Practice Management

When I enrolled in medical school - what seems like a lifetime ago - I wanted to be akin to the sage and compassionate Marcus Welby, M.D. I wanted to be a pediatrician who takes care of and cures sick children.

At Nova Medical, the largest primary care practice in Loudoun County, Va., "The process of going green is ongoing," says Jennifer Stokols, M.S., a registered dietitian who heads Nova Medical's green team.

Maybe you've been blindsided by a "crisis" in your business office, and only then regretted not spending time to detect the early warning signs.

Clinical photography in dermatology can be an invaluable tool, if used properly. Following some basic guidelines can take the guesswork out, lend credibility and present a much more accurate picture.

Current Procedural Terminology codes were significantly changed in 2007 to clarify previous confusion, and physicians must understand the changes in order to submit the correct billing and, ultimately, to be reimbursed, one expert says.

Over the past 10 to 15 years, there has been a boom in the phenomenon commonly known as "medspas" - an outgrowth of the purely Aesthetic day spa, combining herbal wraps and massages with medical or near-medical therapies, such as microdermabrasion and chemical peels, and progressing into lasers, fillers and Botox treatments.

As with any legal or insurance planning, the early bird is richly rewarded. Nowhere in practice planning is this truer than in the Buy-Sell agreement. The reason is not so much economic, but political. If this planning is done before any owner is close to a disability, divorce, retirement, or death, all owners are in the same position relative to each other. That makes the negotiation of a standard deal for all owners a much easier and smoother process. Planning early for a Buy-Sell agreement will truly benefit you, your family and your practice.

Every dermatology practices could use a good Web site - and one that provides timely, accurate educational information for patients would be a boon. One enterprising practitioner saw the need, and developed a system to meet it.

Nothing can make a day more stressful - and less efficient - than to have a constant stream of interruptions. To get control of your day, start by noting how often you are interrupted.

The appointment schedule is more than a list of upcoming patients. It's what sets the pace of your day - and largely formulates patients' impressions of your dermatology practice.

Dermatologists are in a position to create the gold standard for medical spas, but first they need to master a retail mindset, an expert says.

Starting a successful cosmetic dermatology practice requires a systematic approach to everything from networking and staffing to advertising and office decor.

Analyses based on census data and membership surveys from the American Academy of Dermatology, the American Osteopathic Association, and professional societies for physician assistants and nurse practitioners show inroads are being made to improve workforce

The physician removed a cyst from the patient's right upper back. The cyst measured 5.0 centimeters in diameter, but it was removed through a 0.9 x 3.1 cm/d opening. I billed the excision based on the 5.0 centimeter size. Is that correct? - Looking for an Opening

To offset the trend of falling reimbursement, you can either see more patients or cut costs. Before you try doubling your patient load or handing out pink slips to your entire staff, consider these ideas to trim expenses in your dermatology practice:

A couple of years ago I changed my e-mail address from AOL to Gmail. I am still redirecting people from my AOL address to Gmail, and I am still finding document templates, organizations and directories that have not updated my e-mail address.

Motivating employees and fostering a happy, healthy work environment requires a little extra effort. Let employees know your expectations and let them know they are appreciated for a job well done.

National report -- For dermatologists interested in posting online videos, experts offer these do's and don'ts.

National report - Now that picture-and-text websites are commonplace, dermatology practices that want to stand out are finding that online videos fit the bill, sources say. This may be particularly true for cosmetic-oriented practices, they add.

Simple steps can transform the office visit from one that is forgettable for the dermatologist, patient and staff to one that is unforgettably positive.

From a financial perspective, your time should be spend in billable activities.

A panel of experts offers short tips for making things run smoothly, creating a positive work environmen and generating more revenue. Empowering staff improves efficiency and boosts morale.

A recent survey of physician assistants suggests these staff members must spend on average eight months in dermatology offices prior to seeing patients independently to feel comfortable in this role

When the features of the SIMPLE IRA plan and the traditional 401(k) plan are combined into one plan, there are considerable advantages for both employees and business owners.

The elimination of the Mohs surgery exemption to Medicare's multiple-surgery reduction rule will mean that Mohs surgeons who perform multiple in-office surgeries in one day will earn less for secondary procedures than they cost, sources say.

Medicare coverage does not resume until a patient's total yearly out-of-pocket spending is well over $3,000.

At most dermatology and cosmetic practices, between 2 percent and 10 percent of accounts receivables (A/R) are actually credits.

With the introduction of new Mohs codes and changes in the definitions of the destruction codes for premalignant and benign lesions, lots of questions and concerns are being generated from not only physicians but their billing staffs as well.

National report - While dermatology's visual nature makes it ideal for image-rich electronic applications - from teledermatology to training for residents - few dermatologists have embraced comprehensive systems such as electronic medical records (EMRs), sources say. But they predict this will change with the healthcare industry's growing emphasis on efficiency and accountability.

Although the CPT coding changes affecting dermatology for 2007 were not numerous, they were some of the most significant ever.