Fam Pract Manag. 2007 Jan;14(1):45.

Enrolling in Medicare


We have submitted a request to Medicare for a provider number for one of our new physicians. In the meantime, can the new physician see patients if an established physician is present in the same room?


Medicare does not list a physician as a medical professional to whom incident-to rules apply, so there is no basis for billing under the name of another physician who is in the room. Medicare does allow the physician to date the enrollment form with the date he or she begins practicing and to bill dates of service from that date forward after the enrollment process is completed (within the one year limitation). Obviously, holding claims for the length of time it takes to enroll with Medicare is not ideal. However, this is the solution Medicare offers when it is not possible to start the enrollment process before the new physician begins practicing. For more information, see

Escort your geriatric patients to the exam room

To improve my care of older patients with ambulatory difficulties, I greet them personally at the reception room and walk with them to the exam room. This allows me to assess their gait and ability to follow directions, and they also generally appreciate my hospitality.

Keep your staff safe

When our clinic closes late in the evening, walking out into the dark parking lot causes safety concerns, especially among our female staff. We've found that leaving as a group alleviates this anxiety, fosters a feeling of togetherness and team cohesion, and reduces the chances of adverse events.

Use metaphors to increase patient compliance

One of my biggest challenges as a physician is getting on the same page as my patients. I have found that coming up with simple metaphors helps me explain complex ideas to my patients. For example, I explain the parts of cholesterol by saying: “HDL is the happy kind, and you want it high for your heart. LDL is the lousy kind, and you want it low.” I explain the classic idea of prevention by comparing it to changing the oil in a car: It can be an inconvenience and it costs money, but it prevents trouble later.

I use dozens of metaphors like these, and I am delighted when patients say, “No one has ever explained it to me like that before.” I know that information encourages compliance.

Get to know your staff with games at staff meetings

Staff meetings can be boring, directed affairs, so we begin with a game that enables members of our office team to get to know each other better. We started our last staff meeting by each writing two true facts about ourselves and one untrue “fact” on a sheet of paper. We collected and redistributed the papers so that each person read someone else's out loud. We tried to guess the person's identity and which fact was not true. We kept score so it was competitive, but the real fun was finding out who came in first in the National Spanish Exam, who drove a Corvette and who hates folding laundry. Getting to know your staff builds morale.

Display family pictures in your exam rooms

I like to display pictures of my wife, children and extended family in the exam rooms where patients can see them. I update the pictures every two or three months and as special events take place in our lives. Many of my patients tell me they look forward to seeing my family pictures, and they are eager to talk about them. Talking about my family seems to calm my patients and makes patient care more enjoyable for me.


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 © 2007 by the American Academy of Family Physicians.
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