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START & RUN A MEDICAL PRACTICE
Preface
Introduction
1. Careers Suited To Owning And Operating A Medical-Type Practice
1. Medical Doctors
2. Allied Health Professions
2.1 Audiology
2.2 Chiropractic
2.3 Dentistry
2.4 Dietetics
2.5 Midwifery
2.6 Naturopathy
2.7 Nursing
2.8 Occupational therapy
2.9 Optometry
2.10 Osteopathy
2.11 Physiotherapy
2.12 Podiatry
2.13 Psychology
2.14 Respiratory therapy
2.15 Speech-language pathology
2.16 Veterinary medicine
2. Is The Health-Care Field The Right Choice For You?
1. Good Reasons for Choosing a Health-Related Profession
1.1 You are a caregiver
1.2 Exciting
1.3 Rewarding
1.4 You want to help people
1.4a “B” — unconditional desire to help people despite the “background” of the patient
1.4b “O” — unconditional desire to help people despite the “outcome” of the patient
1.4c “A” — unconditional desire to help people despite their “appreciation” level
1.4d “T” — unconditional desire to help people despite the “treats”
1.5 You are dedicated
1.6 You are patient
2. The Wrong Reasons to Choose a Health-Related Profession
2.1 Family pressure
2.2 Money
2.3 Status
3. There Are Many Different Specialties from which to Choose
3. Important Information To Know Before You Begin
1. Licensing, Registration, and Membership
2. Continuing Medical Education
2.1 Additional Learning
3. Reviews
3.1 Peer reviews
3.2 Billing reviews
3.3 Licensing body review
4. Professionalism
5. Personal support
4. Choosing The Type Of Office Practice
1. Solo Practice
2. Group Practice
3. Associate
4. Locum Tenens
5. Factors to Consider When Choosing a Style of Practice
5.1 Time commitment
5.2 Financial arrangements
5.3 Options for continuation
5.4 Possibility for change
5.5 Mobility
5.6 On-call
5.7 Flexibility
5. Develop A Business Plan For Your Practice
1. The Business Plan
1.1 Executive summary
1.2 The mission statement
1.3 History and background
1.4 Practice values
1.5 Operations and employees
1.6 Market research
1.7 Marketing strategy
1.8 Financial plan
1.9 Forecasts and predictions
2. Revisiting Your Business Plan
6. Deciding On A Facility And Location For Your Office
1. Proximity to Ancillary Services
2. Group Environment versus Stand Alone
3. Building Facilities
4. Access for the Disabled
5. Washrooms
6. Public Transport and Parking
7. Other Factors to Consider When Choosing Your Office
7.1 Square footage
7.2 Design of the office
7.3 Adequate examination rooms
7.4 Adequate patient waiting area
7.5 Noise considerations
7.6 Storage space
7.7 Dedicated child play area
7.8 Security
7.9 Side entrance
7.10 Signage
8. Purchase versus Rental
8.1 Purchasing a house or condo for an office
8.2 Renting office facilities
8.3 Lease considerations
7. The Legal, Business, And Insurance Aspects Of Running A Practice
1. Hiring a Lawyer and Getting Legal Advice
2. Litigation
2.1 Consent to release information about a patient in a legal case
2.2 Expert consultant for a law firm or insurance company
2.3 Be aware of the possibility of negligence and malpractice lawsuits
3. Hiring an Accountant
4. Investment Advisors
5. Insurance
5.1 Office insurance
5.2 Disability and life insurance
5.3 Liability and malpractice insurance
6. Incorporating Your Medical Practice
6.1 Professional limited liability company (PLLC) in the United States
6.2 Incorporation in Canada
7. Additional Information
8. Equipment And Supplies
1. Adherence to Guidelines for Equipment
2. Technology
3. Phone System
4. Furniture
5. Destroying Confidential Files
6. Stationery
7. Office Cleaning Supplies
8. Notices and Signs for Patients to Read While Waiting
9. General Medical Supplies
9. Hiring Employees
1. Hiring Options
1.1 Contract services
1.2 Whether or Not to Hire Staff with Experience
1.3 Hiring family or friends
2. Where to Find Employees
3. Interviewing Potential Employees
4. Checking References
5. Salary
6. Benefits
7. Staff Contracts
8. Employment Rules and Regulations
9. Training the Staff
10. How To Get Your First Patients
1. Advance Preparation
1.1 Word of mouth
1.2 Personal visits
1.3 Notice boards
1.4 Mass mailings
1.5 Presentation at relevant venues
1.6 Being available
2. Don’t Rush Patient Visits
3. Daily Schedule
4. Dealing with Patients that Miss Appointments
11. Announcements, Promotional Material, And Advertising
1. Business Cards
2. Announcement Cards
3. Introductory Letters
4. Flyers
5. Advertisements
6. Website
7. Open House
12. Making Sure Your Office Runs Smoothly
1. Importance of the First Line of Contact
2. Avoid Long Wait Times for Your Patients
3. Medical Records
4. Dictation
5. Investigations and Results
6. Emergency Provisions
7. After-Hours Coverage
13. Additional Topics To Consider
1. Office Hours
2. Child Safety
3. Reading Material
4. Other Nice Things to Have in the Waiting Room
5. Retention of Files
14. Billing of Services
1. Billing Practices
1.1 Fee-for-service
1.2 Salary
1.3 Contractual
1.4 Income splitting and commission
1.5 Associate or locum tenens arrangements
1.6 Block payments
15. Evaluating Your Practice
1. Direct Feedback
2. Indirect Feedback
3. Periodic Review
4. Self-Assessment Tools
5. Lectures and Rounds
16. Troubleshooting
1. What to Do When a Staff Member Phones in Sick
1.1 Family or friends cover the shift
1.2 Everyone in the office pitches in
1.3 Contact temporary staffing agencies
1.4 Close until employee returns
2. Safety Issues While with a Patient
3. Management in the Event of a Fire Alarm
4. Prolonged Patient Visit
5. What to Do During a Power Failure
5.1 Ground-or low-floor practice
5.2 Higher floor office
6. Outdated Patient Contact Details
7. Bad Weather
8. Staff Conflicts
Conclusion
About The Author
Other Titles in the Start & Run Series
Notice To Readers
Self-Counsel Press thanks you for purchasing this ebook
Contents
To start and run a health-care practice is a continuum — from the time you think about a career in a medical field to the day you finally take down the shingle, and everything in between. None of the steps along the way can be considered in isolation as each and every part of the journey plays a key role as to how your career, or practice, will shape up in the end.
Having a fulfilling career in a medical field, or in any career for that matter, is based on having sound motivation, goals, and expectations for what lies ahead. Also, doing due diligence when it comes to researching the field before you dive into things head first will make for a happy camper in the long run! The office staff who are involved in a medical practice will also understand and appreciate things so much better if the appropriate background is gained at the outset.
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Just to demonstrate the forever and rapidly changing scope of the allied health professions, in the area that I practice, very recently a new ruling has come to effect that naturopathic doctors are permitted to prescribe limited medications themselves.
In terms of the naturopathic office environment, things can run in a similar fashion to an office of a primary care medical doctor, and I know several naturopaths who practice in the same office as a medical doctor.
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