So far we have presented 3 different articles on our various Silkin Management Group blog sites, including this one, concerning investigation type questions that a practice owner can use to help analyze their practice. These are the types of questions that Silkin Management Group consultants use when doing an initial evaluation of a new client’s practice. We thought we’d pass along these tools to any practice owner, whether a Silkin Management Group client or not, to help them understand their practice better.

The three previous articles covered the following practice areas:

• Human Resources
• Marketing and Sales
• Financial Controls

You can link to previous articles not on this site at these Silkin Management Group blog sites: http://bit.ly/IJLLdm and http://bit.ly/JtMECq .

Today we’ll present some areas that one can look into regarding Quality Control. Here are some questions to ask yourself regarding this area:

• How do you maintain quality control on your product or service? Do you have ay specific methodology for this?

• How do you know if your patient/client is satisfied?

• Are you able to immediately determine if your patient/client is dissatisfied?

• What type of corrective actions do you use when finding a dissatisfied patient/client?

• What type of corrective actions do you employ for production problems or drops in production statistics?

• How do you correct employees who make mistakes or who err in handling patients/clients or in creating production?

• Do you have a regular continuing education program for yourself to consistently improve your technical abilities?

• Do you have any type of training or educational program for increasing your management skill at running the business side of your practice?

• What type of training program or programs do you have to improve the ability of your staff to produce their products or services?

Quality control includes detection and prevention systems for patient/client satisfaction, corrective programs for problems found and training to improve every employee’s competence at their job (and this includes the Doctor’s technical and management ability).

If you run through the above questions you should be able to determine what improvements you need to do in the area of quality control.

JACK HENNESSY
Silkin Management Group Consultant

For more information about this subject or practice management in general, visit our website at www.silkinmanagementgroup.com or like us on Facebook at http://www.facebook.com/silkinmanagementgroup

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Silkin Management Group consultants have analyzed and evaluated thousands of health care practices during the 30 years we’ve been in business. We know what to look for and how to then write a specialized program or business plan to handle the issues found in the analysis.

We thought that, over the next few days on our various Silkin Management Group blog sites, we would present some basic areas that our consultants look into when evaluating a client’s practice so that anyone, whether a Silkin Management Group client or not, could start looking into these areas of their practice on their own and start determining the state that they are in. These areas are all the most fundamental functions that any business, practice or organization of any kind must have working to be successful. Look into your business and determine the state of each of these areas or functions.

Human Resource Issues:

• Who does the hiring in your company?
• How do you determine who to hire?
• Is there any kind of testing to determine who’s qualified?
• Who fires people?
• How is firing done – does it conform with the legalities of your state and federal laws?
• Do you have problems getting rid of people?
• Are there job descriptions for each position in the company?
• Are there office policies covering all basic aspects of being an employee?
• Do you have any problems with staff in areas like theft, alcohol, drug abuse, lying, cheating or unethical activities of any kind?

Office Communication:

• When mail comes in for you does it reach the individual concerned rapidly, i.e. same day?
• Do you find any slows on your internal communication lines?
• Do you find that backlogs of communication develop within your organization, either between individuals within or with others outside?
• Does your promotional material or bulk mail get out when it is supposed to?
• Do you have an efficient intra-office email system?

Office Organization/Stat Management:

• Do you have statistics for each position in the office?
• Are the key statistics of your office posted where they are easy to look at and inspect?
• If there is an area in your company with a significant boost or crash in production, do you have an effective means of investigating those areas to determine the causes so as to support the increased production or correct the failed production?
• Do you have any methods of monitoring production for each segment of your business?

We will continue this series of areas of evaluation in upcoming Silkin Management Group blogs.

ERIC KORB
Silkin Management Group Consultant

Like us on Facebook at http://www.facebook.com/silkinmanagementgroup. Visit our website at www.silkinmangementgroup.com

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I just read an article by an employment attorney that we have referred many Silkin Management Group clients to concerning the use of student interns. We’ve offered internships to local students over the years at Silkin Management Group and have found them rewarding for the student as well as the supervisory staff. This is something that many employers like to do to give back to the community. In our case, we work with schools that have some sort of introductory business type class and are thereby interested in their students gaining some experience to help them understand better what they’ve learned in class.

But, as pointed out in the article I read, there are legal pitfalls to be aware of when involving yourself with a student intern. The first thing to know is that employers must pay at least minimum wage to anyone who provides labor/service to a business. Therefore, unless you take the following points into account, you will be required to pay the intern at least minimum wage. But, if the intern qualifies under these points from the Department of Labor, then you are generally ok without paying the intern.

• The training/internship must be of a similar nature to that which they would receive in an educational environment and/or vocational school.

• The work done must primarily be of benefit to the student, not the employer.

• The student/intern is not replacing any employee.

• The student/intern is closely supervised by an employee.

• There is no immediate gain by the employer from the student/intern’s actions and, in fact, it is not uncommon for there to be impediments to the employer by the work of the student and/or time put into supervising the student.

• The end result of the internship is not that the student/intern gets a job.

• It is understood upfront that the student/intern is not being paid.

