This test is designed to give you an easy way to evaluate the strengths and weaknesses of your practice. We hope it will help you decide where to concentrate your energy on making improvements and changes in the way your practice functions.

Why take the self-test?

When you complete the self-test, you will be able to score your practice on several different scales that ought to give you food for thought. And we'll point you in the direction of information that can help you make improvements.

If you take the additional step of sharing your results with us at Family Practice Management, we can give you further insight by showing you how your scores compare with those of other readers who have reported results. We will also use the results to help target FPM articles to the needs of our readers. (If you do share your results with us, we will keep them confidential; see below.)

The self-test was developed by the editors of FPM in consultation with Marc L. Rivo, MD, MPH, medical editor of FPM and with members of the FPM Board of Editors and Panel of Consultants. Items were selected to cover the range of topics that FPM deals with -- that is, everything but the purely clinical aspects of practice. The self-test makes no claims of scientific validity as a survey instrument, and its goal is not to develop a picture of the advancement of family practice as a specialty. Rather, the self-test is an informal way for you to get a clearer picture of the characteristics of your own practice -- both things you would like to change and things you wouldn't change for the world. (See the related editorial on page 11.)

Is it hard to complete?

No, it's actually quite easy; you can answer all the questions in half an hour or so, and you won't need to do any chart review or other research in the process. All you need to do is answer the questions as thoughtfully and honestly as you can.

The easiest way to take the test is to enter your answers online. The interactive, online version of the test will calculate your scaled scores and generate a report for you on the spot. To take the test online, go to www.aafp.org/fpm/selftest.

Who is the self-test for?

We have designed the self-test with practicing family physicians in mind, but if you are not in a mainstream family practice, you may still find the test useful. The self-test is designed to work for solo physicians as well as for members of groups -- even large groups -- but it is definitely intended for physicians who spend at least some of their time in patient care.

Are the results confidential?

Since this is a self-scoring test, you can keep your results completely private. If you choose to share them with FPM, the FPM staff will not share results with anyone except in the form of aggregated data. Nor will we share your name, address or other contact information.

How do I take the test?

The self-test consists of 44 statements, with two simple questions about each:

1. How well does this statement describe your own practice?
2. How important is it for family practices to be able to do this?

On paper. In answering Question A, please circle the number that best indicates how closely the statement describes your practice. Similarly, in answering Question B, circle the number that best indicates how important you think the capability described by the sentence is. At the end of the self-test, you'll find instructions for calculating your scaled scores.

Online. The easy way to take the test is to use the interactive version available online through the FPM Web site. Just go to www.aafp.org/fpm/selftest and click your answers to the questions; your scores will calculate automatically.

Save time. Take it online! To have your scaled scores calculated automatically, take the practice self-test online at the FPM Web site. Just visit www.aafp.org/fpm/selftest and follow the instructions.

Some of the statements in the list reflect qualities that are currently advanced as strengths by various authorities. While most of the statements are clearly related to some aspect of practice quality, family physicians may well disagree about others; where one sees a mark of quality, another may see a fad or an unnecessary complication. That's why we're asking you to indicate how important the capability implied by each statement is for optimal family practice. Your estimation of the importance of each item should be factored into your evaluation of your own scores.

Some of the statements link several things; give your practice a 4 on such a question only if all parts of the statement are true.

The test does not appear in this online version of the article. To take it online, go to www.aafp.org/fpm/selftest, or to print a copy of the test and take it on paper, download a PDF copy of this article.

Now what?

Once you have answered all the questions, you can calculate your scaled scores using the tear-out score sheet that follows page 48 in the print version of this article, or you can enter your answers online at www.aafp.org/fpm/selftest to have them calculated automatically. To use the paper score sheet, remove the form at the perforations and follow the instructions for calculating your results. Then refer to the following section for a discussion of what the results mean.

Assessing your results

As you've seen from the scoring form, each of the items on the self-test pertains to one or more of nine scales (see box).

FPM Practice Self-Test: The Scoring Scales Scale Number of items Notes Continuity of care   6     Experimental focus   11   Cutting-edge modifications of family practice in ways that hold promise but may not have been proved successful yet Finances   8   Capabilities that indicate a financially stable, well-run organization Physician wellness   7     Quality   11   Capabilities that tend to produce high quality clinical care Service   9   Capabilities that promote patient satisfaction Staff and others   5     Systems and Efficiency   20   Office systems designed to ensure that whatever should happen happens all the time; capabilities that ensure physician and staff energy produces the maximum of useful work Technology   9   Mostly aspects of computer technology

When evaluating your scores for each scale, consider the following:

• The scaled scores can give you a general sense of where you stand, but it's the scores on individual items that you can do something about by making changes in your practice. For any scale you are concerned about, go back to look again at the items that make up the scale.
• As we said previously, not all of the statements in the self-test are universally accepted as positive characteristics; your estimation of the importance of each should be factored into your assessment.
• Where "Importance" scores (scores for Question B) are considerably higher than "Descriptive" scores (scores for Question A), you are saying that your practice falls short in ways you consider important.
• Whatever the importance score, a low descriptive score on any scale may be a cue to examine related aspects of your practice. It may mean little, or it may mean you need to get to work. For instance, if your practice is basically urgent care, you may not care about a low score on the "Continuity of care" scale, but if you have a more conventional family practice -- or if you want your practice to be more like the conventional model -- it's a different story.
• The scaled scores give you one sense of where you are. For a reality check, you need to see how your scores compare with those of other family physicians who have taken the test. To do that, see the next section.

How do your scores compare?

To find out, just share your self-test responses with FPM and provide the contact information necessary for us to get back in touch with you. There are two ways to do this:

• If you have Internet access, simply take the self-test online, answering all of the questions. The online version is available at www.aafp.org/fpm/selftest. This has the advantage of computing your scaled scores automatically. And once enough readers have taken the test, the pooled data will be available at the same Web address for comparison.

• If you don't have Internet access, fill in the tear-out score sheet that follows page 48 in the print version of this article and fax or mail a copy to us. Our fax number is 913-906-6010, and our address is Family Practice Management, 11400 Tomahawk Creek Pkwy., Leawood, KS 66211. Once we have a significant number of responses compiled, we will send you a report of the pooled results against which you can compare your own scores. (But remember: We can't send you a report if you don't give us your name and address. Please print clearly!)

Improving your scores

If you don't like what you see when you evaluate your self-test results, you and your staff may have some work to do. Don't try to fix too much at once, though. Consider concentrating only on the scale that concerns you most -- and even there, focus on one small area to begin with -- an area you know you can have an impact on. The online version of this self-test includes links to some past FPM articles and other resources you may find helpful. Of course, FPM will continue to provide what help we can in future issues. Good luck!

The authors are the editors of Family Practice Management.

This is a corrected version of the article that appeared in print.

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Copyright © 2001 by the American Academy of Family Physicians.
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