Practice Management

When your employer doesn't keep its promise

QThe large single-specialty group I work for promised to offer me partnership after I completed three years as an associate. Instead, the group reneged and offered me only a productivity bonus on top of my salary. Nonetheless, I remained with the practice for an additional three years.

Things haven't improved for me, so I plan to leave as soon as I find a new job. Under these circumstances, am I subject to the original noncompete clause that extends for two years after I leave?

A Since your employer failed to honor its pledge, our consultants are inclined to believe that courts would strike down the noncompete clause. However, the laws regarding restrictive covenants vary by state, so you'll need to contact a health care attorney.

Whether to cross-train your staff

QMy office manager wants our three-doctor practice to allow employees to swap jobs for six months at a time. That way, each employee would be able to learn all aspects of the practice—reception, scheduling, billing, and collections. I'm all for the concept. But I worry that patients will be inconvenienced by staffers who aren't familiar with their jobs. Should we proceed anyway?

A No. Scale back the plan. Requiring every employee to know every job will create confusion and inefficiency. Besides, not every claims clerk is cut out for the reception desk. There's no sense in forcing people into jobs they're ill-suited for.

Having two staffers proficient at one task should be enough to ensure coverage for vacationing or sick workers. To cross-train employees and keep their skills up to date, let them trade jobs—between the same two every time—for one month a year.

Does new practice ownership call for new patient records?

QI'm about to take over the practice of an FP who's been in business for 13 years. As I begin to assume care of his patients, should I create new charts or build on the existing ones?

A Continue using the old ones—it would be way too time-consuming to do otherwise. But change the format to suit what you're comfortable with. You can either place a divider between the old and new paperwork, or start a new folder and label it "Volume 2." Be sure to document which records are yours, and which are the previous doctor's.

No matter what you decide, make sure all information is current. Ask returning patients to complete a new health questionnaire and registration form with an up-to-date address and phone number, emergency contact, and health-plan information.

The cost of billing a patient

QWhat is the typical cost of processing a patient's invoice? What should I take into account when trying to calculate whether my office is spending too much on this task?

A Billing expenses usually comprise 3 to 6 percent of operating overhead. When calculating those costs, factor in staff time for coding; billing third-party payers and individuals; processing reimbursements; reconciling payments; and handling incoming or outgoing phone queries. In addition, consider the costs of office space, computers and telephones, paper, and postage.

Edited by Kristie Perry,
Contributing Writer

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 mepractice@medec.com (please include your regular postal address). Sorry, but we're not able to answer readers individually.

Kristie Perry. Practice Management.

Medical Economics

2002;8:100.