Results of an initiative to charge for previously uncompensated care in an academic primary care practice.

Increasing clinical workload with dwindling compensation has challenged primary care medical practices over the past decade. This has led to more physicians leaving and fewer medical trainees entering primary care. In an effort to make primary care practices viable, many groups routinely charge for providing care that was uncompensated in the past. We initiated a program in our practice that charged for certain after-hour and electronic communications, completion of forms outside of office visits, and failure to show for appointments. We assessed the effect on workload, patient adherence to appointments, and financial outcomes. This initiative decreased our physicians' workload, increased physicians' satisfaction, and produced a modest increase in revenues.

Building the office team: what's the payoff?

Bogged down in the everyday mire of a busy medical practice with multiple locations, a management team was faced with issues of cohesiveness, employee morale, and communication. Enter an outside facilitator who, with the executive director and president of the organization, developed a plan for a management retreat and subsequent monthly management meetings. The results were nothing short of astonishing, with a shared vision and goals communicated throughout the organization, communication being consciously expanded to all locations, and palpable physician support of employees.