Practice Management Q&As

When two doctors share the same patient

Q Recently, my partner and I split up to form our own solo practices. While we practiced together, we had a few mutual patients whom we both treated for different conditions. Now these patients continue to visit us at our separate practices. We used to keep one chart for each patient. Now, do we each need a full copy of their records from our old practice, or do we need only the parts relevant to the treatment we provided?

A For clinical and legal reasons, both of you should have a complete chart. If you both continue to treat your mutual patients, faxing notes and labs after each visit will keep you up to date. You might want to suggest to these few patients, though, that they make a choice between you and your former partner to assure that their care isn't compromised. Explain to them the logistics of maintaining two charts and the possibility of things falling through the cracks on busy days.

Q My group practice is located in a high-crime area, so we want to place a sign at the entrance to our building prohibiting weapons. Could this put our staff and patients at greater risk, because criminals might target people leaving the office on the assumption that they're unarmed?

A Possibly. Also realize that, even with a sign, someone could carry in a concealed weapon. Talk to your local police about what safety measures you should be taking. You might also need to speak with your casualty insurance carrier. They may have coverage exceptions to accidents or crimes involving weapons.

Does it make sense to change your practice name?

Q When I registered the name of my new medical office with the state, they gave me the go-ahead. Now a local physician, who opened his office two months before I did, claims that the names of our practices are so similar that it's confusing his patients. He's threatening me with legal action unless I change the name of my office. What should I do?

A Find a solution outside of court; the bad publicity surrounding a lawsuit would only hurt both practices. Changing the name of your practice would presumably satisfy the other physician, so perhaps that's a wise move. And after you resolve the matter, you and he should meet, just to smooth ruffled feathers.

Working part time for a home health agency

Q A local home health agency has asked me to consult on an hourly basis. What should I find out before deciding whether to accept? What's a reasonable per-hour consulting fee?

A First, check out the agency's medical reputation by contacting your county medical society and local physicians whose patients may be clients. Then make sure your malpractice insurance will cover your services there. Review the agency's protocols to make sure they comply with HIPAA. Get all the information you need about your schedule and make sure the work won't conflict with your practice or other responsibilities. Find out exactly how you'll be paid (for example, will you receive extra for emergency after-hours care).

As for your fee, divide your annual gross income by 2,080 (40 hours per week multiplied by 52 weeks) to get an idea of the hourly rate you should charge. You may want to charge half this rate for travel time.

How to evaluate a hospital's income guarantee

Q I plan to relocate my internal medicine practice, and an area hospital has offered to help me by guaranteeing my income for a year up to $100,000. If I practice in the community for three years, the hospital will write off anything it paid me. But if I leave before that time, I must repay the hospital in full. Is this a good deal?