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It's time to set some practical goals that will improve your life as a family physician

Fam Pract Manag. 2007;14(1):52

Dr. Cohen is a private practice family physician and adjunct faculty member at St. Peter Family Medicine Residency in Olympia, Wash. Author disclosure: nothing to disclose.

Every January, millions of people resolve to lose weight, exercise more, become better organized or stick to a budget, just as they've resolved to do in the past. I've made similar resolutions myself, but not this year. Instead, I have decided to gear this year's goals toward my professional life. Here are my practice management resolutions for 2007.

1. See one more patient BID. It's always tempting to look at your daily schedule and say to your receptionist, “I'm full. Don't squeeze anyone else in.” Over a year, however, one extra patient before lunch and at the end of the day could translate into more than $15,000 in revenue.

2. Write to my public officials. Like many physicians, I spend a fair amount of time complaining about our health care system, or lack thereof. Perhaps it would be more productive to let my legislators know my thoughts as well. Not long ago, my partner testified before a legislative committee about the difficulties of practicing obstetrics in a rural area. Later that year, amazingly, we started receiving a little extra reimbursement per delivery for Medicaid patients because of our rural location.

3. Expand employee benefits. Small practices like ours don't have the purchasing power that large groups have when it comes to employee benefits. Nevertheless, we can't afford to neglect this aspect of our practice, as it affects employee recruitment and retention. Last year, to show our staff how important they are to us, we added disability insurance. This year, our goal is to add a program similar to a 401(k) but geared toward small businesses.

4. Explore electronic health records. The vast majority of practices without EHRs probably have this on their list of things to do as well. My goals here aren't terribly ambitious given my trepidation on the subject (see “Why I Never Had an Atari Video Game System,” FPM, September 2006). Perhaps if I tried some voice recognition software and made a list of EHRs geared toward small practices, that would be adequate for the year. Baby steps.

5. Create a handbook of practice policies. Most of our practice policies are written on separate scraps of paper located somewhere in our office manager's office. This has led to some controversies over what our actual policies are. Our goal is to put them in writing in one easy-to-access handbook.

6. Stay caught up on CME. This is probably the “lose weight” of practice management resolutions. While I tend to do a reasonable job keeping up with my reading, I seem to be forever putting off those self-assessment modules (SAMs) now required by the American Board of Family Medicine. My resolution is to do one before June 2007.

7. Make more effective use of office space. Whether it's a bottlenecked layout that impedes patient flow or dictation stations that require a hike to the other side of the practice, the feng shui of the office can affect productivity. For example, we have an old X-ray machine that is not cost effective for us to operate. My aim is to get it out of our office so we can actually utilize this area.

8. Attend a local AAFP meeting. This ties in to resolution No. 2, being part of the solution, particularly on the local level. Everyone else in the health care system is well organized – insurers, lawyers, pharma. Why shouldn't we be?

9. Take a vacation, or two. Like many physicians, I tend to have a hard time getting around to doing this – much to the chagrin of my family. After my productivity has been boosted by resolution No. 1, perhaps vacationing will be easier.

So there it is – a list of nine resolutions covering many of the challenging non-medical aspects of being a family physician. Time will tell how well I do on this year's list. If it doesn't work out, next year I can always go back to “lose weight” and “exercise more.”

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