Fam Pract Manag. 2006 Nov-Dec;13(10):63.

Hold a flu shot clinic

My geriatric practice designates Halloween as flu shot day, making the event festive for patients and easier for them to remember. We decorate the office and provide refreshments, and some of us wear bumblebee costumes that reflect our theme: “BEE prepared for flu season!” Announcements in our waiting room promote the event. We use large, color posters designed to be reused each year (there's white space for us to write in the day, date and time of the flu shot clinic). Appointment postcards are mailed to patients inviting them to be present at one of four time slots. We hold a staff meeting prior to Halloween to discuss each staff member's responsibilities for the day. This is key in running the flu shot clinic efficiently. Two costume-clad greeters guide patients, many of whom use walkers or wheelchairs, from the lobby to the registration desk to the vaccination “beehive.” No patient waits more than 10 minutes. We give more than 250 shots in five hours. Patients always thank us for a fun and efficient flu shot day, and they make plans to come back next year.

Detecting warning signs of fraud


What are the warning signs of embezzlement in a practice? What are the most common hustles?


Most fraud perpetrated in small businesses, such as medical practices, is relatively unsophisticated. The perpetrators are successful mostly because no one but them ever looks closely at the business' financial records. We recommend periodically having a second staff person assume the accounting responsibilities for at least five consecutive days. The fraud may be relatively easy for this person to spot. These are among the most common, and easily detected, types of fraud:

1. Payments of personal expenses as company expenses. In such cases, the person committing the fraud simply writes company checks for his or her own expenses and records them in the check register as a legitimate practice expense. For example, a check may be written to pay the perpetrator's credit card bill but listed as an office electric bill.

2. Multiple payments for salaries. In these instances, the person committing the fraud simply writes more than one salary check for the same period.

3. Thefts of cash or checks. This is probably the simplest method of fraud and involves stealing money paid to the practice, either before it is entered in the accounting records or by shorting the bank deposits.

Of course fraud can be much more complicated. We would recommend Joseph Wells' book Corporate Fraud Handbook: Prevention and Detection as a good starting point for anyone interested in learning more.

Document visits with Instant Text

I no longer dictate office notes. Instead, I type my own notes using the Instant Text program available at The program replaces short keystrokes or abbreviations with complete words, phrases or paragraphs that have been assigned to them. So, by typing only a few letters, I can produce an entire Microsoft Word document, which I then paste into my electronic health record. I use Instant Text to document all office visits (e.g., physical examinations, office visits and procedures), to write prescriptions, to record ICD-9 codes, to compose e-mails to patients, and to generate content for patient and medical student education. My transcription costs have decreased by more than 80 percent, the program saves me time and my documentation has improved.


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.
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