible that many medical malpractice lawsuits can be avoided by not expecting superhuman behavior. Most of the time family practice physicians are treated by other doctors for stress related issues. Stress is said to have contributed greatly to the decline of the health and well being of all people and family practice doctors as well as doctors in general are not falling short of that assumption. Doctors can become depressed and exhausted which inadvertently will affect their profession. There have been several indications and accusations where doctors were sued because of negligence that resulted from stress related error. Several programs are since rising to the forefront to assist family practice doctors but not limited to in reducing the amount of stress that they are facing hence, reducing the amount of error causing medical malpractice to soar. These programs are intended to improve a doctors physical and emotional well being, enhance job performance, and their personal satisfaction. Family practice doctors that experience medical malpractice have a very difficult time obtaining further coverage, affording insurance, and the overall stress that the doctor suffers from the litigation itself can be traumatizing. Family practice doctors are sometimes holding a two sided sword. One side is the obligation to the patient to pursue their needs and the other is dealing with managed health care plans/ AKA insurance companies. Even in cases where the family practice doctor may not be all at fault, many times they are still held accountable over the managed health care plans, unjustly. If a doctor prescribes a medication that he believes to be the best drug of choice for a particular condition and the insurance company will not cover that as their first choice drug, which is at fault? The doctor is the person who interacted with the patient and should be allowed to prescribe what he feels in his expert opinion would be the best choice. If you took your car to a mechanic and he diagnosed it with needing a new carburetor, you surely wouldn't go across the street and have them fix the brakes. It is just common sense. Tax Entities and Family Practice Tax entity choice can affect family practice in many ways. Making the right choice will help protect both practice and physician. Family Practice Entity Types Typical entity options for family practice include sole proprietorships, general partnerships, limited liability companies, limited liability partnerships and professional S or C corporations. The two biggest influences in choosing the right entity are protection against litigation and the financial issues associated with the entity. It's important to consult a legal professional before making this family practice financial decision because the implications can be tremendous. Choosing to operate the family practice as a professional corporation, a limited liability corporation or a limited liability partnership usually provides protection against personal liability regarding the actions of any other physicians in the practice. For financial reasons, most group family practices tend to choose professional corporations. The professional corporation, whether S type or C type, provides the practice with protection from financial creditors. Sole Proprietorship & General Partnership The sole proprietorship is the cheapest and easiest choice in choosing a tax designation for the family practice. Business income and expense are reported on a schedule C. The problem with a sole proprietorship is that the physician's assets can be taken if the business is sued. This is a lot like a sole proprietorship, except that there are multiple business owners involved. Again, there is no liability protection when using this entity. Limited Liability Limited Liability Partnerships are the only kind of unincorporated entity that provide some form of protection from personal liability (including protection from liability for the actions of staff or other physicians in the practice.) A physician could lose his practice with this form of entity, but personal assets would be safe. Limited liability companies are much like a mix of the best available entity benefits. They are fast becoming the entity of choice for many family practices. Incorporated Entities Incorporating the family practice is more involved and more expensive but more protection is offered. The biggest reason physicians choose an incorporated entity is the protection from personal liability regarding the actions of colleagues. C corporations have several benefits. They also have a downside -- it's possible to be doubly taxed. S corporation profits are not taxed twice. Entities and Tax Issues for Family Practice Tax liabilities are important to consider when choosing an entity. Professional C corporations will pay a flat 35% rate tax on net income but profits can be taxed twice. Professional S corporations don't result in double taxing of profit but it isn't possible to write off the cost of all benefits. There are many implications when considering tax rates and entity. In order to avoid duplicate taxing and other negative consequences, consult a financial advisor and make sure all involved details are understood. Cost of Entity Set Up for Family Practice The cost to set up an entity and maintain it vary according to state rules and regulations. Professional corporations require more record keeping and paperwork than do limited liability partnerships or limited liability corporations. When setting up the Family Practice, it's important to take the time and money necessary to