FEAR FACTOR : A TYPICAL DAY AT THE OFFICE

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FEAR FACTOR A TYPICAL DAY AT THE OFFICE

• David M. Deci, M.D.
• Department of Family Medicine
• Practice Management Curriculum

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Where Skills are Tested
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and Brains and Brawn are required!
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SCENARIO 1

• You are one of three partners in a small family
  practice named Good Family Health, LLC. Your
  most junior partner, Max D. Outte has been with
  you for about 5 years. He is married to a
  physician specialist in another town and takes
  primary responsibility for his two young children
  who are often sick and unable to attend daycare.
  He frequently arrives late to work with one or
  more sick youngsters and beds them down in his
  office. Occasionally the children require
  supervision from the office staff and they often
  become loud and disruptive.

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Case 1 CONTINUED

• Today, your LPN, Madonna Lovemeister, brought her
  six year old daughter to work because she was ill
  with conjunctivitis and could not attend school.
  When your office manager gently reminded Madonna
  that she needed to find alternative child care
  arrangements, Madonna burst into tears and said
  but Dr. Outte does it all the time! I am a
  single mother and cannot afford a babysitter like
  he can!

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CASE 1 CONTINUED

• Your office manager comes to you in between
  patients and asks your advice on what to do next.
• How are you going to address the problem(s)?
• What are the main issues involved here?
• What could have been done to prevent this
  personnel (and maybe personal) crisis?
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•  

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SCENARIO 2

• The winter flu season has just subsided and
  you are looking forward to a weeks vacation in
  the Caribbean. Just as you are finalizing your
  plane reservations, your office manager comes
  into your office and closes the door. Doctor,
  she says, I think that someone is robbing us
  blind. Look at these statistics for December.
  We put 350,000 on the books that month alone and
  so far in the first two months of this year we
  have collected only 107,000. I dont think that
  we can make payroll this month. You doctors are
  going to need to come up with the shortfall.

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CASE 2 CONTINUED

• After a brief cardiac arrest, you take a deep
  breath and ask to see the practice finances for
  the past year. You notice that cash flow took a
  dive in November and has not recovered since then
  despite record monthly charges.

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CASE 2 CONTINUED

• What are the main issues involved here?
• What are your next steps?
• Should you confront Mona Poormouth, your new
  billing clerk who was hired in October?
• What are you going to do about payroll?
• Your monthly staff meeting is tomorrow. Do you
  say anything? If so, what do you tell your
  employees?
• What could have been done to avoid this mess?

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SCENARIO 3

• Viva LaFrance has been your receptionist at
  Good Health, LLC since she moved to your town
  from Montreal three years ago. She is outgoing,
  engaging and very pleasant to patients both on
  the telephone and at the front desk. In the last
  month, a handsome new drug rep by the name of
  Lance Hardman has been frequenting the office
  twice a week and leaving samples of Levitra.

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CASE 3 CONTINUED

• As you step out into the hall, you see Lance
  and Viva engaged in lighthearted laughter and
  conversation at the front desk while several
  patients line up in the reception area. In
  addition, you become aware that Viva is wearing a
  seductively short dress with a plunging neckline.

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CASE 3 CONTINUED

• What are the main issues involved here?
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• What are your next steps?
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• How could this ticklish? situation been
  avoided?

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SCENARIO 4

• Wesley Whitetail, your clinical assistant,
  also serves as your main lab technician at Good
  Health, LLC due to his background in Medical
  Technology. Your lab is preparing for an
  upcoming CLIA inspection and Wesley asks if he
  can come in on weekends to get better prepared.
  Although your budget is tight, you let him know
  that he can spend a few extra hours getting the
  data formatted for the inspection.

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CASE 4 CONTINUED

• Two weeks later, your office manager comes
  into your office and asks if you authorized
  overtime for the employees. It seems that
  Wesley has logged an extra 24 hours this pay
  period she says. In addition, Wynonna Diehard,
  our other clinical assistant, has put in for 12
  extra hours. Did you guys have a weekend clinic
  that I didnt know about?

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CASE 4 CONTINUED

• What are the issues here?
• What do you do next?
• How do you address this issue with Wesley? What
  about Wynonna?
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• What could have been done to avoid this costly
  problem?