Fam Pract Manag. 2006 Jan;13(1):65-66.

Let your dog be your receptionist

I let my receptionist go and demolished the reception desk area in my waiting room. Now the waiting room is homier, more spacious, and I don’t have to worry about HIPAA (Health Insurance Portability and Accountability Act) violations occurring there. My patients thought it was odd at first, but now they are used to signing in and taking a seat. They know my nurse or I will help them in a few minutes. I replaced the receptionist with my dogs. They are excellent greeters, and my patients love visiting with them while they wait. The dogs work for nothing and are never rude to the patients.

Source: Barbara Hartley, MD, Benson, Ariz.


Reduce credentialing hassles


What can I do to get credentialed and re-credentialed more quickly and with fewer hassles?


Your best hope is the Council for Affordable Quality Healthcare’s Universal Credentialing Data Source, an online tool that enables physicians to submit a “universal” credentialing application that can be accessed by health plans that the physician authorizes. The service is free to physicians. The tool vastly simplifies re-credentialing as well, since physicians need only provide updates to their information and fax supporting documents as needed. Currently, more than 250 organizations, including Aetna, Cigna, Humana, United Healthcare and many Blue Cross and Blue Shield plans, participate, and more than 250,000 providers have used the system. If you contract with any health plans that do not participate, encourage them to do so. For more information, including a list of participating health plans, see

If you have no choice but to apply for credentials the old-fashioned way, you may find the following tips helpful:

  • Apply early. If you’ve signed an employment contract but are still finishing residency, it’s not too early to start filling out the paperwork.

  • Consider designating one staff member in your practice to be responsible for completing and tracking the paperwork. This will improve efficiency and compliance.

  • Identify a contact person at each health plan who can address your questions and provide updates.

  • Seek approval to bill under another physician’s name temporarily. Some private payers will agree to this; Medicare and Medicaid won’t.

  • Seek approval to temporarily reassign patients to a credentialed physician in your practice. The patients can be moved to your panel when you are credentialed; in the meantime, you can treat them and work out the financial arrangements within your practice.

  • Ask if you can bill retroactively for services you provide during the credentialing process. Some payers will agree to this.

Source: Trevor Stone, AAFP, Leawood, Kan.


Motivate with numbers

Clear, achievable, measurable, short-term goals can help encourage staff to give 100 percent. Work with staff to set goals that are personalized to their duties. For example, a receptionist might set a goal to greet and make eye contact with each person who enters the room or to answer the phone within three rings.

Source: Reichheld FF. Motivating through metrics. Harvard Business Review. September 2005:20–24.


Modify patient handouts and forms “just in time”

I never restock the forms in my exam rooms. My patient education materials are stored as Microsoft Word or Adobe PDF files, and I print them out as needed. When medical “wisdom” changes, I can update the computer file and never have to throw out an obsolete form. I take a similar approach to handicap sticker requests, health care proxies, school physical forms and even federal employment forms. The computer is a much better filing cabinet than a filing cabinet.

Source: David M. Newman, MD, Brockport, N.Y.


Avoid burnout

The demands of practicing medicine along with physicians’ tendencies to self-sacrifice and not ask for personal help can lead to burnout. To prevent it, try these tips: exercise; block your schedule to allow for a reasonable departure time and short periods of reflection throughout the day, and don’t overlook them; develop interests outside of medicine; say “no” more often; and pay attention to your values and goals.

Source: Calandra R. Rediscovering the need for personal renewal. ACP Observer. December 2005:1,24–25.


Get rid of waste

Quality experts have identified five types of waste within organizations: delay (idle time spent waiting for a test result or payment), rework (retesting, rescheduling, refiling), overproduction (excessive paperwork, defensive medicine), movement (unnecessary transport of people, products or information), and defects (prescribing errors). Engage your clinical and office staff in finding sources of these errors in your practice, and develop a plan for stamping them out.

Source: Institute for Healthcare Improvement. Improvement tip: Find “muda” and root it out. Available at:



Practice Pearls presents the best advice on effective, efficient practice operations and patient care drawn from the medical and business literature, along with tips developed from your experience. Send us your best pearl (250 words or less), and if we publish it, you’ll earn $25. We also welcome questions for our Q&A section. Send your pearls and your questions to us at


Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Send us your best pearl (250 words of less), and you'll earn $50 if we publish it. We also welcome questions for our Q&A section. Send pearls, questions, and comments to, or add your comments below.


Copyright © 2006 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 for copyright questions and/or permission requests.

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