"Sicko"

It probably won't come as a surprise to longtime readers of this blog, that I'm a fan of filmmaker Michael Moore. His politics aside, I enjoy his sense of humor and willingness to take chances and explore issues most mainstream movie makers would never even think of mentioning.

His latest film, "Sicko," opens this Friday, and I am very hopeful that it will help spark a national debate about the dreadful state of healthcare in this country. From what I've read, Moore has abandoned his confrontational approach and is now just trying to encourage a discussion about the issue. I read an interview where he said he felt his old films were divisive and he felt the issue of healthcare was too important to polarize people through politics.

The movie apparently deals with people who are insured, and yet still couldn't cope with the devastating effects of illness and the predatory practices of health insurance companies. I guess Moore also interviews employees from those companies, who admit to pushing the bottom line, and showing little or no mercy to the people covered by their organization.

Of course, this comes as no surprise to those of us in the field. We are caught in the middle, making life or death decisions not just about actual medical care, but the financial liabilities as well. I'm not sure if universal healthcare is the answer, but I'm glad Michael Moore has made a major movie asking the question. What do you think?

Administrative Pitfalls

I recently read a wonderful article about pitfalls to avoid when trying to be an effective medical office administrator. I have learned many of them the hard way, so I hope this helps people who are new to the profession or in need of a refresher. They are:

1. Ignoring patient satisfaction while focusing exclusively on business performance. This is a huge temptation, since if the profit margin suffers, you feel like a failure. After all, you don't treat the patients medically, your job is to run the office. However, that misses the obvious fact that the patient is the lifeblood of the practice, and if their needs are ignored, you won't have a business.


2. Losing track of inventory. Sometimes it's tempting to take advantage of discounts and specials, but it's important to have a long and accurate record of needed supplies to avoid overstocking. Bad decisions about what to order can be like throwing money away.


3. Failing to maintain adequate and appropriate staffing levels. When I first started managing, I tended to hire too much staff. The fear I had was not having the proper coverage, but what I wound up with was too many part-time staffers who had virtually no loyalty to me or the practice.


4. Being too timid with physicians. Many doctors cultivate a presence that can be hard to get past. It doesn't matter. An office manager who fears the doctors in her practice cannot be effective at her job. Period. Whatever intimidation you feel, you have to get over it.


5. Communicating too little or too much with physicians. The office manager is the conduit of information for the doctors, who have their hands full taking care of patients and staying abreast of their profession. The key is knowing when to tell them important things about patients or business matters, and how much they need to know.

Much of the above is learned through trial-and-error. There is no perfect way to manage a practice. The main thing is to have a good sense of organization, and a system for things like inventory and staffing. The overwhelming nature of medicine is an exciting challenge when you have your priorities in order. Any thoughts or additions to the list?

Nipping Malpractice in the Bud


One of our staff doctors just received a favorable verdict in a malpractice suit, so I thought I'd discuss that briefly today. As office manager, it's crucial that I keep the staff properly trained in risk management.

As with physicians, one of the main things I stress is courtesy with the patient. In a professional, courteous manner, make them feel like you are invested in their healthcare. Lawsuits often arise over perceived neglect, so it is important to never forget the simple rule of good manners.

For doctors, it is crucial to properly document every aspect of care, so that the thought processes that lead to a given diagnosis are crystal clear. The staff must then make sure this information is properly transcribed and stored for easy access.

Tracking lab results and informing the patient of their meaning is another step in the process. We work extra hard in our office to leave no thread hanging when it comes to any form of testing.


Follow-up care to patients with chronic care issues is also of paramount importance. We all know that sometimes a patient may neglect or refuse treatment, so it's vital that the medical staff make the effort to demonstrate the need for it. In our office, we keep detailed phone logs so that all patient contact is recorded and in black-and-white.


We live in a very litigious society, so it makes good business sense to always keep your staff current and aware of the implications of their actions. Not only does it help prevent you from being sued for malpractice, but it also helps to finetune the quality of care a practice gives to each patient. Please let me know you're thoughts!