Perhaps one of the most challenging aspects of implementing an electronic medical records system (EMR) is managing its effect on the staff.

According to a study by executive search firm Korn/Ferry International, one of the most common mistakes that executives make when joining a company or making changes is failing to properly read the existing corporate or office culture. An example would be a control-oriented manager coming into a company with a collaborative culture, leading to tension and resistance.

In this column, I’ll explain how to adapt the existing office culture to facilitate the staff’s acceptance of a switch from paper records to EMR.

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Your medical practice is really no different than any other type of business when it comes to the economy. Granted, perhaps medicine is a bit more insulated than the retail industry - people always get sick, but they don’t always need a new car or house. However, discussions we have had with physicians in a variety of specialties suggest that the economic downturn we are experiencing (recession, depression, or whatever you feel comfortable calling it) has had a detrimental effect on medical practices. So, when revenue is down, expenses should be trimmed. And what better area to cut than your marketing budget, right?

Many educated people confuse marketing and advertising, so it is important to distinguish the two. We all know what advertising is: billboards, magazine ads, radio or tv commercials, etc. But this is just a part of marketing. According to the American Marketing Association, marketing is defined as “the process of planning and executing the conception, pricing, promotion, and distribution of ideas, goods, services, organizations, and events to create and maintain relationships that will satisfy individual and organizational objectives. ” But what does that really mean?

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I’ve been asked to respond to the question: what would you do if a staff member came to work with a tattoo or tongue ring? Well, this happened to us a while back, so we developed a policy statement which is now incorporated into our employee handbook.

Basically, it covers jewelry and personal appearance. It states that staff may only wear a certain number
of earrings, necklaces, rings and bracelets. It also says that there shall be no jewelry that is visible to a patient which involves a piercing of any kind, which would include a tongue ring. For someone with a visible tattoo, they are told that Read the rest of this entry »

Every so often there is an article in a newspaper written by someone complaining about “rich doctors” giving professional courtesy (not charging each other or their families for medical care), and blaming that in part for the escalating costs of medicine in this country. Don’t you just hate when the misinformed have a platform from which to blather incessantly?

And then recently I had a discussion with a non-physician “professional” who complained about this practice. So I felt compelled to explain to him

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So, you’ve now made the decision to get your office running on an electronic medical records (EMR) system and you’ve chosen the specific software you want. Before you start making any major software or hardware purchases, however, you should have someone help you implement EMR into your practice - an IT (information technology) consultant or firm.

While a larger practice may have the resources for full-time IT personnel, what is a smaller group or solo practice to do?

IT is not just one narrow field, but many categories rolled into one, just as medicine comprises many distinct specialties. So, you may require different IT services depending on your practice’s needs.

But first, there are some things you need to consider before hiring your potential IT consultant or firm: Read the rest of this entry »

Winding down a medical practice need not be an anxiety-provoking process for a retiring physician. If he or she practices within a group, this process has probably already been addressed on some level. But what about doctors who are in a solo practice? How should they best accomplish a graceful exit? In an article in American Medical News, Karen Schecter addresses some key points to keep in mind.

Step 1: Present a Timeline to the Staff

First notify the staff by presenting a timeline. It is recommended that you give employees at least 90 days notice. Understand that at the first mention of a physician’s retirement, some employees may become skittish and tender their resignations. You may want to preempt this by offering some bonuses or severance packages to those employees who stay.

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I recently read a book entitled Corporate Agility (Grantham et al, 2007 AMACOM). And although initially I thought it was just applicable to large corporations, I realized that in fact it could be very useful for the typical medical practice. It describes a process known as collaborative strategic management (CSM). This is a strategic approach to management that incorporates three main areas: human resources (HR), information technology (IT) and corporate real estate (CRT).

The main principle of CSM is that, although these three areas may seem completely distinct, they need to be thought of as interdependent. Most of us are familiar with the terms HR and IT, but what does corporate real estate mean?

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Medical practices that are considering recruiting new physicians may want to consider the following fact: most residents will ultimately practice in the state in which they trained. The Florida Statutory Teaching Hospital Council, which represents Florida’s six teaching hospitals, says that about 70% of residents end up practicing in the community in which they do their residency. They attribute this primarily to residents developing relationships with hospitals and with other physicians in the community during their training.

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Recent studies suggest that larger physician groups not only have advantages over smaller groups and solo practices when it comes to negotiating contracts but they may also offer better quality of care. According to a report in American Medical News, larger practices are more likely to result in the “public practice of medicine”, where peer review and pressure improves the quality of the medical care delivered.

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The new federal pay-for-performance pilot program may prove to be short-lived.On December 20, 2006, President Bush signed into law the Tax Relief and Health Care Act of 2006 (TRHCA). A broad tax reform omnibus that also included a number of key health care measures, the bill authorized the establishment of a pay-for-performance program known as the Physician Quality Reporting Initiative (PQRI). According to the website of the Centers for Medicare & Medicaid Services, PQRI establishes a financial incentive of up to 1.5% of the total allowed charges for covered Medicare physician fee schedule services for eligible professionals whose performance meets a designated set of quality measures.

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