Authors: Dr. John Guiliana and Dr. Hal Ornstein, with Mark Terry

Publisher: Greenbranch Publishing – 146 pages

Book Review by:  Nano Khilnani

This is the most comprehensive book on the business side of a medical practice that I have read and had the pleasure to review.

There are 28 to 31 days in a month. There are 31 ½ chapters in this book. Are you supposed to read one chapter per day? The title itself of the book makes you ponder. Of course, there are far more than 31 ½ problems doctors have to think about and find solutions for. This is a very useful book for both the beginning doctor contemplating on setting up a private practice or one who already has an established one.

In the Foreword to this book written by Dr. Neil Baum, author of Marketing Your Clinical Practice – Ethically, Effectively and Economically, he points out that when he meets other doctors in hospital dining rooms and lounges, he hears a lot of bickering, complaints and overall negativity about their work, what tomorrow will bring and what the future of healthcare will be like.

The dismal state of healthcare in theUnited Stateshas many doctors, families and individuals worried. Health insurance premiums have soared and there seems to be no end to their relentless climb upward. Hospitals have been forced to shut down after being on financial life support for some time.

Today, doctors are being squeezed by larger and larger premiums for malpractice insurance and other rising costs on the one hand and smaller and smaller reimbursements from Medicare, Medicaid and health insurance companies on the other hand. They face higher rents or property taxes if they own the property they work out of. A doctor friend told me recently that he had to “give away” half his income just in residential and office property taxes, and office maintenance charges.

Along with financial challenges, a doctor who is self-employed having his or her own practice has the responsibility of ensuring that it is run smoothly in terms of billing and collection as well as patient satisfaction.

This book deals with the business aspect of a private medical practice and all the activities involved to ensure that it is run smoothly. The responsibilities and tasks for you the doctor starting your practice ranges from choosing an office location, equipping and furnishing it, setting up the communications system in it, hiring staff, motivating them or ensuring they are reasonably productive, writing the office manual, marketing your practice, billing, and collection.

But that is not all. After everything is set up, you need to think about and add features to improve the efficiency and profitability of your practice, to save you time, money and effort as well as to increase revenue.

So some of the things you can do to save time and effort that the authors recommend are: a paperless office, remote access to people and records, e-prescribing, e-billing, e-collection and constant view and implementation of ways to reduce overhead expenses, including salaries and benefits. (Read chapter 22 on five ways to plug leakage of revenues).

To increase your revenue, the authors suggest offering ancillary services like physical therapy; in-office dispensing of prescriptions; and bringing on an associate or two, or several of them, so that shared expenses result in a larger net income for each doctor.

There are chapters also for you on enhancing the overall work environment and experience of doctors and members of their staff, such as on time management, office design, patient scheduling, dealing with stress, tips for collecting money owed, dealing with difficult patients, and balancing your personal and professional lives.

Dr. John Guiliana is the managing partner of a busy four-person podiatry practice inHackettstown,New Jersey. He holds a Master of Science degree in healthcare management.

Dr. Hal Ornstein I chairman and director of corporate development for the AmericanAcademyofPodiatric Practice Management, and consulting editor for the magazine Podiatry Management.

This is an excellent book for the doctor planning to establish a private practice or for you the doctor if you already have one, as it can help you overcome many of the problems that challenge you currently.