Chapter 4: Assessing your practice – take a critical look at what you are doing
|"Good criticism is very rare and always precious. "
- Ralph Waldo Emerson.
After practicing for a few years, we tend to get into a rut. This is why it’s a good idea to step back and critically appraise your practice every year . You can use the following criteria in order to do so objectively. If you can request another doctor to do this for you, this is even better. Critical patients can also help you improve , provided you don’t get defensive when they censure you. Use their feedback constructively to improve the care you provide to your patients !
a. General Clinic Facilities
Is the area big enough ? What about the design, atmosphere, cleanliness, maintenance ?
Are the waiting rooms comfortable ? Do the patients feel pampered ?
Do the examination rooms offer privacy ? Are they well-equipped ?
Are the toilets clean ? easily accessible ?
b. Telephone System
Are their enough incoming lines ?
Are phones answered promptly and politely ?
Are fax, e-mail services available ?
Is there a scheduled call back time or other means of returning calls ?
Is there a system to ensure incoming messages are appropriately directed and acknowledged ?
Do patients know how to contact you after the clinic is closed in case of emergency ?
c. Appointment System
Does it satisfactorily accommodate patients ? Is there a very long waiting list ?
Do you keep to your appointment schedule ?
Is there a system to accommodate urgent or emergency appointments ?
Is there provision for coverage after the clinic is closed ?
d. Filing System
Is the filing system efficient and accessible ?
How are the charts coded ?
Is there a system to avoid mis-filing ?
e. Medical Instruments and Equipment
Is the equipment modern and uptodate ?
Are appropriate sterilization procedures in place ?
Is there a system for managing biomedical waste ?
f. Drug Supplies and Samples
Are appropriate drugs available and properly stored ?
Is there a proper system for maintaining current list of drugs on hand and monitoring expiration dates
Are narcotics and other controlled drugs stored securely ?
g. Emergency Facilities
Is the emergency medical cart appropriately stocked, centrally stored, and readily available ?
Does the staff know what to do in the event of an emergency or disaster ?
h. Laboratory Investigations
What type of investigations are available ?
Are they accessible on-site or close by ?
Is quality control maintained ? Are the results verified ? checked ? recorded properly ?
Is there enough staff for running the clinic smoothly ?
Are they well trained ?
Do they work well with each other ?
Are regular staff meetings held to trouble shoot problems ?
Are there documented job descriptions and office policies ?
k. Miscellaneous Observations
Is there a system for handling incoming medical reports and test results ?
Is there a system for handling consultations and referrals ?
Are educational and medical reference materials available for the
doctor ? for the patients ?
It’s also a good idea to pretend you are a new patient, and subject your clinic to the following First Impressions Test . This can help you identify deficiencies in your present practice, so you can work on improving it
First Impressions Test.
Don’t get disheartened if your score is low – this checklist can give you a goal you should aim for !
Historically, physicians have not formally benchmarked their practices. However, benchmarking is not such a new concept, and it’s something all of us have been doing informally for years. For example, when we compare our past year’s income with our present year’s performance, we are using internal benchmarking. Has your income gone up or down? Have expenses remained steady, or have they spiked up? Looking internally will show you how well you are progressing.