Practice Management

Rotation Information

Faculty: Pat Borman, MD Swedish 1st Hill
Resident: Wellesley Chapman, MD

Practice Management is defined as the planning, developing, managing and operation of a professional medical practice. The educational objectives for the Practice Management Curriculum are taken from the AAFP Recommended Core Educational Guidelines on Practice Management for Family Practice Residents www.aapf.org. and are presented following this curriculum.

The practice management curriculum unfolds longitudinally during residency. The curriculum is sensitive to the skill level and receptivity of residents as they traverse family medicine training. Our experience shows that most practice management learning takes place in the continuity clinic and during the third year of residency.

R1 Experiences

The residents learn clinic and hospital policies and procedures in R1 orientation. In R1 Clinic Block, the practice management workshop focuses on coding and billing basics including legal requirements for Medicare billing, medical record systems, consultative medicine and insurance referral processes, and Labor and Industry claims. The residents also learn about the people and processes of the front and back office and working with interpreters.

R2 Experiences 

R2 orientation includes training in telephone triage and hones leadership skills for the new R2 responsibility for teaching interns on the Family Medicine Service.  In the second year during Clinic Block, the practice management workshop highlights more advanced coding and billing techniques and the basics of hospital billing. R2’s learn the principles of long-term care and home visits to expand a systems based approach to medicine.

R3 Experiences 

R3 orientation provides more exposure to leadership training and teaching techniques as they prepare for chief resident roles. During the third year, residents meet bi-monthly to explore practice management in depth with particular focus on finding a job and personal and professional finance.* The R3’s have four sessions in preparation for the R3 Graduate Talks. These professional presentations hone skills in leadership, public speaking, literature search and evidence based medicine.

* The R3 bi-monthly morning topics include but are not limited to:

 

Practice Options

    Assessing Specific Career Options

    Physician Owned-Solo, Group, Multispecialty

    Health Care Maintenance Organization

    Public Sector

    Alternate Practice Styles

Selecting a Financially Healthy Practice

    Financial Statements

    Benefits Packages

    Non-tangible Benefits

Starting the Process

    Finding Jobs

    Writing your Curriculum Vitae

    Cover Letters

Personal Finance

    Loan Repayment

    Budgeting

    Insurance

    Planning for the Future

Interview Skills

    Compensation

    Ownership

    Workload/Performance

    Organizational Structure and Function

    Contracts

Selected Readings

    Salary Trends

    Employments Agreements

    Job Share

    Fatal Organizational Flaws

Solo Practice/ Starting From Scratch

    Models

    Time Tables

    Affiliations

    Consultations

Managing Ancillary Services

    Pharmacy, Medications, Radiology

    Ultrasound, Stress Testing, Procedures

    Maternity Care, Psychosocial Services

Twice a month, the Tuesday lunch hour is devoted to large or small group sessions that focus on clinic dynamics, productivity, efficiency and problem solving for clinic and residency issues. Residents are involved in quality improvement, patient satisfaction, risk management, employment law, regulatory compliance and scheduling issues or curriculum development.  Once a month the clinic hosts the Morbidity and Mortality Conference, a confidential forum to explore system based improvements and quality issues.  Once a month the residents sponsor a practice management dialogue during Tuesday Didactics.

Pick-A-Partner/Pick-A-Practice

King County Academy of Family Practice

Each year in October, the King County Academy of Family Practice sponsors the Pick – Practice/Pick a Partner seminar. This weekend course is required at least once during residency, usually in the third year. The first day of this weekend course features a full day of workshops and lectures on practice evaluation, job selection strategies, practice styles and practice management tips. The second day of the seminar is a job fair that allows residents to meet representatives from local practices with job opportunities. This seminar is highly rated each year by our graduates and many Swedish residents have found jobs at Pick – Partner/Pick a Practice.

For more information contact Sally Gasparich: e-mail sgasparich@aol.com or call (425) 289-0054.

Practice Management Longitudinal Curriculum

Twice a month the Tuesday lunch hour is devoted to large or small group sessions focusing on clinic dynamics, productivity, efficiency and problem solving for clinic and residency issues.  Residents are involved in quality improvement projects.  Some quality improvement projects residents have completed included: clinic guideline updates, design improvement of obstetrical charting, writing a clinic wound care protocol, revising the clinic DepoProvera protocol, patient satisfaction surveys, and POLST form completion surveys.

Once a month, there is a mandatory morbidity and mortality conference.  Discussions about patient dissatisfaction, iatrogenic harms and undesirable clinic outcomes are reviewed.  Every death is also explored.  Morbidity and mortality often generates system changes to enhance the services we provide.

Practice Management discussions are provided once a month in Tuesday afternoon didactics.  Residents and faculty pair up to pick a topic which can cover anything related to practice management.  This list covers some but not all of the topics chosen over the years:

Elements of Medical Risk Management

    Informed Consent

    Treatment of Minors

    Documentation

    Handling Adverse Outcomes

    Dissatisfied Patients

    Avoiding Delay in Diagnosis

Labor & Industry

Credentialing

Communication

Choosing a Practice that Fits

Reimbursement- Who Pays What: Medicare, Medicaid, Private, Self

Social Security Insurance/Disability

The Pharmaceutical Industrial Machine

Coding and Billing

HIPAA

The Future of Family Medicine

Policy and Advocacy: Organized Medicine

Human Resources - Hiring, Firing, Training, Retaining

Practice Options

Budgets

Health Care Financing/Access

Medical Marketing

Quality Improvement Projects

Patient/Customer Satisfaction

Compensation

Universal Health Care

Personal Financing Planning

Writing your Curriculum Vitae

Clinic Operations

OSHA

JAHCO

 

There are MANY more topics out there- if you think it's related to practice management, it probably is!