NOTICE xiiPREFACE xiiiINTRODUCTION xv1. CAREERS SUITED TO OWNING AND OPERATING A MEDICAL-TYPE PRACTICE 11. Medical Doctors 12. Allied Health Professions 22.1 Audiology 32.2 Chiropractic 32.3 Dentistry 32.4 Dietetics 42.5 Midwifery 52.6 Naturopathy 52.7 Nursing 62.8 Occupational therapy 72.9 Optometry 72.10 Osteopathy 72.11 Physiotherapy 82.12 Podiatry 82.13 Psychology 82.14 Respiratory therapy 82.15 Speech-language pathology 92.16 Veterinary medicine 92. IS THE HEALTH-CARE FIELD THE RIGHT CHOICE FOR YOU? 111. Good Reasons for Choosing a Health-Related Profession 111.1 You are a caregiver 12CONTENTSiv Start & run a medical practice1.2 Exciting 121.3 Rewarding 131.4 You want to help people 131.5 You are dedicated 151.6 You are patient 162. The Wrong Reasons to Choose a Health-Related Profession 172.1 Family pressure 172.2 Money 182.3 Status 193. There Are Many Different Specialties from Which to Choose 193. IMPORTANT INFORMATION TO KNOW BEFORE YOU BEGIN 211. Licensing, Registration, and Membership 212. Continuing Medical Education 222.1 Additional Learning 233. Reviews 243.1 Peer reviews 243.2 Billing reviews 253.3 Licensing body review 254. Professionalism 255. Personal support 274. CHOOSING THE TYPE OF OFFICE PRACTICE 291. Solo Practice 292. Group Practice 303. Associate 324. Locum Tenens 335. Factors to Consider When Choosing a Style of Practice 345.1 Time commitment 345.2 Financial arrangements 345.3 Options for continuation 345.4 Possibility for change 355.5 Mobility 355.6 On-call 365.7 Flexibility 37Contents v5. DEVELOP A BUSINESS PLAN FOR YOUR PRACTICE 391. The Business Plan 391.1 Executive summary 401.2 The mission statement 401.3 History and background 401.4 Practice values 411.5 Operations and employees 411.6 Market research 421.7 Marketing strategy 421.8 Financial plan 421.9 Forecasts and predictions 432. Revisiting Your Business Plan 436. DECIDING ON A FACILITY AND LOCATION FOR YOUR OFFICE 451. Proximity to Ancillary Services 452. Group Environment versus Stand Alone 463. Building Facilities 474. Access for the Disabled 475. Washrooms 486. Public Transport and Parking 497. Other Factors to Consider When Choosing Your Offi ce 527.1 Square footage 527.2 Design of the offi ce 527.3 Adequate examination rooms 527.4 Adequate patient waiting area 537.5 Noise considerations 537.6 Storage space 547.7 Dedicated child play area 547.8 Security 557.9 Side entrance 557.10 Signage 558. Purchase versus Rental 588.1 Purchasing a house or condo for an offi ce 588.2 Renting offi ce facilities 598.3 Lease considerations 59vi Start & run a medical practice7. THE LEGAL, BUSINESS, AND INSURANCE ASPECTS OF RUNNING A PRACTICE 611. Hiring a Lawyer and Getting Legal Advice 612. Litigation 622.1 Consent to release information about a patient in a legal case 622.2 Expert consultant for a law fi rm or insurance company 632.3 Be aware of the possibility of negligence and malpractice lawsuits 633. Hiring an Accountant 644. Investment Advisors 655. Insurance 655.1 Offi ce insurance 655.2 Disability and life insurance 655.3 Liability and malpractice insurance 666. Incorporating Your Medical Practice 666.1 Professional limited liability company (PLLC) in the United States 676.2 Incorporation in Canada 677. Additional Information 688. EQUIPMENT AND SUPPLIES 711. Adherence to Guidelines for Equipment 722. Technology 723. Phone System 734. Furniture 735. Destroying Confi dential Files 746. Stationery 747. Offi ce Cleaning Supplies 758. Notices and Signs for Patients to Read While Waiting 759. General Medical Supplies 759. HIRING EMPLOYEES 811. Hiring Options 811.1 Contract services 811.2 Whether or not to hire staff with experience 821.3 Hiring family or friends 822. Where to Find Employees 833. Interviewing Potential Employees 834. Checking References 855. Salary 85Contents vii6. Benefi ts 867. Staff Contracts 868. Employment Rules and Regulations 869. Training the Staff 8710. HOW TO GET YOUR FIRST PATIENTS 891. Advance Preparation 891.1 Word of mouth 891.2 Personal visits 901.3 Notice boards 901.4 Mass mailings 911.5 Presentation at relevant venues 911.6 Being available 912. Don't Rush Patient Visits 913. Daily Schedule 924. Dealing with Patients that Miss Appointments 9211. ANNOUNCEMENTS, PROMOTIONAL MATERIAL, AND ADVERTISING 951. Business Cards 952. Announcement Cards 973. Introductory Letters 974. Flyers 975. Advertisements 1006. Website 1017. Open House 10212. MAKING SURE YOUR OFFICE RUNS SMOOTHLY 1031. Importance of the First Line of Contact 1032. Avoid Long Wait Times for Your Patients 1043. Medical Records 1044. Dictation 1055. Investigations and Results 1116. Emergency Provisions 1137. After-Hours Coverage 11413. ADDITIONAL TOPICS TO CONSIDER 1171. Offi ce Hours 1172. Child Safety 118viii Start & run a medical practice3. Reading Material 1184. Other Nice Things to Have in the Waiting Room 1195. Retention of Files 11914. BILLING OF SERVICES 1211. Billing Practices 1231.1 Fee-for-service 1231.2 Salary 1241.3 Contractual 1241.4 Income splitting and commission 1241.5 Associate or locum tenens arrangements 1251.6 Block payments 12515. EVALUATING YOUR PRACTICE 1271. Direct Feedback 1272. Indirect Feedback 1293. Periodic Review 1294. Self-Assessment Tools 1305. Lectures and Rounds 13016. TROUBLESHOOTING 1311. What to Do When a Staff Member Phones in Sick 1311.1 Family or friends cover the shift 1311.2 Everyone in the offi ce pitches in 1321.3 Contact temporary staffi ng agencies 1321.4 Close until employee returns 1322. Safety Issues While with a Patient 1323. Management in the Event of a Fire Alarm 1334. Prolonged Patient Visit 1345. What to Do During a Power Failure 1345.1 Ground- or low-fl oor practice 1345.2 Higher fl oor offi ce 1356. Outdated Patient Contact Details 1357. Bad Weather 1368. Staff Confl icts 136CONCLUSION 139CHECKLISTS1. Deciding on a Facility for Your Offi ce 502. Other Factors to Consider when Choosing an Offi ce 563. Legal, Business, and Insurance Aspects of Running a Medical Practice 694. Offi ce Equipment and Supplies 775. Hiring Employees 886. Troubleshooting 137SAMPLES1. Interview Questions 842. Daily Schedule 933. Business Cards 964. Announcement Cards 985. Introductory Letter 996. Flyer 1007. Follow-up Assessment 1078. New Assessment 1089. Standard Template for Surgical Report 11010. Effi cient Management of Investigations List for Offi ce Staff 11211. Medical Offi ce Emergency Provisions Checklist 11312. Survey for Patients 128
