Does your office manager need a four-year degree? A 900 number for your practice; A vacation policy that's fair to all; The rules governing overtime pay; When a deadbeat leaves your practice; Giving doctors and staffers adequate breathing room
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Q: Our three-doctor family practice will soon lose our office manager to retirement. She came to our practice straight from high school and worked her way up from receptionist. But times have changed; does it now make sense to require applicants for her position to have a four-year degree?
A: Not necessarily; there may be other gems out there who don't have the formal credentials. So write a job description and help-wanted ad that says you prefer candidates with a four-year degree or comparable experience.
Q: As an adjunct to our regular answering service, my partners and I have been thinking about establishing a 900 number for patients who wish to talk to one of us afterhours for nonemergency calls. Naturally, we'd include a pre-recorded message spelling out the service's cost and limitations. What do your experts think?
A: That it smacks of commercialism, cheapens your image, and will alienate patients. What's more, it could leave you vulnerable to a malpractice charge if a patient called with an emergency.
Q: One physician's wife works in our five-doctor office. According to our group's policy, she's entitled to three weeks of vacation. But because her husband is entitled to six weeks, she's now asking for the same amount herself. Granting her request would be unfair to the rest of the office staff. How should we handle this situation?
A: Explain to both that the wife isn't entitled to special privileges just because she's related to a physician, and that making exceptions for her will erode staff morale.
If the husband and wife team push the issue, allow the wife to take the extra three weeks off without pay. But require the pair to alert you far enough ahead of time to arrange for adequate staff coverage in her absence. And offer the same option to other workers.
Q: My practice bars employees from working overtime without prior authorization. If an employee ends up working more than 40 hours a week without permission, must I pay time-and-a-half?
A: Yes. But remind your entire staff that office policy requires employees to seek approval before working overtime and that repeated violations could lead to disciplinary action or, ultimately, dismissal.
Q: May I refuse to forward the charts of patients who have outstanding bills?
A: No. It's unethical and illegal.
Q: My two partners and I plan to redesign our office space. Would it be a good idea to have separate lounges for the physicians and staff?
A: If each doctor will have his or her own consultation room, a physicians' lounge is unnecessary. But if you won't have that luxury, build separate lounges. Staffers need to have a place of their own where they can relax without their bosses, and vice versa.
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 firstname.lastname@example.org (please include your regular postal address). Sorry, but we're not able to answer readers individually.
Kristie Perry. Practice Management Q&As. Medical Economics Sep. 5, 2003;80:89.