As we always tell Silkin Management Group clients, check with a good employment attorney if you decide to enter a program like this. The above information came from a great employment attorney firm, The Law Offices of Timothy Bowles. You can visit their website at www.tbowleslaw.com and read their articles on this and other employment subjects.

If you have your legal rudiments in, as covered above from the Department of Labor, and as covered in any laws of your state, you will find such a program very rewarding.

JACK HENNESSY
Silkin Management Group Consultant

For more information about Silkin Management group visit our Facebook page at http://www.facebook.com/silkinmanagementgroup and our website at www.silkinmanagementgroup.com

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Silkin Management Group clients are primarily private health care practice owners in the dental, veterinary and optometric fields. Finding and hiring good staff is always something that clients new to Silkin Management Group want help with. And with our dental clients, finding and keeping a good hygienist is often high on their list of personnel issues. Therefore we thought we’d present some successful ideas in this area that Silkin Management Group consultants use with their dental clients.

The basic principle to think with is similar to what one employs in promotion – outflow produces inflow. The more outflow you do along any communication line you can find, the better your chances are of finding the right person. Here is a beginning list of points to consider as part of your outflow activities.

1. Offer a good wage. Ideally offer a wage that equals or exceeds the high end wage for a hygienist in your area. This will help attract any hygienist when they are looking through ads and spot your ad. We recommend you offer the wage in the form of a percentage of production. To do this:

• Compute what could be produced in a full day.
• Divide this by 8 to compute the production per hour.
• Divide the top end wage in your area by the number you find above for the percentage you would offer.

You might promote this in your ad as an “opportunity to exceed $X per hour in a rapidly expanding practice”.

2. Put an ad in as many places as possible such as local newspapers, Craigs List, any other internet sites that post hiring ads, local association sites and/or newsletters, etc.

3. Put a notice up in your reception area.

4. Similar to asking for referrals, mention it to patients who come in the office. “With our practice expanding we are looking for a new hygienist. If you know of any please refer them to us.”

5. Set up a staff referral bonus for any staff member that refers a recruit that lasts through their probationary period.

Please note that many of these points can easily be used for recruiting staff in general. We have many successful recruiting methods that Silkin Management Group consultants use with their clients to help them find good staff. Visit our website at www.silkinmanagementgroup.com for more information about this. You can also give us a call at 800-695-0257.

ERIC KORB
Silkin Management Group Consultant

Silkin Management Group

Silkin Management Group has written numerous articles over the years, presented on our various Silkin Management Group blog sites, covering employee fraud and theft. I recently read a very good article by Greg Jones on cnbc.com that gave a good summary of things to watch for and do to cut down on this type of employee problem.

This article pointed out that, according to a 2009 survey, 7 percent of annual revenue is lost to fraud. Although most Silkin Management Group clients have a small number of staff, and fraud can be more easily hidden in a larger staff, this survey pointed out that the majority of fraud cases occurred in companies with fewer than 100 employees. Over the many years that Silkin Management Group has been in business, we have helped several clients discover fraud and theft in their practice and set up systems to detect and prevent this from occurring in the future.

Here are some pointers that Mr. Jones presented that I thought I’d pass along to help prevent fraud and theft.

• Have different people have the ability to write checks and manage the books.

• Watch your receivables. If you see a significant increase in receivable aging and/or bad debt, look into it very closely.

• Review monthly journal entries for anything that looks out of line.

• Send your credit card statements to your home address.

• Make yourself the only person who can sign checks.

• Have some sort of regular audit of your books by a good outside bookkeeper or accountant.

Proper hiring and training of finance staff will greatly reduce the odds of putting a “bad apple” into your finance area. Silkin Management Group has a system of testing and interviewing potential employees that will aid you in finding the best person possible for this area. This, all by itself, is the best insurance against fraud and theft. If you’d like more information about our hiring processes give us a call at 800-695-0257 or visit our website at www.silkinmanagementgroup.com

JACK HENNESSY
Silkin Management Group Consultant

Silkin Management Group

Silkin Management Group clients often come to us looking for help with their accounts receivables. The first thing they wonder is whether or not their ARs are under good control or if they are bleeding money. There are a variety of ways that Silkin Management Group consultants evaluate the state of a client’s receivables. We thought we’d present one simple and quick way of looking at this area.

First, though, here’s some interesting information for any practice about how one’s accounts receivable dollar dwindles when the money doesn’t come in on time. This information comes from the U.S Department of Commerce and frankly, some of it seems generous.

• 30 days past due……………………. 97 cents
• 90 days past due……………………..90 cents
• 120 days past due…………………… 80 cents
• 6 months past due…………………… 67 cents
• 1 year past due………………………. 45 cents
• 2 years past due……………………… 23 cents
• 3 years past due……………………… 12 cents

Here’s a method of analyzing your account receivables that Silkin Management Group consultants give to their clients for a very quick evaluation.

