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Family medicine is about the people, not the paperwork, says Max Bayard, M.D. But too often, business problems distract physicians from their medical focus and interfere with patient care. That means family medicine residents must learn the science of business so they can practice the art of medicine, he says.
A creative response is up and running at the Johnson City (Tenn.) Family Practice Residency Program, which Bayard directs. The program has implemented a practice management curriculum that aims to transform residents into entrepreneurs who have time for patients, professional development, community involvement, and family and friends. Bayard and James Holt, M.D., medical director, and Cathy Peeples, M.P.H., CME program coordinator at East Tennessee State University, Johnson City, teach the practice management curriculum.
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"Practice management is not just about the money." -- Max Bayard, M.D. |
"Practice management is not just about the money," said Bayard. "It's about the system that results in quality patient care and a rewarding practice for our residents' future. Medical students have a dream practice. This dream is rapidly replaced by reality. We wanted our residents to get the dream back."
To that end, Bayard, Holt and Peeples introduce second-year residents to basics: types of medical practices, curriculum vitae preparation, physician recruiters, licensure processes, contract fundamentals, and the history and financing of America's health care system.
The second-year residents then establish mock practices. They name their practices and develop mission statements; define their patient populations and practice locations; and develop business plans that include budgets with first-year income and revenue plans, defined office procedures and detailed marketing strategies. The residents create floor plans, job descriptions for all staff, and schedules for medical and nonmedical staff. And they attach a cost to each position.
Residents who've completed the mock practice experience said it successfully linked the business of medicine to their ideal practices. As a result, they said they could anticipate practicing family medicine with open eyes.
"You had to brainstorm about practice management difficulties," resident Lydia Thorp, M.D., said about the program. "You never know the difficulties you will face until you are actually dealing with them."
Moreover, the mock practice highlights business planning details that residents don't often consider, said resident Shawn Southwick, D.O.
For example, he said, "we had to look at how many codes we expected each month and what reimbursement for those codes would be."
Residents' response to practice management curricula about 10 years ago indicated the need for innovation, said Bayard. "Eighty-nine percent of program directors surveyed felt their practice management curriculum was average to very effective. Only 10.5 percent felt it was not effective. But in a 1994 survey of recent graduates of family practice residencies, respondents said 94 percent of practice management-related topics were either only slightly covered or not covered at all."
For more information on the mock practice, contact Bayard at bayard@mail.etsu.edu or (423) 439-6487.
FP Report is
published by the AAFP News Department.
Copyright © 2004 by American Academy of Family Physicians.