investigate options regarding incorporation, tax and related issues. Once the best entity has been recognized, it's important to legally implement it and maintain it. When it comes to tax related issues, careful consideration is important, especially regarding the setup of the family practice. Decisions made now affect the practice down the road. Consult with legal professionals before choosing the entity for the family practice. Designing & Furnishing the Family Practice Starting a family practice is a lot of work. When it comes to office layout and design, taking a little time in the beginning can save both time and work later. When leasing a new building that is still under construction, it's possible to design the entire interior layout of the clinic. This will involve total design including plumbing, electrical, walls, flooring and everything involved in building and furnishing the interior. While this is a good way to design the family practice clinic of your dreams, it's also a good way to empty your wallet and take on a large debt. Whether residential or commercial, building is costly. Depending upon the area and current prices, it could cost anywhere from $65 to $95 per square foot to complete the family practice building. Many physicians starting a new family practice start by renting an already completed (and usually already used) building. Setting up the clinic in this case usually involves remodeling, a little or a lot. New paint, flooring and possible fixtures are typical remodeling expenses and much less costly than the building and furnishing process. Maximize Efficiency in the Family Practice Floor plan No matter what type of rental situation is in use, it is recommended that the interior be set up in a way that maximizes efficiency. Exam rooms should be huddled together. This makes it easy to go from room to room when seeing patients. A small workstation within the area will make it possible to review charts and manage telephone calls. Most experts suggest a minimum of three exam rooms per physician. The best laid layouts move patients from waiting area to reception to exam rooms in a streamlined fashion. The receptionist should be able to see the entire waiting area. All hallways, doorways and pathways should be wide enough to accommodate wheelchairs. Waiting areas should be comfortable and relaxing. An aquarium can be an excellent addition to the furnishings. The waiting area is the new patient's first impression of the family practice. Make it a good one. Stocking the Family Practice Furnishing and stocking a new family practice can get costly if attention isn't paid to details. The first step is to find out what discounts are available from professional organizations. Ask other physicians where they shop. Consider buying used furniture and furnishings. Used furniture stores and office supply stores are good places to start looking. Often banks and hospitals redecorate and sell used furnishings at a good price. When it comes to purchasing equipment and clinical supplies, many vendors have checklists. Consider creating a list and asking for bids from several vendors. Chart materials and office supplies can be found online and at local supply stores. Setting up a new family practice is an involved process. If starting from scratch with a new building that must be designed, there's even more work (and money!) involved. No matter which method of renting or purchasing is being used, do make checklists of the tasks that need to be done and the supplies that must be acquired. Carefully consider layout and use a floor plan that saves time and money. When your family practice becomes a successful, busy one, you'll be glad you did. Choosing Family Practice For Replacement Therapy. Some family practice doctors have advanced in being some of the very few doctors that are legally able to prescribe buprenorphine, which is also known as Suboxone. This drug is prescribed as an alternative in replacement therapy for opiate addiction. Family practice doctors must get certified in order to join the program and are, by law, only allowed to prescribe to a certain number of patients annually. If a person with an opiate addiction chooses to select this method of treatment chances are that their family practice doctor will not be able to help him but may be able to refer him to another family practitioner. Because these offices are regular family practices, when the addict goes in for his initial visit, he will blend in as no one will know why he is there. The family practice doctor will examine the patient and get a thorough history because he will need to know the opiate of choice and how much the addict uses in order to dispense the replacement drug. The family practice doctor will not be able to council the addict but can probably send him in the right direction. The family practice doctor's sole purpose is to dispense the correct dose of buprenorphine and monitor its effectiveness. Medical insurance will not pick up the cost of the visits to the family practice doctor but may cover the extreme expense of the prescription itself. Some family practice doctors have chosen not to deal with the implications of offering replacement therapy but others have decided to enter this new facet of medicine in hopes of building up their practice with minimal insurance ramifications. The problem is that there are so many opiate addicts and so few doctors who have selected to become certified. That number needs to increase so that addicts can discreetly enter a family practice of their choosing and get the help that they