How to tally the success of your advertising campaign; When to start gearing up to sell your practice; Consolidating offices without losing patients; Dock a staffer's pay when she slips up? Your responsibility to staff when you pare benefits; Stop an ex-employee from luring away patients; Deciding whether your practice needs another doctor; Another way to ease the doldrums of waiting; Pay for staffers on extended jury duty; The money you need to keep the doors open; When a defunct insurer leaves you high and dry
Q My group has set aside a chunk of money to spend on marketing for the upcoming fiscal year. What's the best way to measure the results of our spending?
A Ask new patients to indicate on their registration forms why they chose your practiceword of mouth, a referral, advertising, brochures, etc. Also, compare the number of patients you had before the advertising effort against the end-of-campaign total.
QI'm 62 years old and intend to practice three or four more years. How soon before I retire should I start thinking about selling? Should I sell the office building and equipment together or separately?
A You should start looking for your successor now. This means deciding whether to bring in an associate as a potential buyer, or to look to an established physician, group, or hospital. Either way, it can take as long as two years to sell, and your buyer may want you to stay on for three to 12 months afterward.
If you're selling to an established practice or a hospital, it's typical to sell the building along with the practice. But a solo doctor would have a tough time affording payments on the office and practice at the same time. So, you could sell him the equipment and practice first, with a long-term lease on the building that comes with an option to buy.
Don't let patients know you're planning to retire, adds a consultant. They may switch doctors early, and their departure will decrease the practice's value. If you advertise the sale locally, use a post office box address.
QI practice out of two different locations about 15 miles apart. The suburban office is open from 9 a.m. to 5 p.m. The central city office is open from 5 p.m. to 9 p.m. I would like to combine these two locations into one that's open from 9 a.m. to 9 p.m. How can I reduce the number of patients who leave the practice?
A When you send patients a letter announcing the change, sell the benefits of extended hours and the value of the established relationships your patients have with you.
Q Our office manager suggested reducing an employee's pay for mistakes such as storing medications improperly or introducing errors into charts or letters. What do you think?
A It's a bad idea. If a staffer consistently makes mistakes, warn her that her job performance is substandard, and explain what she needs to do to improve. Give her a deadline of, say, three months to meet specified goals. Put a written account of your conversation in the employee's file. If her performance doesn't improve, then fire her.
QTo cut soaring benefit costs, our practice was forced to raise the health insurance deductibles our employees pay. Should we ask our 30 staffers to sign a form acknowledging that they've been notified of the increase?
A That's unnecessary. But be aggressive in getting the word out. As soon as possible, post a notice on your bulletin board that announces the increase and the reason for it. Also attach a copy to each employee's paycheck. And update your practice's employee manual.
QSome of our patients have reported that a receptionist who left our practice contacted them and asked them to switch to the doctor she works for now. Is there a way to stop her from doing that?
A First appeal to the doctor she now works for. He may not know she's doing this. If the solicitations don't stop, report the physician to the ethics committee of your local medical society.
QMy partner and I aren't sure whether we're busy enough to hire an additional physician. Should we try out a locum tenens before we launch a hiring search?
A Absolutely not! That would be confusing to patients. Instead, ask yourselves the following questions to determine whether you need a new associate:
Do your patients wait three weeks or more to get a routine appointment?
Have you had to close your practice to certain patients, such as pregnant women or those covered by certain insurers?
Are you seeing more patients a day than you can handle and still maintain quality care?
Is your practice load keeping you from participating in family activities or enjoying hobbies?
A Yes to any of these indicates the need for more help.
QWe're thinking of hanging a bulletin board in our reception room so patients can post their business cards, garage-sale notices, classified ads, even birth announcements. We'd assign a staffer to weed through the board once a week so it doesn't get too cluttered. Can your consultants give any further advice?
A Keep it strictly noncommercial, with the possible exception of "amateur" services, such as youngsters' offers to baby-sit or mow lawns.
Be aware that the employee designated to screen and post items may feel put on the spot where issues of taste and personal feelings are involved, so you may need to provide guidance.
Be sure to reserve a section of the board for health news and notices, including information about your practice. Finally, stamping all items with the date they're posted will hasten the culling process.
QMy office policy handbook states that employees on jury duty will be paid their regular salary minus the court's stipend, up to two weeks. If someone must be out longer, should I cut off her salary?
A Not unless keeping her on your payroll creates a financial burden. It's better to be civic-minded and show good will toward your employees by continuing their salaries. That's what most other employers do, our consultants say.
QHow much gross revenue should be dedicated to paying for office space?
A Most practices spend between 4 and 7 percent of collections on rent or mortgage, utilities, and janitorial services.
QIf I can't bill the patient of a health plan that's declared bankruptcy, what can I do to get paid for my services?
A Not much. The courts will deem you an "unsecured creditor." That means you need to calculate the amount you're due, submit it to the judge, and hope there are funds left to pay you.
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.
Dec. 9, 2002;79:129.