Welcome to this special issue,
with a 12-page section devoted entirely to the management
of your practice. It begins on page 9. For your convenience
and ease of use, the section has been divided into four
parts: Your Practice; Your Staff; Your Office; and Your
Patients.
Much of the section is based on
the nearly 800 returns you submitted earlier this year
to a survey on the state of medical practice in Canada.
Your responses provided invaluable information, province
by province, including gross and net incomes; whether
you own or lease your facilities; the size and makeup
of your staff, as well as such things as your type of
practice — solo, group, partnership, incorporated;
the number of examination rooms you use, and so on.
Taken together the results paint
a remarkably intimate picture of the state of medical
practice in 2006. It's not the macro view that the profession
— and the country — is so used to reading
about in the nation's media: The jam-packed ERs. The
sick unable to find a GP to call their own. The lengthy
waiting lists for operations. In short, that the healthcare
system is going to hell in a hand-basket.
In these pages you'll find a micro
view of practice, day-to-day medicine as it is for your
colleagues in the trenches — and one that looks
for solutions, not problems. A case in point: more than
20% of respondents identified "paperwork" as their most
pressing practice problem, followed closely by "no time
for new patients." The physicians we talked to in preparing
the section told the editors that record-keeping now
gobbles up nights and weekends — as much as 20
hours a week. The solution for an increasing number
of practices is to go electronic. Like so many things
electronic, it's a mixed blessing. Once up and running
it does indeed reduce the numbers of hours spent inputting
and outputting data — except, of course, when the
voice-recognition software forgets who's talking to
it and has to be programmed all over again to recognize
its masters voice (see page "Paperwork, wait times plague
physicians" on page 12).
Another article you'll want to
read looks at the number of examining rooms used by
practices from coast to coast and compares that number
to patient loads and gross billings. If you ever wondered
how many examination rooms per physican is the optimum
number, put your mind at ease. The evidence suggests
the magic number is three. The survey also shows that
a significant majority of practices have fewer than
this number and that many practitioners make do with
only one. You'll find expert opinion on the subject
in the section on Your Office (see pages 17-19).
Problem number two, patient loads,
also has solutions. If your appointment book is fuller
than the fullest and every time the phone rings it's
an irate patient demanding an appointment, have a glance
at the interview with the California doctor credited
with inventing "same-day" booking (see page 11).
While on the subject of medical
practice south of the border, it's worth mentioning
that in general practice and in most specialties, you're
taking home more pre-tax dollars than your US counterparts.
The trends confirms what the 2005 NRM income
survey found — though gross physician incomes are
substantially higher in the States, net incomes, after
deducting practice expenses, are lower there and the
gap is growing. See where you fit by having a look at
the article "Canadian MD earnings inch upward" on page
9.
This barely scratches the surface
of the valuable and useful information the section contains
(if you have a moment, please tell us what you think
of the section by filling in our questionnaire).
Thanks to all of you who sent in responses and shared
your practice joys, sorrows and solutions for inclusion
in these pages.
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