1. Add up the most recent 6 and 8 week production.

2. Look at the most recent week ending’s A/R: what’s the total?

3. If your total A/R falls between the 6 to 8 week mark, you’re in decent shape.

4. If your total A/R is greater than 8 weeks, you have some work to do. It is likely that your patients are not properly educated on your financial policies or you don’t have financial policies to present to patients. It’s also possible that your collections secretary is not properly trained on how to collect from patients and/or insurance companies or, if trained, is not doing their job and needs to be replaced.

In our next Silkin Management Group blog we’ll go over some solutions to finding yourself in category #4 above.

ERIC KORB
Silkin Management Group Consultant

If you’d like information about how Silkin Management Group can help you with your A/Rs, give us a call at 800-695-0257 or visit our website at www.silkinmanagementgroup.com

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Unless you are living on another planet you know that the national dread-day of April 15th is rapidly approaching. Sometimes clients new to Silkin Management Group do not have proper financial systems in place to insure that their taxes are done in time. When this happens they naturally wonder what their alternatives are.

Silkin Management Group is not an accounting business, rather we offer training and consulting in practice management. But a key aspect of practice management, or running any business for that matter, is having your financial records in good shape – a key prerequisite for getting one’s taxes done. We help our clients to attain that state. But, if they are “behind the 8 ball”, we recommend that the client contacts their accountant immediately and work out how to get an extension. Getting an extension is not complicated. Here are some key points regarding getting an extension:

• For an individual, find and file IRS form 4868. You should be able to find it on the IRS website. It provides you with 6 extra months to file taking you out to October 15th.

• For a corporation or partnership, find and file form 7004. You should be able to find this on the IRS website.

Extensions are automatic once you file the correct form. Just find the form, print it, fill it out and submit it. It is very easy to do.

But, as we tell Silkin Management Group clients who file for extensions, the extension only allows extra time for filing the return. It does not allow you to put off paying any potential taxes that you owe. If it looks like you owe money for your taxes, the best thing to do is estimate the amount and pay it with the extension filing.

Once you then finally file your return, the IRS will refund you any overpayment. But if you don’t pay, or underpay, they will charge you interest on the amount underpaid. (Of course they don’t pay you any interest on any amounts you overpaid!).

As we teach Silkin Management Group clients, the best thing to do is have your financial records in order and file on time.

DAVE MCkEVITT
Silkin Management Group Consultant

For more information about Silkin Management Group visit our website at www.silkinmanagementgroup.com. Like us on Facebook at http://www.facebook.com/silkinmanagementgroup

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Silkin Management Group has many specialists as clients, such as orthodontists, oral surgeons, ophthalmologists, vet specialists, etc. These types of practices require their own unique type of marketing as they often primarily depend upon referrals from general practices.

Last month, on one of our Silkin Management Group blog sites, we brought up an idea on how a specialist could write a personal letter to any referral source he/she encounters. This action is a key marketing action for any health care specialist that depends to one degree or another on referral sources for new patients. You can read that article on this Silkin Management Group blog site: http://bit.ly/

A specialty practice should have someone holding the position of a marketing coordinator, whether it is held part-time by someone in the office such as the office manager or, if the practice is large enough, a full time person. Over the next several days we’ll present on our various Silkin Management Group blog sites some ideas of the job description for the marketing coordinator. Today we’ll start with an overview of the job.

Overview

The Marketing Coordinator is responsible for developing marketing strategies for the practice. Their primary objective is to increase new patients coming into the practice through other doctor referrals, patient referrals, external outreach to the public through internet and appropriate media and any public relations activities that would make the doctors and practice more widely known and respected.

This individual would generate specific plans of action in each of the areas described above and ensure that these were executed effectively.

The Marketing Coordinator’s primary metrics would be the number of new patients coming into the practice and the number of active referral sources. Active referral sources are defined as: any practice or doctor who has referred a new patient to the practice within the last 6 months. The job involves careful monitoring of referral sources, taking appropriate action when referral sources decline while nurturing those referral sources who regularly send patients to the office.

An ongoing duty of the Marketing Coordinator is constant outreach to existing and potential referral sources and maintaining very good relations with them once established.

The Marketing Coordinator reports to the practice’s business/office manager.

We’ll go over specific job duties in our next article on this subject.

JACK HENNESSY
Silkin Management Group Consultant

For more information about how Silkin Management Group can help your practice market more effectively, whether you are a specialty or general practice, visit our website at www.silkinmanagementgroup.com

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Last week, on our various Silkin Management Group blog sites, we covered the three days of oral arguments before the Supreme Court concerning the Affordable Care Act (ACA), also known as “Obama-Care”. Each day of debates before the Justices covered different subjects. Day one was concerned with whether this was the correct time legally for the Court to be hearing the case. Day two covered the central argument of whether or not the mandate for all citizens to have health care insurance was constitutional. Day three went over the scenario that, if the mandate was stuck down, would all or part of the rest of the legislation still be valid or not. You can read what we wrote about these oral arguments on this Silkin Management Group blog site as well as these two other sites: http://bit.ly/H0UUer and http://bit.ly/GZHpIj

From what could be divined from listening to the attorneys and the Justice’s questions and comments, our best guess is that a) the Court will certainly decide on the case, b) the mandate will be stuck down on a 5-4 vote and c) the rest of the legislation will be sent back to Congress to re-do given that the mandate is gone. Again, though, this is only a guess. Determining the outcome of Supreme Court decisions is not something anyone with half a brain would bet on.