need to address their problem. The program is newer and is an alternative to methadone. But buprenorphine and methadone are the only two choices for replacement therapy in opiate addiction. Anti drug campaigns are gearing up in an attempt to recruit more family practice physicians to become certified and enter the programs because it has been so successful. The family practice doctor is the best setting for this type of program but the main objective so far is for the physician to evaluate the patient, disperse the medication is adequate intervals, monitor the progress, and provide maintenance throughout the program. While family practice doctors create the perfect setting for this treatment and maintenance as an alternative to methadone treatment which requires those seeking treatment an alternative to overcrowded methadone clinics that require dosing on a daily basis. The replacement therapy is working and many addicts are seeking relief from this program. More family practice doctors should consider become certified and also offering this form of treatment especially because they are known for general health and overall well being and in some many cases of opiate abuse it may have been the family practice doctor who prescribed the prescription of opiates in the first place. Choosing A Family Practice Facility Preparation and planning aren't just for the boy scouts. Anyone who is reaching for success in a business will do well to plan and prepare. This can be especially important for the opening of a family practice. Who's Doing the Choosing? If the family practice is a new one featuring only one physician, it's pretty obvious who will be making the decision on where to locate the practice. If, however, the family practice is a large, complex one, the answer might not be so clear cut. If multiple physicians will be part of the family practice, it's important to determine if each and every physician will be part of the process in finding and choosing a location. If multiple office managers will be part of the practice, members must decide if any or all of the managers will be involved in the hunt. Some professionals suggest that the final decision be left up to a small representative segment of the family practice. Many suggest that staff members from all areas of the family practice be included in the decision making. The first decision in choosing a family practice location is deciding who will do the choosing. What to Seek in a Family Practice Facility Once the decision has been made regarding who will be doing the choosing, it's time to clearly define as much as possible what is expected of the facility. Consider patient base. If the family practice is geared toward treating retirees and older adults, a facility located near housing for younger families with children shouldn't be given much consideration unless there's no other facilities available. It's also important to consider distance and location regarding hospitals and other medical services. If physicians in the family practice will be using the hospital facilities often or will be referring patients to the hospital on a frequent basis, locating the facility near the hospital and other medical services could save time. Competition is a consideration in any business, even family practice. Are competitors located near the potential facility? Can the family practice offer something the competition does not? What reasons can the family practice give patients to choose the practice over the competition? A little reputation goes a long way. When looking at potential family practice facilities, it's important to consider the reputation of neighboring businesses, especially if those businesses are medical facilities. Choose a facility near respected physicians with good reputations so that if the family practice is judged on the merits of the surrounding businesses, those merits are good. Type of Family Practice Facility Is the family practice location committee determined to find a professional building or can the practice be set up in whatever facilities are available, even if that means setting up business in a strip mall or remodeling a home? Is the goal building or renting facilities for the family practice? If looking to build, the criteria are different than those for renting or leasing. Parking is an issue no matter where or how the family practice is located. Make sure there's plenty of parking in an area that's easy to enter and easy to exit. Handicap access is another issue that cannot be overlooked. Searching for a Family Practice Facility Once it's been determined what type and what size facility is needed, it's time to begin the hunt. Narrow down search areas as much as possible. Ruling out areas that are not adequate will help narrow the list. Choosing a family practice facility can be exhausting. It can also be rewarding. It doesn't have to be more difficult than necessary. Preparation and planning will go a long way in making the search a successful one. Cash Only Family Practice Pros and Cons In a world where plastic reigns, the idea of a cash only Family Practice sounds almost antiquated. The truth is that more physicians and health care providers are taking a serious look at the cash only business model. Cash Payment Methods The phrase "cash only" means that all services are paid for at the time of treatment. The Family Practice adopting this payment method usually accepts payments of cash, debit card, check or credit card. Why are some Family Practices giving serious thought to cancelling health care contracts and adopting cash