Whether to mix spirits with staff when celebrating the holidays, Are free exams a way to increase patient census? Sharing sensitive personnel decisions with your office manager, Renounce third parties? First, do some homework
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Q My partners and I want to throw a holiday party for our staff. We'll invite employees and their families over to my house for a catered buffet. Would it be unwise to serve alcohol?
Q I have a small rural internal medicine practice. After years of struggling with paperwork, treatment denials, and battles over admissions and discharges, I'm thinking of opting out of all insurance plans, including Medicare. I know I'll be giving up some income, but the freedom it promises seems worth the sacrifice. What do your consultants think?
A Although some medical practices have successfully given up managed care, opting out is risky: You may lose too many of your patients to competitors. Before you make a decision, carefully review your community's patient demographics, as well as the competition. Then go over your contracts with health plans. Do they cover out-of-network care for members? If so, your patients might continue to see you, depending on what it would cost them. Talk with some long-time patients to gauge whether they'd be able or willing to shoulder higher out-of-pocket costs.
When it comes to Medicare, consultants voice even stronger reservations about dropping out, especially if the elderly make up at least a third of your patient load. They also urge you to find out what your hospital has to say about its physicians opting out of Medicare. By not participating, you might create treatment or billing problems for the hospital.
Rather than drop out altogether, our consultants suggest that you consider sticking with just one or two plans that account for the greatest number of patients. That would ensure a patient base and cut down on the time required to comply with health plan regulations.
Q When should we notify our office manager that we can't afford to replace a retiring worker? Before we tell the rest of the staff, or at the same time?
A Let her know ahead of time so she can figure out how to reassign duties to keep the office running smoothly. If you doubt her ability to keep the information confidential, she may not be the right person for the job.
Q To promote our family practice, our four-doctor group would like to offer free appointments to the first five new patients we get next month. We'd advertise this "special" in the community paper. Does our plan have drawbacks?
A Yes. It sounds like you're offering the "BlueLight Special" at Kmart. Don't cheapen your image by promoting deals. Instead, build your practice by providing excellent patient care, writing health articles for your local paper, or speaking at community health events.
Do you have a practice management question that may be stumping other doctors, too? Write: PMQA Editor, Medical Economics magazine, 5 Paragon Drive, Montvale, NJ 07645-1742, or send an e-mail to email@example.com (please include your regular postal address). Sorry, but we're not able to answer readers individually.
Kristie Perry. Practice Management. Medical Economics 2001;24:56.