In any case, there seems to be four possible scenarios that could come out of this. We will discuss one of them today and others later this week on some of our Silkin Management Group blog sites.

• Both the reforms from the legislation as well as the mandate are invalidated.

This would essentially gut the entire legislation and Congress – the Democrats – would have to start all over. If the important rules, including the mandate, are removed then the insurance companies will no longer be required to not deny coverage due to pre-existing conditions and will also be able to vary charges based upon a person’s age and other factors. Although both Republicans and Democrats profess to want health care reform, each side approaches it differently and the outcome of such a ruling will likely be determined by who wins the Presidential election and who controls Congress. It could get very messy. If, for example, insurance companies are then required to provide certain benefits but not have the large insurance pool required by the ACA, insurance rates will go up significantly which will certainly not make the populace and voters very happy.

We will go over some other possible scenarios in upcoming Silkin Management group articles.

SCOTT BARNARD
Silkin Management Group Consultant

For more information on Silkin Management Group visit our Facebook page at http://www.facebook.com/silkinmanagementgroup or our website at www.silkinmanagementgroup.com

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Silkin Management Group blogs have presented numerous articles in the last year concerning “Obama-Care” and outlined the various pieces of litigation and rulings that have been going through the Federal Court System ending up at the Supreme Court. We pointed out that the Supreme Court would hear oral arguments on this at the end of March, and that all started yesterday.

There will be 3 days of oral arguments concerning different aspects of this monumental piece of legislation. Yesterday was the first day and the arguments were focused on a specific subject: whether the Court should even be hearing any challenge to the law. This is based upon an old law and ruling called the Anti-Injunction Act which disallows courts from hearing cases about the validity of specific taxes until the tax itself has been collected. It seemed that the Administration was arguing that the case should not even be heard due to the Anti-Injunction Act because the “penalty” or “tax” would not go into effect until 2014 for those persons who do not buy insurance. The words “penalty” and “tax” were attempted to be used as one in the same.

By all indications the judges didn’t buy this argument at all. As Justice Breyer said, “Congress has nowhere used the word ‘tax.’ What it says is ‘penalty.’ Moreover, this is not in the Internal Revenue Code but for purposes of collection.” He further pointed out that the penalty is in no way attached to a tax; rather it is simply part of a health care requirement in the legislation. Because it is being collected in the same manner as a tax (by the IRS) “doesn’t automatically make it a tax”, he said.

So it looks like the argument that the Supreme Court shouldn’t even be hearing this matter at this point is going nowhere, and that seems to be the result of yesterday.

Today, the crux of the legislation will be discussed and argued – the mandate that everyone in the country is required to buy health insurance or be penalized. Arguing against the legislation will be representatives of the 26 different states and National Federation of Independent Businesses who successfully brought their “Anti Obama-Care” litigation through the court system to the highest court in the land. It will be extremely interesting to see how today’s arguments go and which way the judges are leaning based upon how they question the different attorneys on both sides. We’ll update this in upcoming Silkin Management Group blogs.

JACK HENNESSY
Consultant for Silkin Management Group

Visit our website at www.silkinmanagementgroup.com and like us at Silkin Management Group’s Facebook page at
http://www.facebook.com/silkinmanagementgroup

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We’ve presented two previous articles on our various Silkin Management Group blog sites about how a receptionist should handle new patients/clients who call in for prices on certain services. We call such a person a “shopper”. You can link to those articles at these Silkin Management Group sites: http://bit.ly/GC0yly and http://bit.ly/GFL28w

The first article pointed out that shoppers ask about price because that is the only thing they have to compare about the service from one office to another, but underneath that they are truly interested in getting good, effective service. That article also discussed that, when talking with a shopper, you shouldn’t discuss prices right off the bat, rather engage them in conversation about why they are interested in the service and what their needs and wants are while showing real interest in them.

The second article gave some examples of different ways to get in communication with the “shopper” without jumping directly into prices. Today we’ll go over what to do once you have fully engaged the potential patient/client in discussing what the problem is they want handled.

At an appropriate time, after you have gotten some more information and established a good, comfortable level of communication and rapport, you can give them a general price range along with a full explanation of what the price includes. For example, in an optometry office, the receptionist would explain that an eye exam in this office costs $X dollars, but the patient should know that this includes extensive testing (explain in lay terms what the tests are and what they accomplish), a complete exam from the doctor that will determine the prescription needed, an evaluation of any optical needs depending on the person’s lifestyle and job as well as any medical situations found from the exam. You may also say that the exam entitles the patient to X% off of a second pair of glasses, if your office offers such a discount.