policies? With the cash only method, the Family Practice does not file insurance claims or other such paperwork. Avoiding insurance paperwork, filing, and billing means there is no need to pay a staff member to process insurance claims and forms. There's no need to invest in software to track collections and insurance claims. Overhead is greatly reduced. Potential Problems with Cash Only Some health care plans prohibit physicians from serving members of the health plan if that physician has recently terminated the contract between the insurance company and the physician. State insurance regulations must be taken into consideration. Medicaid rules regarding the cash only Family Practice should be carefully reviewed. Most Family Practice physicians who choose to go "cash only" opt out of Medicare. Doing so involves completing several steps of Medicare rules and regulations. Questions to Consider with Cash Only Family Practice physicians and health care providers considering the cash only basis should first decide if doing so would put the practice at severe financial risk or even end it. If the practice is operating in an area with large numbers of patients who are uninsured, the cash only system may work quite well. How do current patients feel about the switch to a cash only method? If too many of the current patients are not willing to stay with the Family Practice, more thought and consideration should be given to the idea. Consider services and fees. What services will the Family Practice offer? What will be charged for each service? It's also important to take the hospital into consideration. Will patients in the hospital be seen by the Family Practice physician(s) or will in-hospital care be managed by the referred medical professional? Meeting Financial Responsibilities and Setting Up Fees How will switching to a cash only basis affect the Family Practice bottom line? How hard will it be to pay bills and maintain cash flow during the transition? Calculate all overhead and expenses. How many patients will the Family Practice need to see in order to cover current overhead? How much money will be saved by switching to the cash only method? How much time and staff expense can be cut by making the change? It isn't unusual for a Family Practice to make the switch to cash only to find more patients can be seen, quality of patient care does not suffer, and the bottom line improves. The cash only management method of Family Practice is worth considering. It isn't for every practice but when it does work, it tends to work very well. Building a Patient Base in Family Practice The whole point of a family practice is treating patients. Once the clinic is set up, staffed and all the necessary systems in place, it's time to cultivate a client base. Referrals The first step in getting referrals from other physicians is in letting those physicians know you are available. If you've applied for and been approved for hospital privileges, attend meetings and get to know other physicians. Make an effort to meet local surgeons and other professionals. Social workers, dentists, nurses, daycare owners, chiropractors, and pharmacists come into contact with large numbers of people. Advertising Run announcements in local newspapers and on radio. Consider using a professional mailing service to send out announcements. A professional mailing service will have targeted mailing lists making it possible to send the announcements to those people most likely to seek treatment at the family practice. Some physicians swear by postcards. The postcards announcing the family practice are sent to both medical professionals and individuals. It costs less to send a postcard than it does a letter and people are usually more likely to read the postcard. The hospital marketing department may have a service in place for announcing new physicians in the area. Ads aren't the only way to get the family practice noticed in the newspaper. Health information articles, notices of special prices for certain services, and frequently asked question columns in newspapers are good ways to advertise. Create brochures advertising the family practice and give them to local Chamber of Commerce and Welcoming Services. The brochure should state general information including where the family practice is located, what services are provided. The physician's photo and personal information, including credentials, should also be in the brochure. It's generally recommended that staff photos not be included. Website Internet websites aren't considered productive advertising methods. They are a necessity, however. The Internet is becoming a household tool and people hearing about the family practice are likely to check it out online. Do make sure the family practice has an Internet presence featuring a website that reflects the tone and general target audience of the practice. This is a good place to feature staff photos and information. It's much easier to update a web page if staffing changes than it is to change brochures and print information. Newsletter A family practice newsletter can be a good way to build and maintain the patient base. With the popularity, ease and low cost of email newsletters, the newsletter has become a cost effective means of family practice advertising. Some family practice newsletters are available in both print and electronic editions. Easy to use software makes it possible for clinics to do their own newsletters in house and save money. When considering a family practice newsletter, it's important to decide how often the newsletter will be