Essentials of Selecting the Ideal Family Practice David

Essentials of Selecting the “Ideal” Family Practice David Kolva, M. D. Practice Management Seminar #5

Career Seminars Review n Career Options Finish Personal/Professional Goals Worksheet. List and Stick to ‘Deal. Breakers’ Find Job Opportunities. Networking.

Career Seminars Review n Job Hunting Basics Finish Resume (C. V. ) Practice Cover Letters. Interviewing Techniques: Research, Personal Conduct, Post-Interview

Essentials for Selecting Your Ideal Practice Four Elements of Physician Job Satisfaction 1) 2) 3) 4) Geographic/Lifestyle Colleagues Patient Caseload Compensation

Geographic Lifestyle Practice visit is key. n Tour local hospital. n Community physician turnover. Why? n Housing costs n Schools for children n Spouse’s needs n

Colleagues Practice Governance Structure: staff meetings and dispute resolution. n Autonomy with clinical decision-making n Physician turnover. Why left? n Appropriate feedback for quality, billing, coding. n

Patient Caseload Patients per day. Quotas or minimal expectations. n Payer mix: Insured, Medicaid, charity n Night and weekend call volume n Quality of charting. EMR? n

Compensation Salary and benefits package. Insurances: life, disability, health, malpractice, umbrella n Billing procedure: in-house or service n How is your productivity measured? n Overall financial health of practice n Use of consultants for law, accounting, pension, practice management n

The key THREE C’s of evaluating practice opportunities 1. Control: YOU assert control over process by sticking to key issues 2. Courtesy: Be nice and polite. Avoid burning bridges with possible future colleagues 3. Common Sense: If it sounds too good to be true, it is.

Selecting a Financially Healthy Practice Once you have narrowed choices, decide which will be most likely to succeed. n Important to ask about future partnership/ownership ability. n A financial assessment is crucial. n

Selecting a Financially Healthy Practice Successful practices welcome your inquiries into current status and future plans, BUT…Must be truly interested in joining that practice. Respect privacy. n BEWARE of practice that can’t answer reasonable questions: analysis not done, or information doesn’t exist. n

Is Practice Sound? General rule: 2, 000 patients per MD (patient panel) n Daily patient visits? ~28/d or 3 -4/hr. n Accepting new patients? If full, how many new requests per week? >5 is good indication of need. n How are patients who deselect practice handled? Questionnaire or Staff Contact? n

Is Practice Sound? q Overhead Expense Ratio: defined as percent of medical revenues that go toward paying costs of operation. q Gross charges per physician per year. q Net Compensation to Collections Ratio defined as physician compensation divided by total adjusted collections

Overhead Expense Ratio n MGMA Sheet #1 n (Performance and Practices of Successful Medical Groups: 2006 Report Based on 2005 Data) Page 129 n Find Mean for All Primary Care n Find Mean for “Better Performers” n Benchmark to Remember = _______%

Gross Charges per M. D. per Year n MGMA Sheet #2 n (Physician Compensation and Production Survey: 2006 Report Based on 2005 Data. Page 112) n Find Mean for FP w/o OB +/- S. D. n Find Mean for Best Practices (>75%ile) n Benchmark to Remember =$ _______

Net Compensation to Collections Ratio n MGMA Sheet #3 n (Physician Compensation and Production Survey: 2006 Report Based on 2005 Data. Page 96) n Find Mean for FP w/o OB +/- S. D. n Find Mean for Best Practices (>75%ile) n Benchmark to Remember = 0. ______

Compensation Arrangement Salary: Guaranteed? How long? n Production: Bonus for targets, or share of billings? n Capable of predicting income over next 5 years? n Benefits: Moving expense, paid vacation, CME, Insurances, Dues n Student Loan payback (IRS rules) n

Before You Sign n Employment Agreement (Contract) Must Exist in Writing!! MUST CONSULT ATTORNEY ! Let lawyer be your negotiator (Dr. Knoll will review key contract components in October seminar) Partnership Agreement (Contract) is needed if future buy-in is selected.

Signs of Effective Practice Existence of Job Descriptions and Policy/Procedures Manual n Mission Statement n Delegation of non-M. D. tasks to support staff n EMR or dictation of charts n Good scheduling software to minimize waiting time and gaps n

Signs of Effective Practice Few “No-Shows” [phone confirmation] n Practice Budget and Quarterly Income/Expense Statements n Low Employee turnover rate n Elimination of employee overtime n Regular Staff Meetings monthly. Employee Input Welcomed n Patients are Customers n