It's so easy to take a quick phone call from a patient.  Maybe you're returning calls in the office. Or maybe you're talking to patients while you're on vacation or when you are in a seminar.  But what happens after you hang up the phone?

Do you make sure you document the phone call? And if so, how do you handle it if you are 50 miles away from your office?

Even a short phone call from a patient should be documented.  Whether you take the call while you're in the office, at home or traveling, documentation is both essential and the ethical thing to do.

What happens if a patient calls your office...does your staff answer questions about their care?  Do they try to "help you out" by not having you talk to your own patient?  If so, they ethically shouldn't be having those conversations and/or making those decisions without your knowledge of reason and content. 

If they do take the call for you where is the documentation? 

Ideally, they should be taking a message for you to return the call to your patient.  To make it easier for you and your staff I have put together a checklist to help you make a telephone log form that is both easy and essential to follow up on your calls and record as well.

• Date and time of call
• Patient name and name of caller (relationship to patient) if other than patient calling
• Office personnel taking the call
• Recommended care
• Follow-up needed

Make sure you have processes in place. How does your office handle patient calls?

Recently, there's been much talk in my town about Tiger Woods and Tim Tebow. The tabloids are busy telling tales about each during every news cycle. While initially of vicarious interest, as the daylight hours get shorter, my attention more importantly turns to contemplating the past year and considering the new one, which is just around the corner.

As many have said, as you get older the years pass faster. It seems like just yesterday that the world was consumed with the possible calamities associated with Y2K which was 10 years ago.

And how about 9/11? Does it seem possible that 9 years have passed since that fateful day? Each week when my teenage son and I discuss his school work and our family activities, we regularly remark that with a blink of an eye, we go from Monday morning to Friday evening. And for me, it's surreal that I've practiced chiropractic for more than half my life.

As we reflect on 2009 and plan for 2010, consider what works well in your office and how can you improve and refine other aspects.

• Is your facility adequate and serving your needs? 
• How about your staff? Are they well trained and representing you as you would like?
• And most important to your success.... how is the  person you see in the mirror each day doing and what changes might you make to be happier both personally and professionally?

New Year's is a great time to reassess, renew, reinvigorate and make positive changes for the future. While we're all affected by the world around us from H1N1, credit meltdowns, unemployment, and the persistent bickering of our elected officials, we still live and work in a great place and are blessed in so many ways.

Our challenges and opportunities are abundant so let's be optimistic, make each day count, and make 2010 a great year. Happy Days!

When starting into practice there will be many concerns to address. One major concern that will need to be tackled immediately is insurance - and not the kind your patients bring in! 

I'm talking about insurance for YOU as a doctor and business owner.  Your head may be swimming with questions like what kind, where to find it, why it's needed, and who can help? 

There will be certain policies that will be mandatory while others will be elective, but recommended.  Some policies to consider include professional liability (malpractice), business owner policy (BOP), disability, and life insurance.

Malpractice Insurance - This will provide you protection from lawsuits, and is most often related to healthcare professionals as well as others, like attorneys. This will be your must have.  In fact, many insurance companies will not allow you to be a participating provider without evidence of an effective malpractice policy.  Let's face it, the way the world is today, having sufficient insurance coverage is a key component of being financially secure.  While there are several good companies out there, with NCMIC you will be very pleased, like I am.  They recognize new D.C.'s financial instability and work with new practitioners. If you need advice or have a touchy situation, they are ready and willing to listen and offer advice. 

Business Owner Policy (BOP) - This type of insurance can be compared to a homeowners policy for business.  Typically you will be covered in the event of property damage, harm done by an employee, and lawsuits arising from accidents. This is not a mandatory policy but HIGHLY recommended.

Disability Insurance - This insurance will replace a portion of your income if you become disabled and/or no longer able to work.  As chiropractors we work daily with our hands and use manual therapy to make a living, so going without this insurance s a big risk. 

Life Insurance - This is a unique insurance because, even though there can be personal advantages to having life insurance, the real impetus is love or concern for those you care about - to make sure they are taken care of in case of your death.

The truth is, I'm not a professional in this area.  Most of what I learned about insurances I fingured out after already being in the trenches.  For new grads or those still in school, ASK questions.  Talk to teachers, docs in the field and representatives from insurance companies like NCMIC.  I don't know all the asnwers when it comes to insurances, but I do find relief knowing I have taken care of myself and my family. 

Take it in stride, get insurance while you are insurable, and don't put it off!! 

Young D.C.s seeking associateships are eager to begin working on their new career.  Often times, the fine print is not read, the due diligence is not done and the care is not evident in “careful” and the experience which started out as a dream becomes a nightmare. 

What do you do?

When your relationship turns sour for whatever reason, first read the fine print in the contract (if there is one).  You will be surprised at what you will read and learn because some of the fine print is very, very difficult to extract yourself. 

However, there are usually clauses which require you to give notice. Pay attention to those requirements and if you did not consult an attorney initially, now may be a good time to do so.  Honor the contract, which is a key responsibility you have and also one which will be a lasting teachable moment in your life. 

Following your review of the contract, give notice, begin to plan for your exit and then - as Kenny Rogers says "fold 'em" and move on. 

If there is no contract, do the right thing. Give several weeks notice and extract yourself like a bad tooth from the jaws of an unpleasant, unethical or unfulfilling experience immediately.  Better to be searching for another associateship without the stress than trying to continue in a mental state of dysfunction. 