If the person is still being a “shopper” it may be appropriate to say something like:

“When shopping for prices it’s important to find out exactly what the price you’re quoted includes. Some offices quote a price which is the most basic service as a come-on, but when you arrive at the office you find out about all sorts of extra fees that are necessary to get what you really need. I’m bringing this up so you can be an educated shopper. In this office we take pride in fully educating our patients at every step so they really understand what is happening and what the service is all about. I can also tell you that we are very aware of prices in other offices in our areas and our prices are quite competitive. We may not be the cheapest, but we are not the most expensive. Our philosophy is to deliver the highest quality service at a fair price and to inform the patient fully what the service includes so there is nothing hidden.”

We’ll go over some final ideas on dealing with shoppers in our next Silkin Management Group blog.

SCOTT BARNARD
Silkin Management Group Consultant

If you’d like to know more about Silkin Management Group, you can visit our website at www.silkinmanagementgroup.com , like us on Facebook http://on.fb.me/8JfoVU or give us a call at 800-695-0257.

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Last week we began a series of articles covering some ideas for a practice owner’s job description and list of job duties. We are doing this because we have found through the years that very few, if any, clients new to Silkin Management Group have clearly written job descriptions for each position in their office and none have a job description for a practice owner or for the doctor.

You might want to look at our first two articles to pick up some ideas on what a practice owner’s job description might look like. You can link to our first two articles on this subject at these Silkin Management Group sites: http://bit.ly/yC2nKD and http://bit.ly/xdHshh Today we’ll present some further duties for this job.

SAMPLE JOB DESCRIPTION FOR THE OWNER OF A HEALTH CARE PRACTICE, CONTINUED.

• Ensure that patient record protocols are consistently complied with.

• Maintain HIPAA, OSHA and other regulatory requirements.

• Set aside time to plan, resolve operational issues, and work out any problems related to practice flow and management.

• Have regular meetings with office manager and key employees to hear and help resolve issues related to practice operation.

• Relay problems and concerns to your appropriate managers or supervisors so these are fully addressed and are not allowed to persist.

• Demand that staff work towards continuous improvement in both clinical and administrative skills.

• As a leader, set realistic goals and objectives for the practice monthly, quarterly and annually. Make these objectives real to staff in a way they can understand and accept. Discuss hurdles that have to be overcome to accomplish and how these goals can be achieved.

• Adhere to your scheduling policies.

• Maintain a high level of communication with the office manager and support him/her. Do not go around their decisions, but correct these by use of their job description, discussion with them and permit them to make the necessary corrections.

• Never discipline a staff member in front of others.

We will present more ideas on this subject in future Silkin Management Group blogs.

A full job description and list of job duties for each job in a dental, veterinary and optometry office, including the owner’s job description, can be found in Silkin Management Group’s 400 plus page Job Description and Office Policy Manual.

JACK HENNESSY
Silkin Management Group Consultant

If you would like more information about Silkin Management Group’s Job Description and Office Policy Manual visit our website at www.silkinmanagementgroup.com You can also visit our Facebook page at http://on.fb.me/8JfoVU or call us at 800-695-0257

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Many Silkin Management Group clients are specialists in their field. In addition to general practitioners, we also consult and train specialists such as oral surgeons, ophthalmologists, orthodontists, veterinary specialists, etc. These practices are unique in terms of their marketing templates as they often primarily rely on referrals from GPs for their new patients.

One key marketing action that a specialist should use is to write a personal letter to any referral source he/she encounters. This establishes a communication line and adds an important piece of reality between the doctor and the potential referral source. Below are some ideas that Silkin Management Group consultants use with their specialist clients when writing a letter to a potential referral source.

• When you meet a new referral source or office, always include a personal letter from the doctor, on the practice’s or the doctor’s letterhead.

• The letter should always be hand-signed by the doctor.

• It should briefly explain what you offer and why you are unique as a provider of this type of treatment. You want to present something that separates you from other doctors who may offer the same or similar treatment.

For example, teaching experience or teaching credentials in a category, “I taught residents at UCSF for 10 years and led the research team on…” “We are the only practice in Georgia that does …” “We are the only practice that limits our treatment to… in Northern Nevada.” “I have treated over 2000 such cases and spoken throughout the US and Canada on the subject (please see my CV attached).”

• The explanation of what the doctor offers should be simple and direct, but no more than 2 or 3 sentences or it won’t get read.

• Always invite the referring doctor to call, and indicate that your office will follow up to find a time you can get together. Keep the letter warm, friendly and personal. Leave your doctor’s cell phone number as a contact along with the office.

• Include articles or any material in which the doctor has been interviewed or has appeared in newspapers or magazines.

• The letter should be a few short paragraphs, not longer than ½ of a page. That is short enough that a busy doctor might read through it. Although other materials should be included, the doctor’s letter should be noticeable and what you want the referring doctor to take note of.
Silkin Management Group has many other very successful marketing actions for any specialty practice. If you’d like more information about how Silkin Management Group can help your marketing efforts, whether you are a GP or a specialist, give us a call at 800-695-0257. You can also visit our website at www.silkinmanagementgroup.com

SCOTT BARNARD
Silkin Management Group Consultant

Silkin Management Group

Silkin Management Group clients have interest in bringing on a partner usually for two reasons: a) to continue the expansion of the practice as they have maximized the level of production that can be done by one doctor and/or b) to bring on a future buyer of the practice for retirement purposes. This often starts by first bringing on an associate with the potential to buy into the practice or buy the entire practice. Silkin Management Group consultants closely work with their clients when any of these situations arise.

