Making collection calls in a small office; Coaxing "competitors" into a coverage group; Is this considered "patient stealing"? Whether it pays to hire another staffer.
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Q: I'm a solo FP who sees 25 to 30 patients a day. My collection clerk doubles as my bookkeeper. How many collection calls should she be able to make in an eight-hour day?
A:Three to five. Consultants say that the best times to make collection calls are on Tuesdays and Thursdays between 5:30 and 8 p.m. So you may want to rearrange her schedule or hire someone to work uninterrupted during those hours.
Q:I recently moved to a community short on physicians in my specialty. I've subsequently discovered that there's no call-coverage group for my specialty because my colleagues are afraid they'll lose patients to competitors.
I'm worried that relying on hospital ED physicians could lead to charges of malpractice. Are my concerns unfounded? Should I work harder to cajole colleagues into forming a coverage group?
A:It's unlikely a patient could make a malpractice claim stick in such circumstances, but there is a risk you could be accused of abandonment. Our experts agree that there's probably little you can do to convince such insecure colleagues to form a call-coverage group. Short of cutting your losses and setting up shop somewhere else, you have few options but to rely on the ED for coverage.
Q:A patient who came to me for a second opinion asked me to take over his care after I told him that I disagreed with his current doctor's diagnosis. Would it be ethical for me to do this?
A:Only if the patient came to you of his own accord. If he was referred by his current physician, send that doctor a letter explaining that the patient wants you to assume his care. Give the patient a copy of this letter. If the patient then returns to you, you're in the clear. Patients are free to choose their physicians: They don't "belong" to any one doctor.
Q:The office manager of our five-doctor practice says we're so busy that we need to add a staffer whose sole function would be answering phones. That way, our receptionist would be able to focus on greeting patients. Would the extra salary be well-spent?
A:Yes, if you're seeing a bottleneck at the reception area and patients are complaining about long hold times on the phone. Think of the additional staffer as an investment rather than an expense, since you're bound to see improvements in patient flow.
With the extra help, your receptionist will have more time to get insurance paperwork in order, make sure charts are ready, and schedule patients for follow-up appointments. And both of these front-desk workers will be able to devote more of their time and attention to patients, which is sure to boost patient satisfaction.
Between calls, your phone receptionist can help her co-worker perform small tasks, such as setting up charts.
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 Jul. 25, 2003;80:80.