Fam Pract Manag. 2010 Jan-Feb;17(1):34.

Offer patients interesting reading materials

The rat-eared National Geographic in the waiting room is a cliché I've always tried to avoid. Every year or two I visit the magazine section of a large bookstore and pick out new magazines to subscribe to. My criteria are that they have to be unusual (usually ones I've never heard of), attractive, tasteful and less than $1 an issue with a subscription. Several patients comment about our reading selection each week.

Catalogs are another patient-pleaser. The unsolicited mail-order catalogs we all receive can be quite interesting to our patients. We cut off the address labels if they were sent to our homes and place them in the waiting area and exam rooms. We attach labels to the catalogs that invite patients to take them home if they wish. It's surprising how often they do.

Prepare to impress

Nothing is more irritating to a patient than to have to answer the same questions three times, so I always review the nurse's history, labs and the previous visit before I put my hand on the doorknob of the exam room. My first comment to the patient proves I'm prepared, but here's a trick: We keep our waiting charts at the nursing desk, so the patient doesn't hear me take it out of a slot on the door. That way patients naturally assume that I've got a great memory (I don't) or that I'm exceptionally dedicated (I'm not). You only get one chance to make a good first impression, and every visit to my office is a new first impression. Just one problem: When my patient catches me at the grocery store, and I can't remember her name – let alone her medications – I just have to hope she figures I'm exhausted from my long day of thorough preparation.

Getting into Medicare after opting out


I opted out of Medicare two years ago, and now I'd like to opt back in. Do I have to file a new 855I form?


I reviewed Section 40 of Chapter 15 of the Medicare Benefit Policy Manual (see, which covers the Medicare opt-out rules for eligible physicians and practitioners, and found nothing that would require a physician who has opted out of Medicare to file a new 855I at the end of his or her opt-out period in order to opt back in to Medicare. In particular, Section 40.7, “Definition of a Private Contract,” simply says, “After those two years are over, a physician/practitioner could elect to return to Medicare or to opt out again.” It does not specify any requirements related to returning to Medicare after the two-year opt-out period is over.

If you want or need a more definitive answer, contact the regional office of the Centers for Medicare & Medicaid Services (CMS) in your part of the country. To find contact information for your region, refer to the CMS regional map online at, and click on your state. A PDF file will then automatically download with the appropriate contact information.

Thank your staff regularly

The best way to assure customer service in your practice is to focus on cultivating a staff that feels valued. Praise, encouragement and appreciation (as long as they are sincere) go a long way in getting your staff to perform at their best. The most fundamental way to show appreciation, and the one that makes the most lasting impression, is to create an atmosphere in which saying “thank you” is a part of your normal work day. Take time to notice how hard your staff members work; tell them you understand the pressures they face; acknowledge that their jobs (like yours) have become more difficult.

These are small but effective ways to help your staff feel appreciated. Remember that even routine work can be hard. Don't think of praise as something appropriate only for extreme accomplishments.


Adapted from Eskin E. Staff appreciation: a little praise goes a long way. Fam Pract Manag. October 1996:65–66.


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.


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