In previous Silkin Management Group blogs we’ve gone over key issues that any practice owner should be aware of when going into a partnership. Today we’ll go over a couple of final points and summarize this 6 part series.

• Get agreement on how the partnership will dissolve if it has to.

Partnerships can dissolve for a number of reasons but, no matter the reason, terms need to exist for this potential eventuality. To keep the dissolution as amicable and sane as possible, it is important to have some dissolution terms. Things to keep in mind are:

- How the practice price will be established at that point.
- How quick the payout will be.

• It is recommended to have insurance taken out on all partners so that in case of injury or death, the partner’s remaining buy-in is covered. Check with your insurance agent on how to set up this type of policy. It is a common, well known insurance product.

Remember: an associateship, and certainly a partnership, is akin to a marriage. It is very important that all parties want to work with each other and get along. After all, you will be interacting with this person almost all day, every work day, possibly spending more time with them than your spouse. Therefore all the points that we’ve gone over in this series of articles are vital to confront, workout and implement as part of bringing on a partner, as well as an associate who may become a partner.

Here is a summary of the points we’ve gone over in this 6 part series. (You can find these articles on this blog site as well as the following two other Silkin Management Group blog sites: http://bit.ly/xDn5LR and http://bit.ly/wGRCt4

• Get all partnership agreements put into contractual form
• Work out a sales price based upon equipment and real estate appraisals as well as determining the “blue sky” value of the practice
• Take care to fully pass the management aspects of the practice, and do not sell controlling interest until you are sure the new owner can properly manage the practice.
• Get as much of the buy-in amount financed by a lending institution. Ideally, you want anyone but you to finance the purchase.
• Get in writing how management responsibilities are to be assigned.
• Get profit clearly defined so that there are no disagreements about how much profit there is and who gets how much of it. As part of this, get expenses well defined.
• If you are bringing on an associate to become a future partner, get an agreement on how and when the buy-in will be determined.
• Get in writing how management responsibilities are to be assigned.
• Get agreement on how the partnership will dissolve if it has to.
• Take out partnership insurance.

JACK HENNESSY
Silkin Management Group Consultant

Visit our website at www.silkinmanagementgroup.com and our Facebook page at http://on.fb.me/8JfoVU

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Given that Silkin Management Group clients are all small business owners, primarily private practice owners in the health care field, it behooves them to know applicable employment laws and regulations. Since most Silkin Management Group clients never received any education in practice management, including human resources issues, our consultants are frequently educating and advising clients on these issues. As part of this education yesterday we presented an article concerning vacation requirements which you can access at this Silkin Management Group blog site: http://bit.ly/wxHNqp

Another one of the issues that is important to understand is the federal Family Medical Leave Act (FMLA).Below are the key points that any business owner, whether a Silkin Management Group client or not, needs to know about this law.

• The federal law does not apply to all employers. It only applies to a business with 50 or more employees who live within a 75 mile radius of the business. But most states have similar laws that apply to businesses with less than 50 employees. For example the similar law in Oregon, where Silkin Management Group is located, applies to businesses with 25 or more employees. It is important that you check your state laws for how it works in your state.

• The federal law is relevant only for employees who have been employed by the business for minimally one year and worked at least 1250 hours during the last year. Again, check your state laws for any potential differences in applicability in your area.

• If an employee qualifies under the federal law, they have the right to take up to 12 weeks of unpaid leave if the following circumstances exist:

- Birth of a child
- Adoption of a child
- Placement of a foster child in the employee’s home
- Care of an immediate family member with a serious health condition
- The employee has a serious physical or mental condition that prevents them from working. This does not include things such as a cold, the flu or other minor health issues.
- If an expectant mother’s pregnancy interferes with her ability to do her job duties, she may begin her leave prior to the child’s birth.
- If you offer paid maternity leave for mothers, you must also offer it to fathers.

If the federal law does not apply to you because of the size if your business, it still is vitally important that you check your state laws to determine any potential differences in applicability and the local regulations that are part of the law. You should contact a good employment attorney to determine what regulations you are required to follow and include that information in your general office policy. Silkin Management Group’s 400 plus page Office Policy and Job Description Manual has sample policies that can easily be adapted to any office. If you would like to find out more about this manual, contact us at 800-695-0257.

SCOTT BARNARD
Silkin Management Group Consultant

Visit Silkin Management Group’s website at www.silkinmanagementgroup.com and check out our Facebook page at: http://on.fb.me/8JfoVU

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Yesterday we began a series of articles for our various Silkin Management Group blog sites that cover key points about taking on a partner. You can access Part 1 of this series here: http://bit.ly/wZgLZm

We decided to present this series as many Silkin Management Group clients are beginning to look at how to plan for their retirement and the best use of their practice as a retirement asset. One strategy in such a plan is bringing on a partner who will, at some point, fully buy out the practice. Whether or not you are bringing on a partner for a future full practice sale, or just to help expand the practice, the points brought up in these articles will be of benefit.