published and in what forms. The minimum frequency is four times a year. Monthly newsletters require more dedication as well as time. Delivery will have to be decided, whether print, electronic or both. One advanced marketing method using the electronic newsletter is to create a series of health information emails. Put a signup box on the website and in the newsletter, giving readers the option of subscribing. By using an autoresponder, the health information emails can be delivered over a dedicated period of time. The more people hear or read the information, the more they remember the family practice. Even if they don't need healthcare, they may be asked by a friend or neighbor to recommend a health care facility. Getting patients to a new family practice is all about getting the word out. Attend medical meetings, organizational meetings and community gatherings. Let pharmacists, social workers and others know the family practice is open and accepting new patients. Get in touch with surgeons and others who refer patients. Advertise online and in the community. When patients do arrive, let them know that you appreciate the opportunity to help them manage health issues. Women Are Changing Family Practice Today more than ever women are helping to change the face of family practice. There have always been more men in family practice than there have been women. For many years, women were reluctant to enter family practice because there was gender stereotyping, sexism, and difficulties of mixing and balancing both family and work. Today, women are not only becoming doctors more and more they also fill some of the seats on the board of directors. Women in family practice are rejecting the negative stereotypes and proving that they can not only balance both family and work, they can excel at it. There are many support groups, seminars, and literature available today that encourage women to pursue careers in family practice and how to come up with a harmonious balance between the two. These are only a small part of the changing attitudes that show that people are more accepting of women running family practices whereas years ago, it may not have been so acceptable. Further, there was no help available to women at all that assisted women and gave them a place to turn to. Until recently women have been the minority especially in family practice but as more people have showed an interest in female doctors, the demands are being filled. Many women feel much more comfortable speaking with not only a female doctor but one who has positioned herself in a family practice because there is no greater comfort zone. However, many men want to see a female doctor too, which is another reason that women and family practice fit together and are a perfect match. Many family practice doctors are actually offering partnerships that are geared towards women doctors because they have a tendency to attract new patients. It causes a lot of work for women when they attempt to manage a family practice, balance a family, and continue to work towards furthering their careers but are able to do it. Women are actually an asset to the world of family practice and with this constant growth; it is possible to reestablish the role of family medicine practice. Since family practice embraces health care, mainly preventative, and treats babies to seniors, many people also like the idea of having a woman ran family practice because children are more likely to take to women than men doctors. Family practices are a place that families as a whole can go for medical treatment and see the same doctor each time and continue with an ongoing medical relationship. Times have changed since back in the day and although women have not been able to bust the glass ceiling they surely have put a few cracks in it. If women keep going and not just in family practice in particular, the glass ceiling might just disappear altogether. There is no doubt that women are changing the way that people view family practice in general. They are an asset and are going to show that they can make changes, become leaders, and change the whole concept of what a family practice really is. Valuing the Family Practice Assigning or defining the value of a Family Practice is not something that's easily done. Nor is it something most physicians think about until forced to. Knowing the value of the Family Practice is part of practice management. It can serve as a measuring tool for evaluating practice growth in good times. Should death, divorce or other circumstance force a sale, correctly valuing the Family Practice is important. Standard Valuation Methods: Comparison One way to value a Family Practice is to compare the Practice to others in the local area. While this may work for realty situations involving homes or buildings, it doesn't work in this case. The problem with this method of valuation for Family Practice is that there are too many intangibles involved. Not all Family Practices are the same size or serve the same patient base. There are too many variables to arrive at a reasonable sum. Standard Valuation Methods: Inventory The inventory method of valuation looks like a simple one. All assets are inventoried and a value is assigned to them. The values are added and the total liabilities are deducted, leaving a valuation sum. The problem with the inventory method of valuing the Family Practice is, again, the presence of intangibles. It's hard to assign a definite value to an intangible. Standard Valuation Methods: Cash Flow Cash flow valuation of the Family Practice takes income