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Fam Pract Manag. 2001 Mar;8(3):57.

FTEs per physician

Q

My peak efficiency, which I define as dollars in income per time spent in the office, occurs when I’m working with 4 FTEs. My partners say I should cut down to 2.3 FTEs, which is the mean for our area. What’s the average FTE/physician ratio for small family-practice groups in the Midwest?

For family practice nationally, the AMA’s 1999–2000 Physician Socioeconomic Statistics reports a median number of 4 FTEs per family physician, the MGMA 2000 Cost Survey reports a median 5.03 FTEs per family physician and the National Association of Healthcare Consultants’ 2000 Statistics reports 4.23 FTEs per solo-practice family physician and 4.16 FTEs per group-practice family physician.

Although the number of FTEs does vary by region, there’s no reason why it should. The primary factors influencing the number of FTEs, in order of impact, are as follows:

  • Provider productivity;

  • Quality or skill levels of employees;

  • Scope of services;

  • Participation with health plans (the more plans you participate with, the more FTEs you’ll need);

  • Practice operations (the more effective and efficient your work flow, the fewer FTEs you’ll need).

Disposing of patient records

Q

Can I legally throw away selected pages from new-patient medical records I receive from other physicians?

The answer depends on whether your state or state board of medical examiners has laws or regulations defining what is considered to be part of “your records” and the restrictions, if any, on destroying those records. There are also federal laws and national guidelines that should be considered.

Determining which parts of a new patient’s record are your records generally depends on whether you’re receiving the original or a copy of the patient’s chart from another provider. If you take custody of the original chart, the prudent approach would be to treat all those records as yours. In determining whether to remove unnecessary records from the chart, you should apply the same rules you would apply for removing records from your current patients’ charts.

If no legal requirement exists to prevent it, you could copy relevant portions of the patient’s original chart and return it to the previous physician for him or her to maintain in accordance with applicable state and federal requirements. Then, treat the copies as your records.

You should consult the AMA’s Code of Medical Ethics, Ethics Rule 7.05, Retention of Medical Records. It provides a good discussion of the issues that should be considered before you destroy all or part of your patients’ records. You can view the rule on the AMA’s Web site by going to www.ama-assn.org/ama/pub/category/2498.html, clicking on the AMA Policy Finder link located on that page and selecting the Ethical Opinions category. Considerations addressed in the rule include state legal requirements, the statute of limitations on medical malpractice claims, special treatment of immunization records and the Medicare or Medicaid requirements that records be maintained for at least five years.

Medical equipment for sale

Q

I have a used defibrillator I’d like to sell. Where can I advertise it?

You can advertise medical equipment in the Medical Group Management Association’s (MGMA) MGM Update newspaper. The ad would also appear in MGMA’s online classifieds. For more information about advertising with MGMA, call 888–608–5601, ext. 872, send an e-mail to advertising@mgma.com or visit www.mgma.com/advertising.

There are also a number of online auctions, such as Medical EquipNet (www.solumed.com) and U.S. Medical, Inc. (www.usmedical.com), that you can use to advertise your used equipment. These and other online auction companies will charge a commission if your item sells.

Releasing workers’ comp records

Q

Is it legal for me to release a copy of a patient’s workers’ compensation medical record when he or she requests it?

It depends on whether you’re the treating physician or an expert witness. If you’re the treating physician, there’s no law that would prohibit you from releasing a copy of the patient’s records to the patient. If you’ve provided treatment to the injured employee, you have created a physician-patient relationship that makes releasing the records to the patient appropriate, even though the employer or a workers’ compensation insurance company might be paying for the services.

If you’re an expert witness, such as an independent medical examiner, you may be prohibited from releasing the records to the injured employee. In most states, where there’s no physician-patient relationship, you cannot release the records without the authorization of the person paying your bill or a subpoena or court order. If you’re an expert witness and are unsure whether you should release the records, contact the attorney who hired you.


* Denotes member of FP Assist, the AAFP’s online clearinghouse for consultants and attorneys.

 

Copyright © 2001 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact fpmserv@aafp.org for copyright questions and/or permission requests.

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