The two issues discussed yesterday were a) the importance of having all partnership agreements put into contractual form and b) working out a sales price based upon equipment and real estate appraisals as well as determining the “blue sky” value of the practice.

Today we’ll discuss the importance of planning ahead for your transition out of the practice.

When looking at a transition out of the practice you must look at what type of financial ties you will have, even when you are no longer practicing. Many retired doctors end up carrying a note for a portion of the practice sales price. In such a case you had better retain control over the management of the practice until you are sure that the buyer can adequately run the practice and, not only make your payments, but be able to viably run the entire practice.

If you don’t do this, you run the risk that the buyer might mismanage the practice without you knowing about it with the result of not paying you. Then, to avoid losing your investment, you will be forced to return to the practice and salvage it. That will set back your retirement plans considerably as well as most likely push you into a messy scene.

To this end, there are two things we recommend to Silkin Management Group clients who are looking at such a transition:

• Don’t sell a controlling interest until you are confident the buyer has truly picked up the management hat.

• Do a very thorough pass of your management hat as part of the transition process. Take as much time as needed to accomplish this. It might take 6 months or a year to make sure the buyer is fully on top of running the practice. Remember, it took you years to build the practice through a variety of successful actions. Those actions need to be properly passed.

What this involves is writing up your owner/management job description completely (not simply scratching off some suggestions) and then interning the buyer so that you’re sure they really duplicated what you wrote and that they can apply it.

Part of this will be getting a good idea of what the buyer’s weaknesses are. If you don’t address these you’ll end up pulled back into the practice.

We also highly recommend getting the buyer trained on practice management before you leave. If you are a Silkin Management Group client, see to it that the buyer goes through the same Silkin training you did.

We will continue to present important points for bringing on a partner in future Silkin Management Group blogs.

If you’d like more information about how Silkin Management Group can help you attain a practice that is well positioned for a future sale, give us a call at 800-695-0257. Visit our Facebook page and “like us” at http://on.fb.me/8JfoVU

JACK HENNESSY
Silkin Management Group Consultant

Silkin Management Group

Silkin Management Group clients are primarily private health care practice owners in the dental, veterinary and optometric fields. Quite a few of our clients are partnerships, and many of them come to us because of difficulties in their partnership. They may have disagreements of one kind or another including one partner feeling that he/she does more than the other partner, unjust compensation for the work done, who is the primary manager, how management decisions made, etc.

When these types of issues arise, the consultant at Silkin Management Group is faced with the task of sorting these problems out, one by one. Often at the root of these types of problems is a poorly done partnership agreement that doesn’t confront the specifics of their relationship. Even in such a case we have to tackle it head on and attempt to sort it all out with each partner.

In such a situation Silkin Management Group consultants must make certain things clear to each partner. Legally we must clarify with all involved that in a partnership there is a basic rule on “full disclosure”. Anything one partner tells the consultant about the business and the relationships that has anything to do with anything about the partnership cannot be kept “in confidence” and secret from the other partners UNLESS the consultant gets all of their agreement, in writing, that it is permissible for him to withhold data one of them may give about the business workings, any agreements, decisions, etc. This must be done to legally protect each partner, as well as Silkin Management Group.

We normally recommend that each partner not agree to any hidden information, decisions, considerations or ideas from the other partner. Lack of communication between the two is usually the basic problem and is something we can resolve. In resolving this we first find out the disagreements between each partner and get the disagreements clearly communicated. We then take them up one by one and work out resolutions for each including an agreed upon management structure and decision making process, as well as implementing the proper office policies to make the practice more efficient. In the great, great majority of cases, these actions resolve partnership problems.

If you have a partnership situation, feel free to contact us at 800-695-0257 and we can see if we can help you out.

SCOTT BARNARD
Silkin Management Group Consultant

Visit Silkin Management Group’s website at www.silkinmanagementgroup.com. Check our Silkin Management group’s Facebook page at: http://www.facebook.com/silkinmanagementgroup

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One of the most successful actions that Silkin Management Group consultants advise their clients on is the implementation of a yearly game with BIG rewards for the staff.

Below is an actual game instituted by a Silkin Management Group client with a reward of one week in Hawaii for eligible staff and their spouses. The cost of that week was about $20.000. The game resulted in 20% growth for the year with an additional $200,000 in collections. Do you think paying $20,000 for a $200,000 return on that investment is worthwhile? We sure do! And the great thing is the $20.000 investment didn’t have to be made unless that extra $200,000 happened.

The amount of team spirit, mutual cooperation, and level of staff working together in this office was amazing.

Silkin Management Group consultants suggest to every client to institute some type of game like this. Obviously every office can’t afford sending all staff and spouses to Hawaii for a week, but some form of significant reward can be determined and implemented. Try it and you’ll see your staff coming together like never before.

