Just over 40% of the 1,500 physicians who responded to
a recent Practice Management survey were in group practice.
Patient loads which have become almost unbearably high
ranked as the most pressing practice problem by over half
of respondents. That's hardly surprising since 64% of
you reported seeing more than 75 patients a week, with
numbers running as high as 130 in several cases. The time
pressure these loads put on individual physicians was
the second most common complaint.
Clearly these are two major areas
that don't have quick and easy solutions. A series of
articles on what your colleagues are doing — and
proposing to do — about carving some more time
for themselves out of their busy practice is planned
for the fall. In the meantime, let's look at another
problem area the survey identified that does have a
straightforward solution: Dividing group practice expenses.
The simplest method, and one used
by too many groups, is to divide all expenses equally
— simple, certainly, but hardly fair. Some group
members see more patients than others and consequently
earn more and, at the same time, use more of the groups'
resources than others. Conflicts over the division of
expenses can leave certain members smouldering with
resentment that can tear the group apart. Best to get
it right before that happens.
There is no sweeping formula that
can answer this one. Essentially what you have to do
is sit down with your accountant and go through a list
of the expenses and decide how each one will be handled.
Once you begin to look at each item in detail, you'll
find that they do fall into categories and, fortunately,
there aren't an infinite number of these. Practices
that have gone through the exercise commonly divide
each item into one of the following slots.
Divide according to revenue
Fixed expenses are often allocated this way. Rent, for
instance, accounting services and receptionist salaries.
Divide by physician Expenses
that vary according to a group member's use would be
included here. Medical and office supplies, postage,
individual computer expenses and telephone.
According to employee use
Allocation of staff salaries is often done on an hourly
basis, physician by physician.
Divide by actual expenses
This is an obvious one that includes professional fees
or publication subscriptions.
Divide by negotiation Some
splits will have to be worked out by the whole group.
Clinical equipment, computers and CME are a few examples.
These categories will cover most
practice expenses. Once you have a system in place,
make sure new physicians are familiar with expense allocations
at the time they're hired. If you'd like a little help
with this and a variety of other practice problems that
lend themselves to systematic solutions, consider getting
a copy of the US book Medical Practice Forms: Every
Form You Need to Succeed by Keith Borglum and Diane
M Cate, $59.95 US call 1-800-MED SHOP, to order.
|