Is it easy ... hell, no.  But often the right decisions are not!

Hey all!

It has been a few months since I posted last.  Excuses abound, but the bottom line is that I over extend myself a lot.  All of these opportunities are around me and I have had to redevelop an evaluation system for identifying good opportunities from bad opportunities.

When it comes to evaluating an opportunity there are a lot of factors that come into play.  What is the risk of loss?  Is the timing right?  Are the resources available?  etc. 

This process got me thinking about a post.  Well that and an email I received from a student that was considering an opportunity that he had.  As I get back into blogging, I want to do a simple post about some key areas to consider when looking at an opportunity.

1. Run the opportunity by an attorney. Never sign a contract without talking to your attorney. Period. No ifs, ands, or buts. The student that emailed me sounded like he had a good deal as an independent contractor, but the field doc wanted a non-compete clause.  You may need to check your state rules, but this provision would probably make him an employee and therefore would have different tax obligations.  Running afoul of the IRS is never fun.  Have your attorney look it over to help you find these pitfalls.
2. Evaluate your resources. Before you can make a reasonable decision about action steps, you need to take a look at your assets.  Not just monetary, but job opportunities, growth opportunities, educational opportunities, etc.  Spending some time researching this can really open your eyes to your possibilities.  Too often I see people locking themselves into bad deals because they didn't realize there was more out there.
3. What are your long-term goals and does this opportunity meet those goals? Where do you want to live? How do you want to live?  What do you want to be able to do in 5 years?  10 years?  Do you want your own practice?  Do you want vacation time?  These are all things you should begin to consider.  Then, as you evaluate your opportunity, is it helping you reach these goals.  For example, if you want to open your own practice, but don't have the financial resources, make sure your opportunity provides for a saving plan to meet your goal.  Again, too often I talk with individuals that had bad experiences, primarily because they had no plan going into their possibility.
4. What is your exit strategy? What happens if things go sour?  How do you minimize your risk exposure so you can continue towards your goal?  When you enter into an opportunity, whether it is your own office, working for someone else or whatever, plan for things to go south.  Having a strategy to move you past these tough times can really mean the difference between long term success and failure.

Okay.  Bear with me as I get back into the groove, but I look forward to having more conversations with you in the future.

Every year, my associate and I give holiday gifts to those professionals and departments/facilities that support and provide services for us.

Perhaps more important than the gift itself is the fact that we HAND DELIVER the wrapped gift.  This gives us an opportunity to put a face with the name or voice.  I get to personally introduce myself to the front desk personnel. This is especially important since these may be the people who will try to get that emergency patient in if I need to refer; they'll also be the ones who will get the medical records and reports to me when I need to treat a patient.

My favorite is delivering the gifts to the hospital ER, radiology/imaging, laboratory and medical records departments as these tend to be the most used and least appreciated by others.

So if you are planning on sending a professional gift to that person or facility that plays an important role in your practice, why not deliver it yourself instead of using UPS? 

Most doctors that begin a new business don't have the foresight to realize that they might never collect every dollar they earn. Sure, you deserve to be paid, but sometimes the patient's circumstances have changed. In this economy, people are being laid off or bills have overwhelmed them. You're a nice doctor, so they might be tempted to put off paying the money they owe you.

When this happens, you have a few options.

1. You can send them kind notes of reminder
2. You can can send them to a collection agency
3. You can forgive the debt

Sending notes of reminder can let them know you understand their situation, but still need payment. This is often a successful approach.

When you opt to send them to a collection agency, you may be setting yourself up for an angry confrontation and possible litigation, as people tend to sue others they don't like. Collection agencies sometimes use bully tactics that reflect on your practice. They are also costly.

A third option is forgiving the debt. If you see a patient's account passing 180 days with no payment, you can assume the debt may never be paid.

One imaginative D.C. decided to send a letter to his patients informing them that he was extending a "Christmas in July"  and forgiving their full debt amount. He explained that he cared about their health and wished them well. He heard about his actions in various places throughout town, including Wal-Mart where a former patient shared her tearful gratefulness  He turned his loss into a great marketing moment!

With that said, he also implemented a pay in advance program for any "forgiven" patients. I guess what I'm saying is ... think outside of the box. Be prepared in advance for the possibility of not being paid.

Install a credit card processing system that will take debit, credit and company insurance cards. Ask for partial payment in advance. Have staff send bills promptly and be prepared for patients that can't pay! You don't want to come up short!

Lots of good associate relationships are available - the key is to find them. 

How to do that is a lot like the story of the drunkard looking for his wallet under a lamppost to no avail.  A passerby asked him where he lost his wallet, he said half a block down the street.  He asked why he was looking here, and the response –“because the light is better!” 

Ask yourself where you want to be - location is a critical factor to your overall satisfaction.  If you have a spouse or significant other, the decision should be mutual because nothing wears a relationship thin than half the partnership being unhappy. 

Once you have determined the location, do your “sole searching” and that is not finding yourself … that is hitting the street walking from door to door and meeting all your colleagues in a 30-mile radius.

You will be surprised at the positive reception you will find.  By the way, ask these colleagues about the next local meeting of your colleagues and then attend. Ask the chairman if you could say a few words at the meeting. Then have a short bio available for the D.C.s who attend and seek their help in finding a position. 

Your energy and determination will go a long way in creating an image that your colleagues will be impressed with.

Know when to hold 'em … and professionally engage your trump cards.