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Fam Pract Manag. 2009;16(1):29

Remind employees of their total compensation

Our practice implemented a tool to help our employees understand the total compensation package that our practice provides. The tool is a simple worksheet that lists employee pay and benefits and the employer costs associated with each.

The employee’s hourly rate of pay is listed first, followed by the annual compensation, which is shown based on the hours (full time or part time) worked for the year, not including overtime. The next items listed are the employerpaid portions of Medicare and Social Security taxes and health insurance premiums, followed by our contributions to the employee’s profit-sharing or retirement plan. The number and dollar amount of paid days off and holidays are also provided; this number often surprises our employees because it sometimes totals 30 days for our full-time staff. Total compensation is then calculated and listed at the bottom of the worksheet.

We present employees with this worksheet annually. It has helped them to better appreciate the “hidden” benefits we provide, some of which are not reflected in their paycheck, and it has given us an accurate picture of the cost of each employee.


Limiting the number of Medicare patients you see

Q The article “How to Say Goodbye to Medicare” [June 2008;] by Kent Moore provided guidance and tools for clinics that plan to opt out of Medicare. Our clinic doesn’t plan to opt out, but we would like to place a cap on the number of Medicare patients we see, simply so we can remain profitable. Do you have any information or examples for our situation?

A Unlike opting out, capping the number of Medicare patients seen in the clinic does not require any paperwork or procedures.

However, I recommend that if you close the practice to some new Medicare patients, you close it to all new Medicare patients. It is simpler this way, and it is easier to explain to your patients. Also, if you allow some new Medicare patients and not others, you run the risk of being accused of discrimination based on gender, ethnicity, etc.

Additionally, capping the number of Medicare patients below the number you currently see would involve dismissing those patients over the cap, which creates risks similar to those I’ve described above. A better way to get below the cap is through attrition, that is, not accepting new Medicare patients until current patients die, move, change physicians, etc.

If you do decide to dismiss some of your Medicare patients, do so in a thoughtful and deliberate way that ensures the well-being of the patient. Not doing so could put your practice’s reputation at risk.

Maximize your sample space

My colleague Paulo Pinho, MD, recently introduced me to a much better way to organize medication samples. First, we use small stacking bins instead of shelving. This maximizes the closet space. Second, we strip away all packaging except for the package insert. This too saves space. Finally, instead of organizing samples by drug class, we organize them by drug name, which makes it easier for medical assistants who may not be familiar with drug classes to find what they need. This setup uses 50 percent less space than our old method. The photo, right, shows the old system (top shelf) and the new system (bottom shelf). We also use a calendar to keep track of expiration dates of the samples.


Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Submit a pearl (250 words or less) to FPM at

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