Easing the burden on self-pay patients; If your manager oversteps her bounds; Your obligation to charity patients; Attracting a retiring doctor's patients; Coddle a temperamental patient? When doctors cause scheduling havoc
Q: The only patients who pay my full fee are uninsured. This seems unfair. Is there any way my office can offer a 15 to 20 percent discount to self-pay patients without running afoul of insurance rules?
A: Yes. Offer the discount to patients who pay your full fee at the time of service, and make it clear that the discount is reserved for patients who don't cost your office billing and collection expenses.
Q: A popular FP in our community is retiring, and everyone is scrambling to lure his patients. How can I get to them before my competitors do?
A: Ask the retiring doctor to recommend you to his patients, and give him an incentive to do so. For instance, you might offer to store his medical records in exchange for his patient list. Then you can write to his patients, offering your services. To appeal to patients directly, buy a newspaper ad congratulating him on his retirement and announcing that your practice will be glad to accept his patients.
Q: I recently read an article suggesting that doctors set up a "charity care day" for people who have recently lost their jobs. I'd like to try it. But I'm worried about the long-term implications of treating a patient with a significant medical condition. Would I be obligated to provide continuing care free of charge?
A: There's no obligation to provide free care, but you would have a duty of care to the patient. If you've examined a patient even once, you've established a relationship, whether or not you're paid.
Q: My partner and I sometimes neglect to tell each other or our receptionist when we'll be covering for a colleague or assisting at surgery. How can we solve this problem?
A: Instruct colleagues to go directly to your receptionist with their coverage and surgery requests. She should keep track of all your appointments and review them with you every morning. Post your schedules where staffers can see them, as well.
Q: A new patient who's allergic to bee venom called my office after being stung. My nurse advised her to use her EpiPen and go to the ED, so I saw no reason to return her call. A week later, she dropped me as her physician because I didn't return the call. Should I try to win this patient back?
A: It's a good idea. It's also good patient relations to follow up with all patients who are treated after-hours at an ED.
Q: Without my knowledge, my office manager dismissed a patient whose account was overdue. What should I do?
A: Make sure your office-policy manual clearly defines which decisions are within the manager's authority and which should be left to you. Get your collection policy down on paper, too.
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 Q&As.
Nov. 21, 2003;80:75.