Fam Pract Manag. 1998 Sep;5(8):12.

Effective mission statements


I have been in private practice for two years in a rural area. Business issues haven't been a great concern, yet. I would like to become more business-like, though, and the first thing I want to do is develop a mission statement for the practice. Do you have any suggestions?


To develop an effective mission statement, you should first ask staff members to discuss their ideas about why the practice exists and how it can make a difference in its community and in staff members' lives. The following questions are helpful in focusing the discussion: What constitutes the perfect clinic for our patients? How about for us as staff? What standards should we work toward? What needs to be put into place to achieve these standards?

The statement should deal with patient care, physician and staff interaction and ethical behavior. It can be an idealistic portrait of the practice, but to be effective, it should capture what you and your staff really want your practice to accomplish. The truer the statement is to the aspirations of the group as a whole, the more useful it will be.

Once you have decided the statement's content, have an attractively printed copy framed and posted where patients and staff can see it. The finished product will keep your mission foremost in the minds of your staff and will remind new staff members of your philosophy of patient care and service.

The statement should be on the first page of your policies and procedures manual and in front of your eyes whenever you are considering decisions of significance to the practice. A well-written mission statement can help you decide everything from whether to hire more staff to whether you should open a satellite office.

Charging for medical record copies


Our practice does not have a set rate to charge those requesting copies of patient charts. Should the rate change depending on who makes the request? What is a fair rate to charge patients?


Members of the AAFP's Commission on Health Care Services were polled regarding whether they charge patients for copies of their medical records. The results showed that policies for charging patients and others for copies of patient records vary greatly depending on the reason for the request, the community standard and contractual and regulatory requirements.

  • Some commission members responding to the poll charge patients nominal fees for copies of their records. Fees vary from 10 cents to 25 cents per page to a flat fee of $10 for up to 25 pages with a charge of 25 cents per page thereafter.

  • Most of those polled provide a copy of a patient's medical record to another physician at no charge when the patient changes physicians. However, most physicians responding to the poll have office policies to discourage excessive “doctor shopping/switching,” usually by charging patients who request their records be copied and sent to other physicians multiple times.

  • A different set of rules may apply when records are copied for attorneys or health plans. It is common to charge $30 to $50 per chart or a flat fee of $10 for up to 25 pages with a charge of 25 cents per page thereafter.

  • State laws and contractual agreements with managed care organizations (MCOs) may limit what a physician can charge for copying records. For example, workers' compensation programs require extensive documentation as a condition of payment, and MCOs request patient records for medical review or to evaluate referral requests.

*Denotes Charter Member of the Academy's Network of Consultants.


Copyright © 1998 by the American Academy of Family Physicians.
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