For additional information about how Silkin Management Group can help your office, give us a call at 800-695-0257 or visit our website at www.silkinmanagementgroup.com

Jack Hennessy
Silkin Management Group Consultant

SAMPLE GAME:

Goals: 1,250,000 – Services
93% – Collections
800 – New patients

All three goals must be met

Reward: 7 days paid vacation
Airfare and hotel costs covered in Hawaii
Per diem food allocation for the week

Rules: 1. Full time staff that have worked all year = reward

2. Part time staff or staff having only worked a portion of the year
will receive a pro-rated award.

3. Reward only given to persons currently on staff at the end of the year.

4. Reward to be given in February. Executive Board will determine when
you are to be gone. (3 shifts)

5. Two days of comp time to be worked prior to going or while others are
gone to accommodate for our being “short staffed”.

6. If not on staff in February, this will not be “paid” time.

7. If additional staff is hired prior to the end of the year, an adjustment of
goals may occur to compensate for higher overhead for the office. This
will be determined by the Executive Board and issued to all staff in
writing as an addendum to the goals and rewards of this game.

LET’S GO FOR IT!!! SEE YOU ON THE BEACH!!!

Silkin Management Group

Over the last several days on this Silkin Management Group blog site we have gone over the importance of having someone in the office responsible for accomplishing the promotional duties needed in a health care office. This job title is known as the Promotional Secretary. Unless the office is very large, this job is usually handled by the Office Manager. In a very large office it is possible to have one person handling this position on a full time basis.

In the last article we covered some of the job duties of a Promotional Secretary. Today we’ll finish off the list. The job duties and specific job descriptions of this position can be found in Silkin Management Group’s 400 plus page Office Policy and Job Description Manual. Additional information on marketing and promotion for a health care office can be found in our Marketing and Promotion Manual, specifically designed for dental, veterinary and optometric offices.

Here is the second half of the list of key job duties of a promotional secretary:

• Ensures that correct mailings are done, on a continual basis, to the various types of patients/clients – new, active and inactive. This would include new patient welcome letters, patient educational series letters, newsletters, reactivation letters, thank-you for referring letters, etc.

• Sets up a professional website that educates prospective patients on the office and makes the office easy to find and interact with.

• Sets up relevant social media sites so the practice is promoted through all social media outlets available.

• Ensures that the website is properly optimized so it ranks high on search engines.

• Sets up lines for the Doctor to form outside alliances. This would include things such as schools and businesses where arrangements could be made to handle their employees.

• Sees to it that there is always an adequate supply of promotional and educational literature to give to patients.

• Keeps track of the statistics from each promotional piece or activity done. Determines which are the most effective in terms of cost, time and energy expenditure and reinforces those that are most cost effective and productive and eliminates those that are not.

• Sees that the Referral Log is kept up to date at all times and used.

• Makes sure that each staff member is trained on how to prospect for new patients outside of the office. Gets any needed business cards and/or coupons used for this activity made.

• Makes sure that each staff member is trained in and reminded of any promotional function that they can do from their job and sees to it that it is done.

• Promote at all times possible. When done with that, promote more!

Scott Barnard
Silkin Management Group Consultant

For more information about Silkin Management Group’s Office Policy and Job Description Manual and/or Silkin’s Marketing manuals, visit our website at www.silkinmanagementgroup.com or give us a call at 800-695-0257.

Silkin Management Group

Clients new to Silkin Management Group almost always want more new patients. This is usually fairly easy to accomplish by implementing the successful marketing and promotion techniques and activities that we have developed in our 30 years of delivering practice management to thousands of clients. But, in order to accomplish this it requires someone in the office taking responsibility for the actions and getting them done. This would be the promotional secretary.

In part 1 of this series of articles about the job duties of a promotional secretary, we went over a) what promotion and marketing is, and b) the necessity of having someone in the office overseeing the promotion and marketing actions required. This article can be found on this Silkin Management Group blog site. Today we will list our some of the duties of that job. These job duties can also be found in Silkin Management Group’s Office Policy and Job Description Manual which all Silkin Management Group clients receive as part of their management program.

Here is the first half of the key job duties of a promotional secretary:

• Sees to it that all staff are trained and know their roles in asking for referrals.

• In liaison with the Doctor and the appropriate staff, works out which patients should be talked to about referrals.

• Gets business cards and/or appropriate coupons made up for handing out to patients as something for them to give to prospective referrals.

• Does all necessary costing and gets financial approval for all promotional actions.

• Creates a promotional calendar covering six months into the future. Each major promotional event (mailers, social media updates, website changes, newsletters, outside lectures, newspaper articles, patient appreciation week, etc.) would go on the calendar.

• Updates the promotional calendar monthly. Keeps it continually full for six months out.

• Sees that a successful reactivation program is implemented and kept in. This would include letters and phone calls to reactivate inactive patients.

• Arranges promotional lectures for the Doctor to give in the community.

• Prepares all forms of advertisements used.

In our next Silkin Management Group blog we will list out the remaining job duties of this position

Jono LoBue
Silkin Management Group Consultant

For more information about Silkin Management Group’s Office Policy and Job Description Manual give us a call at 800-695-0257.
Or go to our website at www.silkinmanagementgroup.com

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