Fam Pract Manag. 2007 Oct;14(9):41-42.

Manage expectations and waiting time

Our clinic has implemented a process that helps make waiting in the exam room less unpleasant for our patients. On each exam room door, we hang a placard that says “check on me” on one side and “thank you” on the other. “Check on me” reminds the support staff or doctor to periodically notify patients of the wait time and ask if they have any needs. When the visit is complete, we turn the placard over to read “Thank you,” which reminds us to thank the patient for coming in and signals that the room is available for another patient.

Note pronunciation of patient names

When I see a patient with a first or last name that is difficult to pronounce or has a pronunciation that is not obvious from the spelling, I place a note in the summary section of the patient's chart with the name spelled phonetically and surrounded by quotation marks, e.g., Schoenfeld “Shenfeld.” Patients who have grown accustomed to having their names mispronounced are pleasantly surprised to be called back to the exam room or greeted on the telephone with the correct pronunciation. It's a small but significant way of showing respect to our patients.

Understand lease terms

Before you enter into a medical equipment leasing contract, be sure you understand all the associated costs, such as administrative fees, taxes and maintenance fees, and whether they are included in the lease payment. Read the end-of-term provisions carefully. Plan to obtain insurance that will cover the cost of the equipment if it is damaged, lost or stolen.

Source: Frankel A. A leasing primer for physicians: medical equipment leasing. J Med Pract Manag. May/June 2007:328-330.


Offering vaccines in your office


I want to do the right thing and offer vaccinations in my office, but I am not able to do so without losing money. This is especially the case with the newer, higher-priced vaccines for HPV and herpes. If I acquire vaccine that goes unused, it is a significant expense. Should I have patients who need these vaccines pick them up at the local pharmacy and bring them into the office for administration?


Although this approach may reduce the financial risk you must take to stock these expensive vaccines, you should be aware of the drawbacks. Most commercial insurance plans cover these vaccines when provided in your office. However, if a patient takes a prescription for the vaccine to the pharmacy, coverage for the vaccine will be queried under the patient's pharmacy benefit plan, which may not cover vaccines. When told that their pharmacy benefit plan does not cover the vaccine, patients may not understand that their medical benefit plan does. Patients who leave the pharmacy empty-handed or who pay for the vaccine out-of-pocket only to have their claims denied by their health plans may be frustrated with their physicians.

The Vaccines for Children (VFC) program may be a better alternative for some patients. According to the CDC Web site, this federal health program provides free vaccines, including the HPV vaccine, to children and teens under 19 years of age who are either uninsured, Medicaid-eligible, American Indian or Alaska Native. More than 45,000 sites provide VFC vaccines, including hospitals, private clinics and public clinics. The VFC program also allows children and teens to get vaccines through Federally Qualified Health Centers or Rural Health Clinics if their private insurance does not cover the vaccine.

Some family physicians who want to avoid the administrative hassle or the adverse economic impact of providing certain vaccines are directing patients to the county health department. Others may refer patients to a pharmacy that houses a retail health clinic. These patients acquire the vaccine at the pharmacy and have it administered at the retail clinic using their medical insurance coverage.

Create a clear objective for your employees

Energy, enthusiasm and attention are greatest among employees when they are striving toward a single, clearly explained objective. If your practice sets too many goals, employee interest is spread too thin and the results may be disappointing. Choose a single goal and describe it well in terms that are both measurable and urgent, and explain the steps you plan to take to achieve it. This approach will contribute to your practice's success.

Source: Moyer D. Objective selection. Harv Bus Rev. June 2007:144.


Develop a clear policy on personal computer use

A comprehensive policy on the personal use of workplace computers should be implemented to reduce lost productivity and liability risk in a practice.

A policy that prohibits all personal use can be difficult to enforce. Allowing reasonable usage and periodically monitoring employees' use of their computers is a more practical and successful approach.

Practices should develop a written policy which states that all content on the employer's computers is the property of the employer. The policy should authorize the practice to monitor, access and disseminate any messages or other information resulting from the employee's use of the computer. Employees should be required to sign the policy, and copies should be kept in their personnel files.

Source: Gregg RE. Use or abuse of computers in the workplace. J Med Pract Manag. May/June 2007:331-337.


Keep good staff members on board

Your staff members have three basic needs that contribute to their job satisfaction: trust, hope and a sense of worth. Ensuring that these needs are met will reduce the chance that employees will leave your practice.

Try these strategies:

  • Physicians or leaders should work to gain staff members' trust by being open and honest in all communication, treating the staff well and providing accurate and timely compensation.

  • Make sure that staff members are aware of any opportunities for career advancement in your practice.

  • Recognize staff members' dedication to the success of the practice with thank you notes or staff appreciation activities.

Source: Valenzuela P. How to keep good staff from leaving. Physician Exec. July/August 2007:38-41.



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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