and accounts receivable into consideration. Too large a sum in the accounts receivable column can negatively affect cash flow figures and the attitude of potential buyers. Standard Valuation Methods: Appraisal Professional business appraisers usually take several issues into consideration when valuing the Family Practice. Cash flow and a potential practice growth in years to come are part of the process. Standard Valuation Issue: Goodwill One intangible asset that may be overlooked in the family practice valuation process is goodwill. Goodwill is an asset that is often defined by charisma and an inherent talent that invites trust. Goodwill includes the ability to attract and keep clients, reputation, etc. Some professional appraisers add goodwill to the valuation, others do not. According to some reports, the assigned value of many Family Practices is 20 to 50 percent goodwill. This is an important figure. If the physician operating the practice is a large part of the reason the practice is successful, what would the family practice be without that physician? Professional goodwill is a conglomeration of experience, reputation, charisma, skills, abilities, etc. of a physician. Practice goodwill is based more on location and the nature of the family practice and how long it has been in business. Valuating Goodwill One commonly used method of calculating the value of goodwill in a family practice is comparing the family practice to that of another physician with similar background and specialty. The low number is subtracted from the higher one. The resulting sum is then divided by 20 percent. The result is the goodwill dollar value. If the need to value the family practice should arise, a general valuation or valuation method will be available. If a professional appraiser is chosen, it should be one who does use the goodwill factor. The Employee Manual in Family Practice The creation and implementation of an effective employee manual serves several functions in the family practice. Standard procedures and clearly defined job descriptions, duties and expectations are addressed once instead of multiple times. Employee Manual Legally Mandated Content State and Federal employment law affects the contents of family practice employee manuals. For instance, large practices with many employees must include Family and Medical Leave Act information. Medium sized family practices are required to include COBRA information. The State Department of Labor has all of the necessary information required to make sure employee manuals are in compliance. Authoring the Family Practice Employee Manual There are several ways to produce the family practice employee manual. One is to outsource the project to professionals. Another is to produce the manual in-house. Some office managers are experienced in creating employee manuals. There are software programs available as well as templates. Some Chamber of Commerce organizations have employee manual templates available for member's use. The contents of the manual may include brief job descriptions and any mandated legal information or be all-inclusive documents detailing not only job descriptions but how-to perform those actions as well. Consider requesting staff input regarding the manual. Employee Manual as Family Practice Review Request that staff members detail their own job descriptions and information. Reviewing the result will immediately point out any areas where expectation on the part of management isn't made clear. If the required activities blur between departments, details may need to be included in both business and medical staff sections. Once the family practice employee manual draft has been reviewed, any problem issues that have been revealed will need to be discussed and dealt with. It may be necessary to not only re-write the manual but also to reconsider the division of labor among staff members. Pay scale information should be included for each area of labor. Review of this information may reveal inconsistencies that need to be corrected. Legal Issues and Family Practice Employee Manuals No matter who authors the family practice employee manual, it is wise to have a legal professional review the final draft. All practices, payment detail and other information should be reviewed in accordance with local, state and federal law requirements. Provided information should be clearly stated in a way that any employee can easily understand policies and prerequisites. Family Practice Employee Manual Final Once the family practice employee manual has been reviewed for errors in typing, duty descriptions, details, pay scale and legal information, the manuals should be printed and assembled. Assembly options include putting printed pages inside three ring binders (easy to make changes and update) or going so far as to have the manuals printed and bound in paperback or hardcover form. The latter makes re-printing necessary should involved updates be required at any time. Once the completed family practice employee manual is ready for use, all staff members should receive a copy. It is suggested that each be required to sign a form indicating not only the fact that a copy has been received but also the fact that the manual has been read and is understood by the staff member. A well-written family practice employee manual can be a vital tool in the smooth running of the practice. Taking time up front to make sure the manual contains all of the necessary descriptive and legal information saves time, money and explanations later.
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