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 ?

i. Personnel

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 ?

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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.

1	Is the practice easy to identify from the street?	Yes	No
2	Once inside the building, is it easy to find your office?	Yes	No
3	When you enter the office, is the air fresh?	Yes	No
4	If a glass partition separates the reception are and the receptionist, does the receptionist open it immediately when a visitor arrives?	Yes	No
5	Is the reception area furniture free of stains and tears?	Yes	No
6	Is there some individual seating in the reception area?	Yes	No
7	there current issues of different magazines?	Yes	No
8	Are patients greeted with a smile?	Yes	No
9	Do staff make eye contact with the patient?	Yes	No
10	Are first-time patients welcomed to the practice?	Yes	No
11	Does a staff member ask the patient about the name he or she prefers to be called? Alternatively, are all adult patients addressed by their last names?	Yes	No
12	Are patients afforded privacy to explain why they are there?	Yes	No
13	Are patient names and records accessible to staff only?	Yes	No
14	Do staff orient patients about what will happen next?	Yes	No
15	Does the patient meet his or her physician before disrobing, giving a urine specimen, having blood pressure checked, and so on?	Yes	No
16	Do staff or physicians apologize for waits longer then five minutes?	Yes	No
17	Do staff members listen without interrupting?	Yes	No
18	Do physicians and staff appear to be happy in their positions?	Yes	No

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Don’t get disheartened if your score is low – this checklist can give you a goal you should aim for !

Benchmarking Your Medical Practice

While the term benchmarking may be unfamiliar, it’s something doctors do all the time to improve their clinical skills. We compare and observe skilled and experienced surgeons, for example, so we can learn their superior surgical techniques - and in exactly the same way, benchmarking is a business technique which analyses successful competitors to determine the indicators of business success , and then applies that information to achieving business growth and improvement for yourself. For doctors benchmarking is a way of taking a critical look or "snapshot" of your practices health. It provides you with an objective way to measure your practices performance, and to compare it with others’, so that you can learn from the best practices of the leaders.

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.

Clinics have also used benchmarking to improve their clinical protocols. Thus, leading IVF clinics collaborate with each other and compare their techniques and pregnancy rates, so that they can learn from each other, and adopt the techniques which give the best results.

Benchmarking is an excellent tool for assessing the health of your practice and detecting problems as early as possible. Remember that you can learn a lot from other successful doctors – and benchmarking will allow everyone to improve ! Thus, if you are reluctant to share information with your local "competition”, you might want to benchmark with a colleague in another city, whose specialty and practise size is similar to yours. Rather than compete with each other, you can collaborate to create a win-win situation !

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2 comments

Doyle

Monday 29 May, 2017 03:49 posted by Doyle
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ByronthicT

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Chapter 4: Assessing your practice – take a critical look at what you are doing

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