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Many family physicians are understandably uncomfortable with the idea of their Web site having advertising banners prominently displayed at the top. This is particularly true when the advertising may be for a specific drug that the physician doesn’t endorse. Fortunately, there are ways to create an “ad-free” Web page for your practice.If you’re an AAFP member, you can create your own free Web site by going to www.aafp.org. Click on the “My Academy” logo in the upper right corner of that page, enter your member information, and click on “Enter the Site.” Then, under the “My Practice” section, click on “Get Started.” It takes about 30 minutes to create a complete practice or physician Web site or about five minutes to create a simple “information page.” All you need to do is fill out a few online forms.The AAFP service allows you to do the following: Choose from among four Web site designs.Select your own Web address (e.g., www.familydoctor.org/my-practice) and up to five different clinic Web addresses for multi-site practices.Post specific clinic information, such as directions, office hours, scheduling policy and insurance information.Share any additional information you’d like to include on your site, such as physician biographies (e.g., educational background, board status and even photos). You can post information on up to 25 physicians and 10 staff members.List up to 10 links to other Web sites. Your site will automatically include links to a host of health education resources from familydoctor.org, such as patient handouts, self-care charts and a drug interaction calculator.If you aren’t an AAFP member or you simply want to explore other free Web site offers, check out the following: www.familypractice.com/mypractice/mypracticeframe.htm (sponsored by the American Board of Family Practice) or www.yourpracticeonline.com (sponsored by Medem, an organization founded by several major medical societies).

The responsibility of your clinical support staff is to enhance patient care and to maximize physician efficiency. I would recommend that you immediately rewrite the job description for these positions, preferably with the support staff’s input, and establish reasonable expectations for their positions. This may cause some staff to leave your clinic, which will be difficult for you in the short term, but you cannot continue to function with clinical support staff who are not team oriented. Often, attitudes and actions such as these are led by a disgruntled few. If this is the case in your office, addressing those staff members directly may be best.

Actually, the presence or absence of the teaching physician during the yearly physical exam is immaterial. Here’s why: Medicare’s teaching physician rules generally require that a teaching physician be present for the key portion of the service provided by the resident in order to bill Medicare for that service. However, in the case of a yearly physical exam for which CPT’s preventive medicine services codes (99381–99397) apply, this requirement becomes essentially moot. Medicare will not pay for this service under any circumstances, and the patient will be responsible for the physician’s charges.You can find the Medicare guidelines for teaching physicians in section 15016 of the Medicare Carriers Manual, which is online at: www.hcfa.gov/pubforms/14_car/3b15000.htm#_1_8.