Practice Management Q&A

Is my practice healthy or sick?

I'm an internist who's been in group practice for 18 months. My average monthly gross charges are $33,000; my net collections are $26,000. That makes my collections-to-charges ratio 79 percent, which is better than the 66 percent median ratio reported by internist groups of my size. However, my accounts receivable are $126,000. Am I in trouble?

Yes. Something's very wrong with your account follow-up procedures if your A/R is four times your average monthly charges. A reasonable A/R is only slightly more than one-month's charges-and no more than 12 percent of that should be over 90 days old.

Filing corporate minutes

My partner and I have formed an S corporation. He insists we have to file minutes. Please explain what that means.

Minutes are the official record of the significant actions taken by your corporation, such as hiring an employee, signing a lease, or taking out a loan. Filing minutes is the job of your corporation's secretary and simply means that he must keep a signed, written record of your major business transactions and decisions in a corporate minutes book. Nothing has to be "filed" with your state's appropriate government authority.

In a small practice, however, their value goes beyond keeping track of your business operations; well-kept minutes can protect you and your partner in a lawsuit.

Under an S corp structure, if a claim is only against the corporation, the partners' personal assets can't be taken to satisfy any judgment against their practice. However, if a plaintiff can demonstrate that your practice doesn't follow proper corporate formalities-i.e., that it's a corporation in name only-the court might not uphold its status as a corporation in a lawsuit. Then the plaintiff could go after you both personally. Your minutes are your evidence that you do operate as a corporation, and your defense against plaintiffs' efforts to "pierce the corporate veil."

Working for a retail clinic?

These in-store clinics that are popping up in drugstores and supermarkets must need doctors to supervise the NPs that staff them. Do you think this job opportunity is worth investigating?

Possibly. But first, give some serious thought to your career goals. Is this really where you want to go? Would the time you devote to supervising NPs at a drugstore clinic be better spent building your own practice or establishing a secure position with a group?

If you decide to go ahead, you'll need to get answers to a few key questions like: Is the company reputable and solid? Will I be compromising quality of care? Is there a heightened risk for malpractice? Who pays for malpractice insurance?

Also consider that many of your colleagues may view you as a "traitor," helping the drugstore clinics take away their patients. The upside is that salary could be very good if it's hard to attract physicians to take on this responsibility.

Time off for a longtime staffer

How much paid time-off should I give a full-time employee who's been with me for 15 years?

It's not uncommon for employees with 15 years' tenure to receive four weeks of paid time-off. Generally, medical practices offer one to two weeks for the first five years of employment, with a third week for years six through 14.

Providing records when you're not a defendant